The Global and Local Factors Influencing Maternal Mortality Ratios: Barriers and Recommendations for Success

Abstract

__________________________________________________________________Maternal death is defined as the death of a female of reproductive age during pregnancy, labor or within 42 days of termination of pregnancy from causes that are related to or aggravated by pregnancy and relevant care. Maternal deaths are measured by maternal mortality ratios per country and are reported as the number of maternal deaths per 100,000 live births. Each year an estimated 500,000 women die worldwide from complications due to pregnancy or labor and about half of these women live in Sub-Saharan Africa. The rationale for conducting this study is to address the prevalent and preventable issue, maternal death and to assess barriers to the achievement of the 5 th Millennium Development Goal. Purpose: To explore maternal mortality worldwide and in Sub-Saharan Africa, to analyze health risk factors, social/environmental factors, tracking techniques, intervention techniques and policy factors both worldwide and in Sub-Saharan Africa and make recommendations for Sub-Saharan Africa aimed at reducing maternal mortality rates and achieving the 5 th Millennium Development Goal. Methods:The design is a comparative literature review and policy analysis. Variables were chosen based on their relation to the outcome, maternal health. Studies reviewed came from peer-reviewed journals found in Arcadia University's Landman Library. Key words and phrases were used to identify relevant articles. Relevant data was extracted from articles such as demographic information, sample size, intervention being tested or chronic condition being observed and impact on the outcome, maternal health. Recommendations were then made for improving the likelihood of success for the Millennium Development Goal 5. Policy Analysis: An assessment of policies implemented in Sub-Saharan Africa indicated that previous declarations and initiatives have failed within the last 40 years due to lack of funding and enforcement, resource scarcity, lack of government involvement and corruption. A lack of resources has created barriers to access for all of the population, in particular women who face gender inequality and discrimination. Lack of resources, enforcement and funding increase the disease burden and decrease access to care in Sub-Saharan Africa. A lack of education and gender inequality adds additional barriers for women and girls that ultimately influences maternal mortality rates in these countries. Recommendations: Using the Africa Health Strategy: 2007-2015 as a model, policy reform is necessary with elements of female empowerment through education and access to health care including control over social aspects of their lives such as marriage, family planning and cultural rituals such as female genital mutilation. The policy must be comprehensive and have a strong regulation and accountability system so that when decisions are made in the government, they are enforced at the community level. Lastly, communication is vital to policy reform; the system must have effectiv...

Peningkatan Keterampilan Kader dalam Deteksi Dini Risiko Tinggi Kehamilan (Kaderink)

“…Angka Kematian Ibu (AKI) adalah jumlah kematian ibu selama masa kehamilan, persalinan dan nifas yang disebabkan oleh kehamilan, persalinan, dan nifas atau pengelolaannya tetapi bukan karena sebab-sebab lain seperti kecelakaan atau terjatuh di setiap 100.000 kelahiran (DiOrio & Crivelli-Kovach, 2014). Menurut World Health Organization (WHO, angka kematian ibu diartikan sebagai maternal death atau kematian ibu yang merupakan kematian yang terjadi saat kehamilan atau selama 42 hari sejak terminasi kehamilan tersebut, tetapi bukan disebabkan oleh kecelakaan atau kebetulan (World Health organization, 2019).…”

Factors Affecting Health Seeking Behavior among Pregnant Women in rural Areas

“…There was significant relationship between total score level of HSB and the following reproductive history; number of previous pregnancies, number of previous delivery, number of living children, birth order, experience of complication during previous puerperium, the mode of previous delivery, attendance of ANC follow-up during the current pregnancy, the number of ANC follow-up visits during the current pregnancy, the first ANC visit during current pregnancy, cause of first ANC visits during current pregnancy, place of ANC, sequence of follow-up visits and supportive person during ANC visit. Table (5) shows the total score of HSB among the studied pregnant women in relation to health service characteristics. There was significant relationship between total score level of HSB and the following health service characteristics; accessibility to the health care facilities, satisfied with the availability of screening for risk factors during current pregnancy, satisfied with the attitude of health care providers, affordability of medical care cost during current pregnancy and satisfied with the services provided.…”

“…So, Egypt was close to achieving the targets in the Millennium Development Goals five (MDG 5). (4,5) Three well-known factors or delays increase the risk for maternal mortality. The three delays model developed by Thaddeus and Maine is the most common framework used to evaluate the circumstances surrounding a maternal mortality.…”

Determinants of Maternal Deaths in the Eastern Region of Ghana, 2011 – 2016

“…MMR is of immense public health importance and comprises a key maternal health performance indicator 3 with the largest disparities between developed and developing countries 4 . An estimated 99% occur in developing regions of the world where an estimated 98% are deemed preventable 5 ; Southern Asia and Sub-Saharan African countries account for an estimated 85% of the global burden 3 . Increased access to family planning (FP), skilled birth attendance and Emergency Obstetric Care (EOC) have contributed to global reductions from 380 in 1990 to 210 per 100,000 live births in 2013 3 .…”