Progress since 1990 in cutting maternal mortality has been impressive. Globally, the maternal mortality rate (MMR), fell by 44 per cent over the period.  However, while progress was substantial, it was not sufficient to constitute achievement of the MDG 5 target of a three-quarters decline.

In 2015, it is estimated that about 800 girls and women died every day as a result of pregnancy and child birth-related complications. Maternal deaths are now increasingly concentrated in sub-Saharan Africa, where high fertility rates combine with inadequate access to quality antenatal care and skilled attendance at birth to substantially elevate the risk of death in this region.

Antenatal care and skilled health attendance at delivery are essential for eliminating every preventable maternal death. The world, as a whole, has improved access to these services, with 71 per cent of women delivering with the support of a skilled birth attendant in 2014, compared to 59 per cent in 1990, progress has not been fast enough. What is more, very substantial disparities exist in levels of access to services, with poorer, less educated women receiving unacceptably low levels of access to services. Women in the richest quintile are almost three times as likely to deliver with a skilled health attendant as those in the poorest quintile. This disparity has not changed in 15 years. Little progress has been made in closing the gap in antenatal care between urban and rural women.

Neonatal Mortality

While the world has achieved impressive reductions in mortality of children aged under five since 1990, the survival of newborns (young infants in the first month of life) has lagged behind. It is estimated that in 2015, about 1 million newborns  died, equivalent to 2,740 per day A child born in 2015 was approximately 500 times more likely to die on the first day of life that at one month of age. The high burden of still births is also an increasingly recognized problem, with 2.6 million estimated still births in 2015.

A significant proportion of maternal, newborn and under five deaths are in zones of conflict and displacement (probably between 10 and 20% but difficult to estimate exactly due to lack of data). UNICEF’s health strategy also aims at building resilient and prepared health systems and to provide service delivery in crisis context.” As the world begins work on the SDG agenda, it will be essential to bring about significant improvements in levels of coverage, and quality of care provided before, during and after birth, if we are to achieve the goal of ending preventable maternal, newborn and child deaths.

Maternal and neonatal tetanus (MNT) is a swift and painful killer disease that killed 34,000 newborns in 2015 alone. A significant number of women also die to due to maternal tetanus every year.

Maternal and neonatal tetanus represents a very high proportion of the total tetanus disease burden due mainly to inadequate immunization services, limited or absent clean delivery services and improper post-partum cord care. The majority of mothers and newborns dying of tetanus live in Africa and Southern and East Asia, generally in areas where women are poor, have little access to health care, and have little information about safe delivery practices.

Once the disease is contracted, the fatality rate can be as high as 100% without hospital care and between 10% to 60% with hospital care. The true extent of the tetanus death toll is not known as many newborns and mothers die at home and neither the birth nor the death is reported.

Maternal and neonatal tetanus (MNT) is easily preventable through:

  • immunization of women with TT vaccine for protection against Tetanus – a child born to a woman protected against tetanus is also protected from the disease in the first few months of its life
  • hygienic birth practices to ensure infection is not contracted by mother or newborn during the birth process
  • proper cord care to ensure that contamination of cord does not put the newborn at risk
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