Maternal, Neonatal & Child health

Executive Summary
Deaths of women, newborn babies and children are major problem in world and their deaths
occur due to preventable causes adds fuel to misery. Though many interventions which could
save them are available but not for those who truly need them. The major reason for their death is
home delivery of babies without any professional assistance. Below are some statistics about the
death rate of women, babies and children.

Pregnancy complications cause 530,000 women to die while on the other hand unsafe

abortion causes death of 68,000 women.

Death of newborn in first month of their life has reached up to 4 million while still births

death rate is 3 million.

At the age of 5 10 million children die.
Almost 99 percent of maternal, newborn and child death cases have been recorded in low
and middle income countries (Ahrq.gov, 2014).

Though maternal death rate has been dropped down to 45% since 1990 but still about 800
women die because of preventable causes related to pregnancy and childbirth. Major causes of
these deaths are low income areas, severe bleeding, infections, high blood pressure and
complications which occur during pregnancy.
Newborn survival is bound with maternal health. Childhood deaths have rose up to 44 percent
despite many strides which have been made to reduce child mortality globally. Interventions
which been made to reduce maternal and newborn death but they are not reaching to those
people who needed them desperately. Birth facilities are improving with regions and increase in
income of people but quality of care to be provided before and after birth remains major
challenge to mother and children. Majority of women deliver at home without the help of any
skilled health worker who lack access to critical supplies and medicines (Kerber et al., 2007).
Basic purpose of this paper is to find out causes, effects of maternal, neonatal and child deaths.
Recommendations and solutions would also be identified to improve the maternal and child
health.

Causes of Maternal, Neonatal and Child of Deaths

Different causes are associated with deaths of maternal, neonatal and child deaths. Some of them
are discussed in this paper. Many medical conditions during pregnancy, labor and first 6 weeks
after pregnancy cause maternal death. These reasons can be termed as immediate or proximate
causes of maternal deaths. These reasons are further classified as direct and indirect causes
(Ritholtz.com, 2014).
According to estimates of WHO more than 80% deaths occur due to direct causes and remaining
20% are due to indirect causes. Direct causes include hemorrhage, hypertensive disorders,
infections, abortions etc. Indirect causes have no casual relationship with pregnancy or
childbirth. Indirect causes aggravate maternal health and can affect pregnancy to such extent that
it could lead to death. These indirect causes include anemia, HIV/AIDS, malaria, heart disease,
hypertension, diabetes, injuries etc. (Edvardsson et al., 2012).
Poverty/ Access to Healthcare:
Maternal and neonatal death rate is higher in sub-Saharan African countries. Poverty, maternal
health and death are interconnected. Neonatal deaths in developing countries account for 98%
across the globe per year. Poverty is detrimental factor for both mother and child health. Despite
being poor, women in developing countries dont have access to healthcare which causes the
maternal and child deaths.
HIV/AIDS:
HIV rate vary with country in mothers and the highest rates are found in African and Asian
countries. HIV transfers to babies during prenatal period, childbirth and breastfeeding. Mother
with HIV infection and no proper medical care will infect her baby and infection chances are
25% on the other hand mother with proper medical care will not infect her baby, its chances are
98%.
Maternal Weight:
Maternal weight is another reason for deaths of women and children during pregnancy and after
birth. Hypertension, diabetes, respiratory complications and infections are more prevalent in

those women who gain weight during their pregnancy. Women with less weight have low rate of
complications during pregnancy (Black et al., 2008).
Effects on Maternal, Neonatal and Child Health
Causes of maternal, neonatal and child deaths have significant impact on health of maternal,
neonatal and child health. These effects are described below.
1. Poverty, malnutrition and substance abuse by mother lead to impairment in cognitive,
motor and behavioral problems in childhood. If mother is not experiencing good health
during pregnancy or fetus is exposed to teratogen, child would be experiencing health or
developmental problems or even these reasons could lead him to death.
2. Those mothers who are addicted to heroin during their gestational period their babies
show signs of withdrawal symptoms at birth. They also have attention problems and
health issues during their growth. Less weight after birth, small head circumference,
motor & cognitive developmental delays and behavioral problems in childhood occur
because of usage of methamphetamine and cocaine during the pregnancy.
3. Children whose mothers had been smokers during pregnancy, found to have low level of
intelligence than those whose mothers were not smokers. Smoking can create detrimental
effects on health and development of offspring. Major problems which smoking cause are
pre term births, less weight of baby, fetal and neonatal deaths, respiration problems,
sudden infant death syndrome, impairment in cognition, attention deficit hyperactivity
disorder (ADHD).
4. Baby can be infected with HIV/AIDS if mother is infected. Though HIV could be
transmitted during anytime but most common time to be effected with virus is during
pregnancy. This virus is transmitted through placenta during the prenatal period.
5. Obesity in offspring is bound with gestational diabetes. Children can develop type II
diabetes whose mothers are having diabetes (Victora et al., 2011).
Recommendation to Improve Maternal, Neonatal and Child Health
Many initiatives have been taken to improve maternal, neonatal and child health. Following are
some recommendations to improve maternal, neonatal and child health.
1. For maternal, neonatal and child health (MNCH) community there is need to develop an
evidence base and one stop shop to manage knowledge about this issue. Though a lot of

research has been done on this topic and many scientific publications, literature and case
studies have been available describing policy makers and implemented policies
experiences but none of them provide any latest evidence or consensus related to this
issue. Development of knowledge based management system would help to communicate
evidences, actions and experiences related to resolution of this issue.
2. Maternal health could be improved by using many cost effective interventions like use of
antibiotics, cord care, drugs which are used to prevent and treat postpartum hemorrhage,
breastfeeding. Mother care techniques to keep baby warm through skin to skin contact.
3. Provision of first level facilities having quality services, skilled health care officers for
safe delivery and after birth care of baby and mother. Development of new tools and
technologies to accurately diagnose diseases during pregnancy. Through this dangerous
diseases could be diagnosed timely and dangerous conditions could be treated.
4. To harmonize the advance MNCH initiatives in countries for coordination and purchase
of those commodities required to improve MNCH. These commodities have been
distributed under different programs like child health care programs provide commodities
for child survival and reproductive health institutions deliver reproductive health
commodities.
5. In order to improve maternal, neonatal and child health human resource capacity
strengthening is very important. In this effort number, skills and competencies of health
care professional, administrators and other local MNCH stakeholder is very vital.
Increase in number of workers across the globe is required for achieving maternal,
newborn and child health (Rosato et al., 2008).

References

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