Maternal
health, which refers to the health of women during pregnancy, childbirth, and
the postpartum period, according to
WHO Africa, faces a troubling trend worldwide.
Seven
in 10 of maternal deaths occur in sub-Saharan Africa. An estimated 287,000
women globally lost their lives due to maternal causes, according to a report by the
World Health Organization (WHO). The majority of these deaths, a
staggering 70%,
occur in sub-Saharan Africa. The major causes of these preventable deaths
include pre-existing medical conditions that worsen during pregnancy, high
blood pressure, unsafe abortions, excessive bleeding, obstructed labor, and
infections.
A
troubling trend in maternal health worldwide, according to WHO, is the
death of a woman in childbirth or pregnancy roughly every two
minutes. The UN agency warns that without significant
progress towards Sustainable Development Goals (SDGs) global
goals for reducing maternal mortality rates, over a million more women
could tragically lose their lives by 2030
"Despite
global advancements, Africa continues to have disproportionately high maternal
mortality rates. While the global average is 152 deaths per 100,000 live
births, some African nations, including Chad, Nigeria, and South Sudan, report
rates exceeding 1,000 per 100,000 live births," said Professor
Samba Sow, former Minister of Health for Mali and currently Director General of
the Center for Vaccine Development (CVD).
Sow
said newborn deaths also remain alarmingly high in Africa.
In
2022, sub-Saharan Africa accounted for 57% of global under-5 deaths despite
representing only 30% of global live births, reports
WHO. The region also had the highest neonatal mortality rate in the world, with
27 deaths per 1,000 live births. This means that a newborn in sub-Saharan
Africa is 11 times more likely to die within the first month of life compared
to a newborn in the safest regions, such as Australia and New Zealand.
"When
a mother dies in childbirth, the chance of her baby living to see their first
birthday drops to 37%," said Professor Sow. "We must address
this issue urgently to accelerate progress toward the SDGs."
More Than Just a Funding Issue
Beyond
funding limitations, several significant challenges hinder progress across
Africa in maternal, newborn, and child health (MNCH) care.
"While
it is true that MNCH and family planning products receive significantly less
funding compared to other health areas, despite a greater burden of disease -
about 3-5 times more - the challenges extend beyond just financial
constraints," he said.
"We
don't see coordinated product procurement through a defined global
facility," said Professor Sow. "This lack of coordination results in
stockouts, higher prices, and limited access to essential supplies, severely
impacting the availability of life-saving resources."
"In
many of our countries, we also deal with multiple and overlapping crises,
including challenging economic situations with very little room for
maneuver," he added.
"To
accelerate progress toward achieving the 2030 Sustainable Development Goals for
neonatal and maternal mortality rates, our governments need to make investments
that will bring outsized benefits to society and the economy. This means
investing in primary healthcare systems, a fit-for-purpose health workforce,
and innovative products that help us meet more women's needs, bring care closer
to home, and save the lives of women and babies," said Professor Sow.
Building Resilient Healthcare Systems and Improving
Outcomes in Mali
Global
trends in maternal, neonatal, and child health (MNCH) have shown
significant improvement, with a notable 34% decrease in maternal mortality
between 2000 and 2020. However, this has been set back by the pandemic which
affected progress, especially among low-and middle-income countries (LMICs),
where almost 95% of all maternal deaths occurred in 2020.
Professor
Sow said that targeted investments in MNCH play a crucial role in building a
resilient healthcare system capable of sustaining long-term health improvements
for mothers and newborns.
"In
Mali, efforts
to expand healthcare facilities and deploy mobile health units have brought
critical services closer to those in need," said Professor Sow. "This
has significantly reduced the distance and time required to receive care."
"We've
also seen significant improvements in maternal and neonatal outcomes through
the training of
midwives and community health workers. These trained professionals can handle
complications during childbirth and provide essential neonatal care, leading to
better survival rates," he said. "Midwives are the lynchpin of our
efforts. They can provide 90% of women's healthcare, and well-trained midwives
working in a fully functional environment could help prevent two-thirds of all
maternal and newborn deaths."
Professor
Sow said that educating communities about the importance of MNCH services and
encouraging their use can also lead to better health outcomes, adding that in Mali,
community health programs involving local leaders and using culturally
sensitive approaches increased the acceptance and utilization of maternal and
neonatal healthcare services.
Investing in Women's Health Boosts Economies
The McKinsey
Health Institute, in collaboration with the World
Economic Forum Centre for Health and Healthcare, unveiled groundbreaking
research at Davos on the health and economic benefits of investing in women's
health. The report,
titled "Closing the Women's Health Gap: A $1 Trillion Opportunity to
Improve Lives and Economies," reveals that women spend 25% more time in
poor health compared to men. The report found that addressing the women's
health gap could add years to life and life to years - and potentially boost
the global economy by $1 trillion annually by 2040. The report estimates
that women could gain an average of seven additional healthy days per year,
translating to over 500 days throughout a woman's lifetime.
"Healthy
women are more likely to participate in the workforce," said Professor
Sow. "This increased participation boosts productivity and drives economic
growth."
"Why
is this important at this precise moment?" he asks.
"Our
economies are facing numerous challenges, and we simply can't afford to lose
women and children to poor health. This is a critical investment that will
bring significant long-term dividends, with ripple effects that benefit all of
us."
Dr.
Rasa Izadnegahdar, who leads the Maternal, Newborn, Child Nutrition, and Health
portfolio within the Gender Equality Division at the Gates Foundation, said
that leveraging innovative technologies and low-cost solutions holds immense
potential for enhancing MNCH care, especially in remote regions. He says,
"Nearly 80% of the maternal and neonatal burden is concentrated in 30
countries in Sub-Saharan Africa and South Asia. Too often, where you live and
the quality of care you receive determines whether life begins or ends at
childbirth."
"Investments
in innovations
ranging from cutting-edge technologies to low-cost, high-impact solutions –
tools like AI-enabled
portable ultrasound, IV iron, multiple micronutrient supplements, and more
– are propelling advancements in maternal and child health and can help bridge
the current gap," says Dr. Izadnegahdar.
A $4 Life-Saving Package
A
landmark study published by researchers from the World Health
Organization (WHO) and the University of Birmingham identified a potentially
game-changing solution known as E-MOTIVE. This new approach could significantly reduce
deaths from childbirth-related bleeding.
The four-country
trial involved over 200,000 women and demonstrated a 60% reduction in severe
bleeding after childbirth through a simple bundle of WHO-recommended
medications costing only $4 per woman.
"There
are 4-5 products, such as oxytocin, misoprostol, tranexamic acid, heat-stable
carbetocin, and a calibrated drape, that a recent clinical trial involving over
200,000
women in Kenya, Nigeria, South Africa, and Tanzania showed a 60% reduction
in heavy bleeding. These affordable products, costing around $4 for the full
package, are recommended by the WHO, included in almost all countries'
essential medicines lists, and are well-known by providers," Dr.
Izadnegahdar said.
"Solutions
like the simple and affordable tool called a 'calibrated obstetric drape,' used
to address postpartum hemorrhage (PPH), are game-changers. This drape, together
with the WHO-recommended treatment bundle, allows trained birth attendants to monitor
and measure blood loss in real-time, helping them quickly identify PPH and
potentially save lives," said Dr. Izadnegahdar.
"Our
analysis has shown that these interventions that tackle maternal mortality and
neonatal mortality have the potential to avert about 1.9 million cumulative
deaths in low- and middle-income countries by 2030, especially when offered in
bundles," he said.
Future goals
"We
must invest in strong primary healthcare systems and tap into new
constituencies and partnerships to maximize impact. Investments in primary
healthcare systems and a trained, resourced healthcare workforce, including
midwives, enhance the health system's efficiency and improve health
equity," Dr. Izadnegahdar said. "We also need policymakers, the
private sector, and philanthropists to partner together to fund existing
women's health products and push new products into pipelines."
"If
we invest in a robust health workforce, mobilize new funding for maternal care,
and scale the use of proven tools, we can save the lives of 1,000 mothers every
day - meaning two million lives saved by the end of the decade. That's two
million women who will go on to raise stronger families - families spared
unimaginable heartbreak. Two million more women who will contribute to the
economy, shape their communities, and enrich our world," concludes Dr.
Izadnegahdar.
Professor
Sow concluded, "When women and girls have access to the healthcare and
nutrition they need to remain healthy, the freedom to make reproductive
choices, and the opportunity to pursue their ambitions, we unlock a cycle of
prosperity that benefits everyone."
Source: allafrica.com
Written by: By Melody Chironda