eliminating preventable maternal and neonatal mortality
TRANSCRIPT
Eliminating Preventable Maternal and Neonatal Mortality &
Improving Mother and Child Health
Dr. sridhar.DAssistant Professor
Community MedicineKamineni Academy of Medical Sciences and Research Centre
Maternal mortality “Women are not dying because of diseases we cannot treat. They are dying because societies have yet to make the decision that their lives are worth saving ……………”
Prof. Mahmoud Fathalla Past President, FIGO
Every 5 Minute...
Maternal Death Clock
1 woman dies from a pregnancy-related complication
In India
UNICEF
Problem statement• Globally, 289,000 maternal deaths occurred in 2013, 47 % 1990.
• SubSaharan Africa (62 %) & Southern Asia (24 %)= 86 % (249,000 maternal deaths 2013.
• India at 17 % (50,000) and Nigeria at 14 %(40,000). • The global MMR in 2013 was 210 maternal deaths per lac live births.• The MMR in developing regions (240) was 15 times higher than in
developed regions .• Hieghest - Sub-Saharan Africa -510 per lac live births,• Lowest- Eastern Asia 33 per lac live births
• Under MDG 5, countries committed to reducing maternal mortality by 3 quarters between 1990 and 2015. Since 1990, the number of maternal deaths worldwide has dropped by 43%
Annual Rates of Reduction (1990–2013)
• 2013- 178 per lac live births• 2007-09 212 per lac live births• Kerala , Maharastra, Tamil nadu < 100/Lac live
births• EAG states – Bihar, Jharkhand, Madya Pradesh,
Chattisgarh, Uttar pradesh, Orissa, Rajasthan,Assam, Uttaranchal
Causes of maternal mortality
• Indirect Causes: Aneamia, Malaria, Heart disease• Other direct causes: ectopic pregnancy,
embolism, Anesthesia related
20%
8%
25%
15%
12%
8%
13%
Indirect causes
Other direct causes
Severe bleeding
Infections
Eclamspsia
Obstructed labour
Unsafe abortion
34%
8%5%5%11%
38%Other conditionsabortionObstructed LabourHypertensive disorderSepsisHaemorrhage
Maternal deaths timing
50-70% during post partum periodFirt 24 hrs- more than 2/3 rd With in week- 45%During child birth 11-17%
Neonatal mortality
Deaths at birth and ending 28 completed days after birth per 1000 live births.
• 2.8 million die before 4wks
• half die before 24Hrs• 98% daths in developing countries.• 44% contribute total under 5 daeths
• 31% in Sub Saharan Africa and South East Asia.• Lifetime risk for a woman to lose new born
baby 1 in 5 Africa 1 in 125 developed countries
Indian Scenario
• Early neonatal mortality 23/1000 live births
• 25/1000 in rural 12/1000 in urban
Distribution of under-five deaths by age-groups
Source:Calculated based on data from the UNICEF/WHO/The World Bank/UN Pop Div. Levels and Trends in Child Mortality Report 2014
Causes of neonatal deaths
24%
15%
5%35%
1%2%
8% 10%
Intra partum re-lated complica-tions
Sepsis
Pneumonia
Preterm birth complications
Diarrheoa
Tetanus
Other
Congenital abnormalitis
2% 9%3%
20%
35%
15%
16%
DiarrheoaMalformationsOtherBirth AsphyxiaPretermSepsisPneumonia
Causes of neonatal deaths 2013 Globally
causes of neonatal deaths 2013 in India
distribution of causes of neonatal and under-five deaths, 2013
Source: CHERG/WHO/UNICEF for distribution of causes of neonatal and under-five deaths (published in Liu et al, Lancet 2014).
Vision for Improved Maternal and Feotal Health and Survival