The global maternal death rate is estimated at between 500,000 and 600,000 a year, with ninety-nine per cent of the deaths occurring in low and middle-income countries. However, it is not only mothers who die from the lack of maternal and obstetrical care – new statistics compiled by researchers at Karolinska Institutet show that some three million new-born babies also die as a direct result of complications during pregnancy and delivery. There are three dominant causes of neonate death that can be linked directly to the inadequate care of sick mothers: premature birth, infections contracted in utero, and suffocation owing to poor maternity care.
“Adding these deaths to the figures gives us an entirely new picture of how many lives are actually lost through poor obstetrical care,” says Staffan Bergström, Professor of international health at Karolinska Institutet. “It’s quite alarming that this is the first time that anyone’s drawn attention to the fact that poor female health and the absence of adequate care costs 3.5 millions lives a year, more than two global infectious diseases like malaria and TB put together.”
At the start of the new millennium, the UN set up a goal to have reduced the global maternal death rate by 75 per cent by 2015. However, maternal fatality remains at a high, unchanged level in Africa, and in some countries is even rising. One reason for this, argues Professor Bergström, is a lack of about one million health workers in Africa alone, and some four million globally.
However, in some places the converse is true. In Mozambique, the maternal death rate has more than halved in 15 years, possibly owing, in part, to the presence of técnicos de cirurgia, intensively trained medical officers. Out at the provincial hospitals these ‘operating nurses’ have almost entirely replaced the doctors. According to recently published figures, they now carry out 92 per cent of all delivery-related surgery.
“Without their help, emergency obstetric care would be impossible out in the provinces. Providing intensive surgical training for medical staff is a cost-efficient way to address the lack of health workers in these countries,” says Professor Bergström.
“Meeting the need for emergency obstetrical care in Mozambique: Work performance and work histories of medical doctors and assistant medical officers trained for surgery”
C Pereira, A Cumbi, R Malalane, F Vaz, C McCord, A Bacci, S Bergström
BJOG, Online Early Edition 18 September 2007, doi: 10.1111/j.1471-0528.2007.01489.x
The results concerning the total number of annual deaths due to lack of maternal and obstetrical care are to be presented at the Women Deliver conference in London on 19 October 2007 at 11 am – 1 pm local time.
For further information, please contact:
Professor Staffan Bergström
Tel: +46 (0)73-5732741
Press Officer Katarina Sternudd
Tel: +46 (0)8-524 838 95 or +46 (0)70-224 38 95