Africa ending in abortion each year, estimated at 15% in 2010-2014, has changed little since 1990-1994. Nigeria still ranks second globally in the number of maternal deaths. with the largest numbers of maternal deaths are Africa and Asia. Despite a 44% decline in maternal mortality worldwide from 1990 to 2015, South Africa's maternal mortality remains high [1, 2].Notwithstanding the high levels, South Africa has reported a decline in the number of maternal deaths Footnote 1 and institutional Maternal Mortality Ratio (iMMR) since 2009 [].A notable decline in iMMR from a peak of 189 deaths per 100,000 live births in 2009 to 135 . As of 1999, infant and child mortalities per thousand live births were 92 and 156 in Sub-Saharan Africa, respectively, while maternal mortality stood at 844 per 100,000 live births in the region (World Bank, 2002). Maternal mortality was 257/1000 in 1989 268/1000 in 1990 236/1000 in 1991 and 234/1000 in . Prevention of Maternal Mortality in Nigeria: Public Health to the Rescue. Most of these countries are located in sub-Saharan Africa. 1 INTRODUCTION. Research reported in this paper, will, however, focus on the mortality rates, rather than life expectancies. Almost all (99%) of maternal deaths occur in developing countries, and 68% occur in Sub-Saharan Africa alone. that attribute to maternal mortality for African American women can be understood. STATISTICS SOUTH AFRICA viii Maternal Health Indicators: Further Analysis of the 1998 and 2016 South Africa Demographic and Health Surveys, report 03-06-03 Executive summary South Africa has made significant progress with regard to the improvement of maternal health and the reduction of maternal mortality in the last two decades. The Trends in Maternal Mortality 2000-2017 report is a joint effort by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. In terms of the maternal mortality ratio, Nigeria is ranked eighth in Sub-Saharan Africa behind, Angola, Chad, Liberia, Niger, Rwanda, Sierra Leone and Somalia.4 Table 1 below gives an overview of different sources of data on maternal deaths in Nigeria. • The infant mortality rate is the number of infant deaths for every 1,000 live births. Maternal and newborn mortality is a major public health problem, particularly in sub-Saharan Africa (SSA), where the Millennium Development Goals (MDGs) 4, 5 and 6 were not achieved by the end of . Maternal mortality has dramatically increased in the United States since the 1980s by over 150%. Given the rise of maternal mortality within the United States, it is pertinent to track and implement means to reduce maternal mortality rates. Background Maternal mortality remains a public health problem despite several global efforts. maternal deaths worldwide have dropped by 47%. An accurate ratio will only be known when most pregnancies and maternal deaths are recorded. DOI: 10.19080/JGWH.2018.10.555780 Primary Prevention Primary prevention of maternal mortality deals with inhibiting the occurrence of maternal mortality in women of childbearing age whom have been or are exposed to certain Prevention of Maternal Mortality in Nigeria: Public Health to the Rescue. At the close of the last century, Sub-Saharan Africa still had high maternal morbidity and mortality rates, with the goals of safe motherhood eluding many governments. In sub-Saharan Africa, a number of countries have halved their levels of maternal mortality since 1990. maternal deaths globally. The State of Maternal Mortality in South Africa Pinky Lalthapersad-Pillay University of South Africa, Department of Economics P O Box 329, UNISA. Even though maternal mortality was lowest in southern Africa (90-115 vs. 80-1140), percentage of deaths due to HDP was basically high (10-27%). 2.5: Causes of under-5 mortality in the African Region 21 In Bangladesh, maternal mortality is declining. Email: lalthp@unisa.ac.za Maternal mortality is a fundamental public health issue and Millennium Development Goal Five deals with an improvement in maternal health. • Building health communications campaigns with a family -centered, risk- reduction approach. But it is also largely the result of the much higher maternal mortality rates found in lower-income countries. The worldwide maternal mortality ratio was 400 per 100,000 live births in 2005. These health disparities affect These access challenges can result in a number of negative maternal health outcomes including premature birth, low-birth weight, maternal mortality, severe maternal morbidity, and increased risk of postpartum depression. At the current rate of decline, it of dramatic progress, maternal mortality in the United States is once again climbing for women of all races, increasing nearly 27 percent from 2000 to 2014.15 Importantly, the United States is the only developed country for which this is true.16 Like maternal mortality, infant mortality in the United States sharply declined over the 20th century. of reducing maternal deaths by th-quarters from 1995 to 2015.ree Despite the global commitment to reduce the maternal mortality ratio (MMR) by 5.5% each year, the current rate of decline is less than 0.4% per annum [13]. HIV and complications of childbirth are the leading causes of death among reproductive age women around the . In other regions, including Asia and North Africa, even greater headway has been made. In South Africa, there are conflicting reports on the estimates of maternal and neonatal mortality, derived from both direct and indirect estimation techniques. Estimates of maternal mortality ratio (MMR, maternal deaths per 100 000 live births), number of maternal deaths, and lifetime risk, by United Nations Population Division (UNPD) region, 2017 Annex 15. Simona Varrella. Globally, about 830 women die of pregnancy-related death per day, with more than two-third of these cases occurring in Africa. 2018: 10(1): 555780. In sub-Saharan Africa, the combined maternal mortality ratio for severe bleeding, hypertensive diseases, and infections is staggering at almost 500 deaths per 100 000 livebirths, compared with fewer than 300 per 100 000 in south Asia, just over 100 in Latin America and the Caribbean, and four per 100 000 in developed nations. 0003 South Africa. • Despite progress, 57 per cent of all maternal deaths occur on the continent, giving Africa the highest maternal mortality ratio in the world. Estimates of maternal mortality ratio (MMR, maternal deaths per 100 000 live births), number of maternal deaths, and lifetime risk, by United Nations Population Division (UNPD) region, 2017 Annex 15. 1 Many sub-Saharan African countries, including Mozambique, have a maternal death rate of approximately 500 to 1000 per . Measuring and monitoring progress towards Millennium Development Goals (MDG) 4 and 5 required valid and reliable estimates of maternal and child mortality. There are five areas of analysis that necessitate a thorough understanding to better evaluate maternal mortality for African American women in the United States: social determinants of health, adversely affected health, state and federal health care policies and Although Pre-existing maternal disease 59 10.4 56 7.9 61 8.9 maternal mortality reports repeatedly identify the lack or Cardiac disease 28 5 26 3.7 22 3.2 inadequacy of antenatal care as a factor associated with Not classifiable 18 3.2 30 4.2 18 2.6 Total maternal deaths 565 706 684 mortality, the proportion of pregnant women attending an . Maternal mortality declined by 38 per cent between 2000 and 2017 zoom_out_map Maternal mortality refers to deaths due to complications from pregnancy or childbirth. Figure 2: Maternal mortality Maternal Mortality in the U.S. and in NYS • 2015: US ranked 46th in the world in maternal mortality Trends in maternal mortality: 1990- 2015| WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division; maternal mortality rates decreased during the same period (1990-2015). 1 Maternal mortality in sub-Saharan Africa is among the highest in the world. J Gynecol Women's Health. This is partly attributed to the fact that many more babies are born in Asia and Africa than in other regions. Maternal deaths due to non-obstetric causes predominate among women with HIV, and those with advanced disease and least time on antiretroviral therapy (ART) face the highest risk . Adapted from [1,2]. The estimated maternal mortality ratio for South Africa is 135 / 100 000. This study aimed to systematically review the estimates made of maternal and . This trend is worrying and needs urgent attention. much faster, to reach the targets by 2030. highest maternal mortality ratios (MMRs) were all in Africa.1 The average risk of dying from pregnancy-related causes in Africa is about one in 20, compared to one in 2000 in the more developed countries.3 During the past half century there was a marked reduction in maternal mortality rate, especially in developed countries, to such a level 1 . This review was conducted to objectively investigate the prevalence of maternal mortality in Africa Study Design: Cross- Sectional Study The proportion of pregnancies end-ing in abortion ranges from 12% in Western Africa to 24% in Southern Africa; rates in Middle, Eastern and Northern Africa are 13%, 14% and 23%, respectively. The number of home births in the surrounding area during 1988-92 remained stable at about 33% of births. *Maternal Mortality Rate is defined as the number of maternal deaths (while pregnant or within 42 days of the end of the pregnancy) excluding accidents and incidental causes per 100,000 live births. An explanation for this association could be because Botswana and South Africa invested in data for Maternal mortality ration (MMR) - 2008 decision-making approaches in order to investigate causes of Total health expenditure per capital (PP int $ - 2009) maternal deaths and identify possible solutions. prevent new HIV infections, eliminate AIDS-related deaths, and to end preventable maternal mortality. African Americans, Latinos and Native Americans (FIMR). The maternal mortality ratio in Africa will have to be reduced from between 500 and 1 500 to 228 per 100 000 live births for the continent to meet the target of reducing by three quarters, between 1990 and 2015 the maternal mortality ratio. Legal status of abortion Sub-Saharan Africa North Africa South Africa East Africa Latin American-Carribbean Developed countries Annual maternal deaths per 100,000 live births Hemorrhage Abortion Indirect causes Hypertensive disorders Obstructed labor Infection/sepsis Other direct Figure 1. In 2015, in-hospital mortality for deliveries was and maternal mortality and morbidity, but although 66%-92% of WLWH in sub-Saharan Africa report not wanting another child (now or ever), only 20%-43% are using contraception.25 Finally, although the efficacy of ART for preventing sexual26 and vertical HIV transmission27 holds promise for safer repro- J Gynecol Women's Health. Maternal mortality in West Africa 115 rect and indirect obstetric deaths during preg-nancy, delivery, and the first 42 days of the puer-perium (maternal deaths). 6. The disparity in this rate has remained unchanged for six decades. Note Estimates of the true maternal mortality in South Africa vary widely but suggest 200 to 400 / 100 000. 2.3: Causes of neonatal mortality in the African Region 20 Fig. DOI: 10.19080/JGWH.2018.10.555780 Primary Prevention Primary prevention of maternal mortality deals with inhibiting the occurrence of maternal mortality in women of childbearing age whom have been or are exposed to certain FACTS ON MATERNAL MORTALITY IN AFRICA MATERNAL DEATHS ARE PREVENTABLE • Every year globally approximately 536,000 girls and women die from pregnancy-related causes - one girl or woman dies every minute.7 A recent Lancet study, using a revised maternal mortality methodology, estimates this number to be significantly lower - 343,000 in 2008.8 Two-thirds - 201,000 - occurred in Sub-Saharan Africa. had shown progress, although levels of maternal mortality remain unacceptably high in Africa.1 Objectives: This narrative literature review study was conducted for exploring the key social determinants and ways of coping mechanisms, for the reduction of maternal mortality, among African women living inside the African continent. Maternal mortality estimates by cause and world region. indicators such as maternal mortality, child mortality, HIV AIDS rate, health financing, vaccination coverage for under 1year child and others. The national pregnancy-related maternal mortality ratio (number of deaths per 100,000 births) increased from 7.2 deaths per 100,000 births in 1987 to 17.3 in 2013. 2.2: Global distribution, by region, of maternal deaths, world population and live births, 2000 19 Fig. The maternal mortality and child mortality rates are indicative of the health of the population and reflect deeper issues such as an inequitable distribution of the country's The Programme of Action of the International Conference on Population and Development of 1994 and the Fourth World Conference on Women of 1995 were created in an attempt to tackle these issues and drew unprecedented attention to . 2018: 10(1): 555780. in maternal mortality rates across different race and ethnicity groups. Maternal mortality is extremely high in Nigeria, it is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes. The State of Maternal Mortality in South Africa Pinky Lalthapersad-Pillay University of South Africa, Department of Economics P O Box 329, UNISA. Data on life expectancy of females, number of females aged 15-49 years, number of births, were derived from UN projections for the period 1980-85 [15]. There are five areas of analysis that necessitate a thorough understanding to better evaluate maternal mortality for African American women in the United States: social determinants of health, adversely affected health, state and federal health care policies and Worldwide, maternal mortality fell from 342 to 211 maternal deaths per 100,000 live births during the period 2000 to 2017. The maternal mortality ratio is 433 per 100,000 live births, and accounts for 36 per cent of all deaths among women aged between 15 and 49 years old according to the demographic and health survey 2013. Preliminary data from Minnesota Vital Records, 2011-2017, shows African American/black women are 1.5 times more likely and American Between 1990 and 2015, the global maternal mortality ratio (the number of maternal deaths per 100 000 live births) declined by only 2.3% per year between 1990 and 2015. South Sudan recorded in 2017 the highest number of mothers' deaths per 100,000 live . Progress in sub-Saharan Africa, however, has been much slower. Maternal mortality We examined the spatial distribution of maternal mortality in Africa and explored the influence of SDoH on the spatial In the chart here we see global maternal deaths by region. Most maternal death reviews in Nigeria are isolated research based reports from a single health facility. Maternal mortality rates in the United States plummeted over the 20th century; 13 however, non-Hispanic white women experienced a steeper decline in maternal mortality than did African American .
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