A STUDY OF maternal and child health in developing countries gives an insight into the challenges faced by women and babies.

The Lancet study: Countdown to 2015 and beyond, looks at the health agenda for women and children.

The end of 2015 will signal the end of the Millenium Development Goal era, so Countdown to 2015 has focused its 2014 report on how much has been achieved in intervention coverage for mothers, infants and children.

Progress being made

It says that progress has accelerated over the past decade in most of the 189 countries it looked at, but some of the biggest gaps are in family planning, interventions for newborn mortality, and case management of childhood diseases.

Here’s some of what they found in the Countdown countries:

• Progress in reduction of mortality and undernutrition is accelerating – but not quickly enough.
• Child mortality has decreased substantially since 1990
• About 18,000 children are dying every day, mostly in disadvantaged population groups
• The main causes of post-neonatal child deaths are preventable infectious diseases such as pneumonia, diarrhoea and malaria.
• There has been an increase in the percentage of child deaths occurring in the first four weeks of life.
• Newborn deaths account for a median of 39 per cent of all under-five deaths
• Neonatal deaths and stillbirths can be significantly reduced by increased investment in quality care around the time of birth.
• Africa is the region with the highest mortality and (with a few exceptions) the slowest rates of reduction
• Unsafe abortion exacts a high toll of avoidable maternal deaths, which could be averted through programmes and policies that support women’s access to affordable and high quality family planning, and antenatal, delivery, and postnatal care.

Nutrition

The research also looked at undernutrition, and found that in the Countdown countries:

• Nearly half of all deaths to children under five are due to undernutrition – that’s three million deaths each year.
• Stunting is a big indicator of the quality of a child’s life.
• In 42 of the 62 countries with available data, 30 per cent or more children are stunted.
• To target this, nutrition-specific interventions for women and children are needed, as well as efforts to combat food insecurity and women’s low social status, and improving access to safe water and sanitation facilities.

Countries with higher levels of intervention coverage tend to have lower levels of child mortality, and vice versa.

According to the study, adoption rates are high for some policies such as oral rehydration salts and zinc for management of diarrhoea, postnatal home visits in the first week of life, and specific notification of maternal deaths.

But “crucial gaps remain”. Fewer than half of Countdown countries have adopted policies in the areas of:

• Access to contraception for adolescents
• Maternity protection in accordance with Convention 183,25
• Regulation of the marketing of breastmilk substitutes.

Many of the countries face severe health workforce shortages, which also impacts on the care available to women and babies.

There are also “massive inequalities” in intervention coverage and health outcomes, and the report says unless these are improved, progress is likely to be curtailed.

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