Saving mothers and children
The death of a child’s mother massively reduces the child’s chances of survival to age 10 years, whereas the father’s death has a negligible effect, a study on child survival in Bangladesh has found.
The findings are reported in a special edition of The Lancet journal which focuses specifically on the health of women and children.
The Bangladesh study noted the greatest effect in children 2 ‘ 5 months whose mother had died ‘ they were 25 times more likely to die than children whose mothers were alive when the children were in this age range. The effect of the father’s death on cumulative probability of survival of the child up to 10 years of age was negligible.
The authors largely attributed the increased risk of death after the mother’s death to the interruption of breastfeeding. They also found that when the fathers died extended family and households tended to step in and help the widowed mother.
Another article in the Women Deliver Special Issue in The Lancet assessed India’s Janani Suraksha Yojana (JSY) ‘ a conditional cash transfer programme to increase births in health facilities.
In 2005, the year JSY was launched, more than 78 000 of 387 200 maternal deaths worldwide, and more than one million of 3,4-million neonatal deaths occurred in India.
The JSY model sees eligible women after delivery in a government or accredited private health facility receiving 600 Indian rupees (U$13) in urban areas and 700 rupees (U$15) in rural areas. JSY was found to have a significant effect in reducing perinatal and neonatal deaths.
China and Brazil were also highlighted as countries on track to meet Millennium Development Goals 4 and 5.
MDG4 requires reduction of child under-5 mortality by two thirds between 1990 and 2015; while MDG5 asks countries to reduce their maternal mortality by three quarters over the same period. Despite three quarters of the 68 Countdown countries showing accelerated progress, only 19 are on track to meet MDG4’including Brazil, China, Mexico, Peru, Nepal, Egypt, Malawi, and Turkmenistan.
Across the 68 countries child under-5 mortality fell from 90 deaths per 1000 live births in 1990 to 65 in 2008, a 28% reduction.
Brazil has made progress through reducing socioeconomic inequities and improving primary coverage to almost universal levels. Nowadays, almost all pregnant women in Brazil have access to a skilled birth attendant.
The authors said China’s successful reduction of newborn and child mortality during the past two decades was a remarkable example of progress through steady investments in reproductive health, primary care, and economic development.
In the two years since the last Countdown report, 19 million women of childbearing age and children younger than 5 years have died because of preventable disorders. Pneumonia, diarrhoea, and malaria still kill more than 3 million children every year, and The Lancet report shows that the long-established treatments for these infections still do not reach half of the children who need them.