The Sunday News
MEDICAL conditions such as diabetes, malaria, HIV and obesity were the leading causes of maternal mortality in 2013 accounting for 28 percent of the deaths.
A report by the World Health Organisation reveals that 60 000 women died worldwide in 2013 because of these conditions which are worsened by pregnancy.
In 2013 the global maternal mortality ratio was 210 deaths per 100 000 live births, down from 380 deaths per 100 000 live births, a 45 percent reduction. In 1990 about 523 000 women died and the number declined to 289 000 in 2013.
Severe bleeding which occurs mostly during and after child birth accounted for 27 percent of the deaths, pregnancy induced high blood pressure had 14 percent while infections accounted for 11 percent.
Other causes were obstructed labour and other direct causes, nine percent and abortions complications and blood clots led to a combined 11 percent of the deaths.
WHO and its partners have called for a more focused approach on non communicable diseases.
“The new data shows a changing profile in the conditions that cause maternal deaths, reflecting the increasing burden of non communicable diseases in women throughout the world. Ending preventable maternal deaths will require both continued efforts to reduce complications directly related to pregnancy, and more of a focus on non communicable diseases and their effect in pregnancy,” said Dr Marleen Temmerman, a director in Reproductive Health and Research, WHO.
She said integrated care for women with conditions such as diabetes and obesity would reduce deaths and prevent long lasting health problems.
According to the report, while levels of antenatal care have increased in many parts of the world during the past decade, only 46 percent of women in low-income countries benefit from skilled care during childbirth.
This means that millions of births are not assisted by a midwife, a doctor or a trained nurse.
“In low income countries just over a third of all pregnant women have the recommended four antenatal care visits and because of various reasons. Some of the factors that prevent women from receiving or seeking care during pregnancy and childbirth are poverty, distance, lack of information, inadequate services and cultural practices,” read the report.
It has also been revealed that the major challenge in addressing maternal deaths is the lack of accurate data.
“In many low-income countries, maternal deaths go uncounted and frequently the cause of death is unknown or not recorded correctly, particularly when women die at home and only one-third of all deaths worldwide are recorded,” read the report.
With the current trends there is a higher probability that most countries will not achieve the MDG target of a 75 percent reduction in MMR from 1990 to 2015 as an average decline of 5,5 percent or more every year is needed to meet the target on time.
According to the report 33 women die every hour while giving birth as a result of complications that arise before and during birth.
“Thirty-three maternal deaths per hour is 33 too many. We need to document every one of these tragic events, determine their cause, and initiate corrective actions urgently,” said Tim Evans, director, Health, Nutrition and Population, World Bank Group.
The report reveals that many countries especially those with low and medium income will not achieve the millennium development goal of reducing maternal mortality by 75 percent compared to the figures of 1990.
Sub-Saharan Africa is still the riskiest region in the world for dying of complications in pregnancy and childbirth.
“A 15-year-old girl living in sub-Saharan Africa faces about one in 40 risk of dying during pregnancy and childbirth during her lifetime. However, a girl of the same age living in Europe has a lifetime risk of one in 3 300 – underscoring how uneven progress has been around the world,” said Dr Geeta Rao Gupta, deputy executive director, and United Nations Children’s Fund.
Despite advances in the last 20 years in fighting maternal mortality, according to WHO there has been too little progress in preventing adolescent pregnancies, abortions, maternal deaths, sexually-transmitted infections and HIV as well as significant gaps in availability, quality and access to comprehensive sexuality education and services for young people, especially in low-income countries.
According to Zimbabwe Demographic Health Survey (ZDHS) 2012, Zimbabwe’s highest maternal death rate was 960 per 100 000 live births.
Health and Child Care Minister Dr David Parirenyatwa is on record saying that there was a need to scale up evidence-based, high impact maternal and health interventions which address the causes or the MDG would never be achieved.
