Maternal Health
Millennium Development Goal 5
Millennium Development Goal 5 aims to improve maternal health by reducing maternal deaths, and improving access to healthcare for pregnancy and family planning.
- Target 5A : is to reduce the maternal mortality ratio by three quarters
- Target 5B : is to achieve universal access to reproductive health e.g. more women receiving antenatal care, fewer teenagers having children, contraceptive use increased,
Maternal health
Maternal health is the foundation for child health, giving babies a good start, and building family health, for which mothers take a leading role.
ISSUES
- Limited access to healthcare in pregnancy and childbirth leads to maternal deaths that are largely preventable
- Effective, relatively low cost interventions are available, relevant to different resource settings across the care pathway for maternal health.
But
- Less than half of all pregnant women in
- the world have the four antenatal visits recommended by the World Health Organisation,
- Africa and South East Asia are attended by a skilled healthcare worker during childbirth.
- Maternity care is least available to
- the poorest women
- women in rural areas
- women with the least education.
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Reducing complications and deaths
Most complications and deaths are preventable.
Facts
- Up to 15% of all births are complicated by a potentially fatal condition, with haemorrhage and hypertension accounting for more than half of maternal deaths.
- Indirect causes account for another fifth of maternal deaths, including malaria, HIV/AIDS, and cardiac disease.
- For every woman who dies, at least twenty others suffer illness, injury or disability.
- In 2008, 358,000 women were estimated to have died relating to pregnancy and childbirth, with 87% of maternal deaths in sub-Saharan Africa and South Asia.
- Women face a lifetime risk of dying from causes related to pregnancy and childbirth of 1 in 31 in sub-Saharan Africa and 1 in 120 in South Asia.
- Trends in maternal deaths show variable progress between 1990 and 2008, with 90 countries improving, while 2 countries showed no progress, and 23 worsened.
PRIORITIES
- Family planning, safe abortion services (where legal), and community-based services.
- Good antenatal and postnatal care.
- Skilled birth attendance by a midwife, or someone with midwifery skills, to recognise, manage and stabilise complications,
- Access to emergency obstetric care and skilled healthcare attendants for childbirth.
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GUIDANCE
Key effective interventions have been grouped as care packages, forming a continuum through pre-pregnancy, pregnancy, childbirth, postpartum, newborn care and care of the child, appropriate to different facility levels.
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Partnership for Maternal, Newborn and Child Health knowledge portal - provides guidance on policy and practice and includes country reports on systems and strategies, effective interventions, essential commodities, human resources, economics, financing, accountability and tracking.
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WHO recommended interventions for improving maternal and newborn health - this has tables listing key actions for health services, families and communities for maternal and newborn healthcare programmes.
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WHO Making Pregnancy Safer publications - WHO guidance on pregnancy care, midwifery, managing complications and emergencies, and managing and monitoring maternity services.
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WHO Reproductive Health Library - provides evidence reviews on specific aspects of care for pregnancy and childbirth.
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Obstetrics, Gynaecology and Reproductive Medicine Guidelines - Geneva Foundation for Medical Education and Research is a resource of international and national guidelines, reviews, position statements recommendations and standards for women's health
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United Nations Population Fund Safe Motherhood - gives an overview of key themes for safe motherhood (contraception, skilled birth attendants and midwives, emergency obstetric care, obstetric fistula, maternal morbidity, and pregnancy in crisis situations).
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WHO Priority Medicines for Mothers and Children. Indications and administration of essential medicines for reducing deaths and illness in mothers and children under 5 years.
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Unintended pregnancy
Providing modern family planning, post-abortion care, and abortion (within national legal frameworks) are key to improve maternal and child health.
Facts
- Modern family planning methods are estimated to have the potential to save 150 million maternal deaths a year by reducing adolescent pregnancy, birth spacing and limiting family size.
- Unmet need is high and globally 215 million women who want to delay or avoid pregnancy are not using an effective method of family planning.
- There are estimated to be 75 million unintended pregnancies each year and 22 million unsafe abortions.
- An estimated 47,000 women died in 2008 from unsafe abortion and others suffered serious health effects.
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Women and Health
Development and reproductive health programmes can be more effective by seeking to address women's status, education and empowerment within their cultural context.
Addressing inequality in the roles and social position of women is part of improving maternal health, linked to other Millennium Development Goals for gender equality and reducing poverty.
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