More women and their children are surviving today than ever before, according to new child and maternal mortality estimates released today by United Nations groups led by UNICEF and the World Health Organization (WHO).
Since 2000, child deaths have reduced by nearly half and maternal deaths by over one-third, mostly due to improved access to affordable, quality health services.
“In countries that provide everyone with safe, affordable, high-quality health services, women and babies survive and thrive,” said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “This is the power of universal health coverage.”
Still, the new estimates reveal that 6.2 million children under 15 years died in 2018, and over 290 000 women died due to complications during pregnancy and childbirth in 2017. Of the total child deaths, 5.3 million occurred in the first 5 years, with almost half of these in the first month of life.
Like many countries around the world, Uganda has also registered slight progress in reducing child and maternal mortality, according to the Uganda Demographic Health Survey (UDHS) 2016.
However, it still ranks among the top 40 countries in the world for high maternal, newborn and child mortality rates.
The UDHS 2016 estimated 368 deaths per 100,000 live births – approximately 15 pregnant women dying every day due to direct causes like haemorrhage and hypertensive disorders compared to 438 deaths per 100,000 live births in 2011 (UDHS 2011).
On the other hand, Uganda has registered some good progress towards the reduction of child mortality. The UDHS 2016 revealed that fewer children die before their fifth birthday – 64 under-five deaths per 1,000 live births in 2016 compared to 90 deaths per 1,000 live births in 2011.
Malaria, newborn conditions, pneumonia and prematurity account for 50 per cent of under-ﬁve deaths. Infant deaths also reduced from 56 deaths per 1,000 live births in 2011 to 43 deaths per 1,000 live births in 2016.
However, there has been no progress in newborn deaths (newborns dying during the first 28 days) with a stagnant figure of 27 deaths per 1,000 live births in 2011 and 2016.
UNICEF continues to support the government towards improvement of quality of care for Reproductive, Maternal, Newborn, Child and Adolescent (RMNCAH) through the provision of supplies, scaling up quality of care standards and upgrades to health infrastructure.
Women and newborns are most vulnerable during and immediately after childbirth. An estimated 2.8 million pregnant women and newborns die every year, or 1 every 11 seconds, mostly of preventable causes, the new estimates say.
Children face the highest risk of dying in the first month, especially if they are born too soon or too small, have complications during birth, congenital defects, or contract infections. About a third of these deaths occur within the first day and nearly three quarters in the first week alone.
“Around the world, birth is a joyous occasion. Yet, every 11 seconds, a birth is a family tragedy,” said Henrietta Fore, UNICEF Executive Director. “A skilled pair of hands to help mothers and newborns around the time of birth, along with clean water, adequate nutrition, basic medicines and vaccines, can make the difference between life and death. We must do all it takes to invest in universal health coverage to save these precious lives.”
Vast inequalities worldwide
The estimates also show vast inequalities worldwide, with women and children in sub-Saharan Africa facing a substantially higher risk of death than in all other regions.
Level of maternal deaths are nearly 50 times higher for women in sub-Saharan Africa and their babies are 10 times more likely to die in their first month of life, compared to high-income countries.
In 2018, 1 in 13 children in sub-Saharan Africa died before their fifth birthday– this is 15 times higher than the risk a child faces in Europe, where just 1 in 196 children aged less than 5 dies.
Women in sub-Saharan Africa face a 1 in the 37-lifetime risk of dying during pregnancy or childbirth. By comparison, the lifetime risk for a woman in Europe is 1 in 6500. Sub-Saharan Africa and Southern Asia account for around 80% of global maternal and child deaths.
Countries in conflict or humanitarian crisis often have weak health systems that mean women and children cannot access essential lifesaving care. Women face the highest risk of dying during pregnancy or childbirth in South Sudan, Chad, Sierra Leone, Nigeria, Central African Republic and Somalia.
Progress linked to universal health coverage
The world has made substantial progress in reducing child and maternal mortality. Since 1990, there has been a 56% reduction in deaths of children under 15 years from 14.2 million deaths to 6.2 million in 2018. Countries in Eastern and South-Eastern Asia have made the most progress, with an 80% decline in under-five deaths.
And from 2000 to 2017, the maternal mortality ratio declined by 38%. Central and Southern Asia* have made the greatest improvements in maternal survival with a 60% reduction in the maternal mortality ratio since 2000.
Belarus, Bangladesh, Cambodia, Kazakhstan, Malawi, Morocco, Mongolia, Rwanda, Timor-Leste and Zambia are some of the countries that have shown substantial progress in reducing child or maternal mortality.
Success has been due to political will to improve access to quality health care by investing in the health workforce, introducing free care for pregnant women and children and supporting family planning. Many of these countries focus on primary health care and universal health coverage.