Eliminating preventable maternal and neonatal mortality
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Eliminating preventable maternal and neonatal mortality
- 1. Eliminating Preventable Maternal and Neonatal Mortality & Improving Mother and Child Health Dr. sridhar.D Assistant Professor Community Medicine Kamineni Academy of Medical Sciences and Research Centre
- 2. Maternal mortality “Women are not dying because of diseases we cannot treat. They are dying because societies have yet to make the decision that their lives are worth saving ……………” Prof. Mahmoud Fathalla Past President, FIGO
- 3. Every 5 Minute... Maternal Death Clock 1 woman dies from a pregnancy- related complication In India UNICEF
- 4. Problem statement • Globally, 289,000 maternal deaths occurred in 2013, 47 % 1990. • SubSaharan Africa (62 %) & Southern Asia (24 %)= 86 % (249,000 maternal deaths 2013. • India at 17 % (50,000) and Nigeria at 14 %(40,000). • The global MMR in 2013 was 210 maternal deaths per lac live births. • The MMR in developing regions (240) was 15 times higher than in developed regions . • Hieghest - Sub-Saharan Africa -510 per lac live births, • Lowest- Eastern Asia 33 per lac live births
- 5. • Under MDG 5, countries committed to reducing maternal mortality by 3 quarters between 1990 and 2015. Since 1990, the number of maternal deaths worldwide has dropped by 43%
- 8. Annual Rates of Reduction (1990– 2013)
- 10. • 2013- 178 per lac live births • 2007-09 212 per lac live births • Kerala , Maharastra, Tamil nadu < 100/Lac live births • EAG states – Bihar, Jharkhand, Madya Pradesh, Chattisgarh, Uttar pradesh, Orissa, Rajasthan,Assam, Uttaranchal
- 11. Causes of maternal mortality • Indirect Causes: Aneamia, Malaria, Heart disease • Other direct causes: ectopic pregnancy, embolism, Anesthesia related 20% 8% 25%15% 12% 8% 13% Indirect causes Other direct causes Severe bleeding Infections Eclamspsia Obstructed labour Unsafe abortion 34% 8% 5%5%11% 38% Other conditions abortion Obstructed Labour Hypertensive disorder Sepsis Haemorrhage
- 12. Maternal deaths timing 50-70% during post partum period Firt 24 hrs- more than 2/3 rd With in week- 45% During child birth 11-17%
- 16. Neonatal mortality Deaths at birth and ending 28 completed days after birth per 1000 live births.
- 17. • 2.8 million die before 4wks • half die before 24Hrs • 98% daths in developing countries. • 44% contribute total under 5 daeths
- 18. • 31% in Sub Saharan Africa and South East Asia. • Lifetime risk for a woman to lose new born baby 1 in 5 Africa 1 in 125 developed countries
- 19. Indian Scenario • Early neonatal mortality 23/1000 live births • 25/1000 in rural 12/1000 in urban
- 20. Distribution of under-five deaths by age-groups Source:Calculated based on data from the UNICEF/WHO/The World Bank/UN Pop Div. Levels and Trends in Child Mortality Report 2014
- 23. Causes of neonatal deaths 24% 15% 5% 35% 1% 2% 8% 10% Intra partum related complications Sepsis Pneumonia Preterm birth complications Diarrheoa Tetanus Other 2% 9% 3% 20% 35% 15% 16% Diarrheoa Malformations Other Birth Asphyxia Preterm Sepsis Pneumonia Causes of neonatal deaths 2013 Globally causes of neonatal deaths 2013 in India
- 24. distribution of causes of neonatal and under-five deaths, 2013 Source: CHERG/WHO/UNICEF for distribution of causes of neonatal and under-five deaths (published in Liu et al, Lancet 2014).
- 25. Vision for Improved Maternal and Feotal Health and Survival