Over 500,000 Women Die Annually From Preventable Pregnancy-Related Causes, WHO

Approximately 530,000 women worldwide die annually from preventable pregnancy- and childbirth-related causes, according to a... World Health Organization report released on Thursday for World Health Day, AFP/Yahoo! News reports. The report, titled "World Health Report 2005: Make Every Mother and Child Count," condemns the maternal deaths and criticizes the fact that seven million infants die annually worldwide within four weeks after birth, mainly from preventable causes. According to the report, a lack of medical care in developing countries contributes to the deaths of women of childbearing age and children. Fewer than two-thirds of women in developing countries -- and less than one-third of women in the world's poorest countries -- give birth with the aid of qualified assistance, the report says (AFP/Yahoo! News, 4/6). Worldwide, one woman every minute dies in pregnancy or childbirth, and 20 children under age five die each minute, for a total of 11 million deaths annually, according to the report. The primary causes of death for children under age five include pneumonia, diarrhea, malaria, measles, HIV/AIDS and neonatal ailments, according to the report (BBC News, 4/7). As part of the U.N. Millennium Development Goals, countries have pledged to reduce maternal mortality by 75% and child mortality by 67% by 2015, Xinhuanet reports. However, the WHO report shows that current trends mean some areas will not achieve the goals for 150 years, senior WHO official Denis Aitken said, adding, "We must not let that happen" (Xinhuanet, 4/7).

Report Details
The report also found the following:

Of the 211 million annual pregnancies in the world, about 46 million end in abortion, with 40% of these occurring in unsafe conditions and resulting in about 68,000 deaths;

Pregnancy and childbirth are the main causes of death, disease and disability among women of childbearing age in developing countries. About one in 16 pregnant women and new mothers die in Africa, compared with one in 2,800 in developed nations (Manning, USA Today, 4/6);

About 43% of new mothers and infants receive medical care;

Approximately 2.2 million HIV-positive women give birth each year;

19 of the 20 countries with the highest maternal mortality ratios are located in sub-Saharan Africa; and

More than 50% of all child deaths occur in six countries: China, the Democratic Republic of Congo, Ethiopia, India, Nigeria and Pakistan (Nebehay, Reuters, 4/6).

Conditions
Progress in improving maternal and infant mortality has "stalled or even reversed" in many areas, especially in countries with severe poverty, widespread HIV/AIDS epidemics, war and natural disasters, according to Ian Smith, an adviser to the WHO director general, USA Today reports. "There are no health workers, no infrastructures, and mothers and children are simply excluded from care," he said (USA Today, 4/6). A lack of access to perinatal health care is a "key feature of inequality" in many areas, and the health of women and children "is at the core of the struggle against poverty and inequality, as a matter of human rights," the report says, according to a WHO release. Many of the most resource-poor settings have a "massive deprivation" in which an "overwhelming majority" of the population is excluded from basic health services needed for survival, according to the release. In addition, women often suffer discrimination, abuse, neglect and poor treatment in health care settings in some areas, the report says, adding, "The care that women are offered may be untimely, ineffective, unresponsive or discriminatory."

Recommendations
In order to reduce and prevent child and maternal deaths, the report recommends providing a "continuum of care" approach from pregnancy through childbirth and into childhood, according to the release. However, this would require a "massive investment" in health care systems, including a need for more midwives, nurses and physicians, according to the release (WHO release, 4/7). In the 75 countries with the highest mortality rates, fulfilling this need would require an additional 300,000 midwives and 100,000 health care workers, according to Smith (USA Today, 4/6). Many child deaths are preventable through "simple, affordable and effective" interventions, including breastfeeding, the administration of antibiotics, antimalarial drugs, immunizations and vitamin A; and the provision of insecticide-treated nets and skilled care during childbirth (WHO release, 4/7). According to Marie-Paule Kieny, director of WHO's Initiative for Vaccine Research, the number of infant deaths could be "substantially" reduced if newborns were washed, warmed and fed within an hour of being born, AFP/Yahoo! News reports (AFP/Yahoo! News, 4/6).

Costs, Next Steps
WHO said that the 75 most-affected countries need a $9 billion investment annually for the next 10 years in order to achieve the U.N. Millennium Development Goals (BBC News, 4/7). Currently, total health spending in the 75 countries is about $97 billion annually (Reuters, 4/6). Of the more than $90 billion additional spending required over the next decade, about $39 billion would be directed toward maternal and newborn care and $52 billion would go toward child health care (USA Today, 4/6). The report says that increasing the number of health professionals needed to provide widespread access to services is the "first and most pressing task," according to the release. "Making up for the huge shortages and imbalances in the distribution of health workers in many countries will remain a major challenge for years to come," the report says. Currently, WHO is evaluating the need for a "massive scale-up" of health professionals in all areas of care over the next 10 years, according to the release. WHO also will develop policy actions and encourage governments to propose the recommended interventions for maternal and child care, which WHO will continue to monitor and evaluate (WHO release, 4/7). "We know what to do. We know how much it will cost," Smith said, adding, "Now it just requires building a political consensus around doing it quickly" (USA Today, 4/6).















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