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CABI Book Chapter

Maternal and perinatal health in developing countries.

Book cover for Maternal and perinatal health in developing countries.

Description

The promotion of maternal health and mortality reduction is of worldwide importance, and constitutes a vital part of the UN Millennium Development Goals. The highest maternal mortality rates are in developing countries, where global and regional initiatives are needed to improve the systems and practices involved in maternal care and medical access. Taking a practical policy approach, this book co...

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Chapter 5 (Page no: 51)

The epidemiology of stillbirths and neonatal deaths.

Six million babies die each year either as late fetal deaths in the last trimester or the first month of life (neonatal deaths); 98% occur in developing countries and 75% in sub-Saharan Africa and South Asia, which is also where 87% of global maternal deaths occur. Between 1995 and 2008, stillbirths and neonatal deaths have decreased by 14.5% and 28.0%, respectively, mostly in East Asia. Unlike child deaths, there are no international goals for reducing stillbirths, making these 2.6 million deaths practically invisible to the international community. The term 'perinatal' is used to refer to outcomes that occur before or soon after the time of birth, so includes the unborn fetus and the newborn. Due to multiple definitions for the perinatal period, the term is unsuitable for epidemiological use, but for programmatic purposes it is helpful to consider stillbirths and early neonatal deaths jointly because many of the interventions to improve these outcomes are similar or related. While data on the causes of newborn deaths are widely available (leading causes: preterm birth, birth asphyxia, sepsis, pneumonia) the causes of stillbirth are less well documented. There is not even international consensus on how to document and report the causes of these deaths. At minimum, the timing of these deaths should be routinely reported (antepartum or before labour and intrapartum or during labour). Improved identification and management of infections such as syphilis, pregnancy complications, intrapartum care, antepartum steroid administration where preterm birth is inevitable, judicious use of Caesarean section where indicated, training in neonatal resuscitation, Kangaroo care, and early identification and treatment of respiratory infections have all been proven effective in improving perinatal survival. Improving the data for all outcomes around the time of birth - maternal and neonatal mortality and morbidity - and using these data for action in programmes is a fundamental challenge for progress towards the MDGs and beyond.

Other chapters from this book

Chapter: 1 (Page no: 1) An introduction to maternal and perinatal health. Author(s): Hussein, J. Blanc, A. K. Donnay, F. McCaw-Binns, A.
Chapter: 2 (Page no: 10) The Millennium Development Goals. Author(s): McCaw-Binns, A. Hussein, J.
Chapter: 3 (Page no: 25) The politics of progress: the story of maternal mortality. Author(s): Graham, W. J.
Chapter: 4 (Page no: 40) The epidemiology of maternal mortality. Author(s): Stanton, C. McCaw-Binns, A.
Chapter: 6 (Page no: 64) Health systems. Author(s): Mavalankar, D. V. Raman, P. S.
Chapter: 7 (Page no: 77) Financing maternity care. Author(s): Witter, S. Ensor, T.
Chapter: 8 (Page no: 96) Implementing clinical interventions within maternal health programmes. Author(s): Langer, A. Knight, H. Charnock, A. Wegner, M. N. Villar, J.
Chapter: 9 (Page no: 114) Medical conditions in pregnancy. Author(s): Webber, R. McCaw-Binns, A. Hussein, J.
Chapter: 10 (Page no: 127) Improving the availability of services. Author(s): Phoya, A. Mavalankar, D. V. Raman, P. S. Hussein, J.
Chapter: 11 (Page no: 139) Geographical access, transport and referral systems. Author(s): Munjanja, S. P. Magure, T. Kandawasvika, G.
Chapter: 12 (Page no: 155) Demand for maternity care: beliefs, behaviour and social access. Author(s): Mumtaz, Z. Levay, A.
Chapter: 13 (Page no: 170) Empowering the community: BRAC's approach in Bangladesh. Author(s): Kaosar Afsana
Chapter: 14 (Page no: 181) Quality of care. Author(s): Achadi, E. Pitchforth, E. Hussein, J.
Chapter: 15 (Page no: 193) Monitoring and evaluation. Author(s): Hounton, S. Newlands, D. Meda, N. Hussein, J.
Chapter: 16 (Page no: 210) Addressing maternal health in emergency settings. Author(s): Bartlett, L. Aitken, I. Smith, J. M. Thomas, L. J. Rosen, H. E. Tappis, H. Burnham, G.