WHO urges coordinated action and accountability to save mothers and children

SEAR/PR 1573

WHO, UNICEF and UNFPA called upon countries in South-East Asia to ensure survival and improved quality of life for each woman, newborn and child, in a joint statement in Kathmandu today. 76 000 mothers died as a result of pregnancy and childbirth in 2012 in WHO’s South-East Asia Region. The Region lost an estimated 1.8 million children under the age of five years, and there were about 1 million newborn deaths in 2012.

“In an ideal world not even a single mother, newborn or a child would die due to a preventable cause” said Dr Poonam Khetrapal Singh, WHO Regional Director for South-East Asia. “There are several challenges that have affected progress in maternal and child health. Low public investments in health, high out-of-pocket expenses, inadequate number and distribution of health workers with the necessary skills-mix are some of them. We are losing children and new mothers at unacceptable rates and issues, such as gender imbalance, early marriage and adolescent pregnancy, suboptimal birth spacing, inadequate water and sanitation facilities, are contributing to these deaths” she added.

As per the United Nations Inter-agency Group estimates (2013), under-five mortality declined from 118 per 1000 live births in 1990 to 50 per 1000 live births in 2012 in the WHO South-East Asia Region. Reduction in the maternal mortality ratio (MMR) from 590 per 100 000 live births in 1990 to 200 per 100 000 live births in 2010 is one of the most significant achievements over the past decade in the Region (World Health Statistics 2013).

Two countries of the Region received the UN Secretary General’s award in 2010: Bangladesh for progress towards achieving Millennium Development Goal (MDG) 4, and Nepal for progress towards achieving MDG 5. While MDG 4 aims to reduce child mortality, MDG 5 targets reduction in maternal mortality by 2015.

Overall progress towards MDGs 4 and 5 in the Region has been variable, and has been uneven among and within countries. Even in countries that have achieved the MDG targets, there are subpopulations or geographic areas that have higher mortality than the national average. Significant inequities exist in maternal and child health on account of economic and social parameters such as gender, poverty, education level and rural/urban location. Universal access to reproductive health remains a big challenge as the contraceptive prevalence rate has remained stagnant over the years in countries.

“A coordinated approach and accountability among the national governments and partners in the health and other sectors are the key to saving the lives of mothers and children in the Region” said Dr Khetrapal Singh. She emphasized that implementation coverage of the life-saving interventions needs to be expanded quickly, especially to reach the marginalized people and quality of care has to be ensured at the same time.

Opportunities to prevent maternal and child morbidity and mortality occur at multiple stages of life-course. Strong public health programmes that provide a “continuum of care” spanning pregnancy, childbirth, infancy, childhood, adolescence and adulthood can increase the health and well-being of adolescents and adult women and men. A recent WHO report shows that addressing maternal health risk factors even before pregnancy contributes to better reproductive health outcomes including better maternal health, healthier babies as well as prevention of certain birth defects. Similarly, investment in promoting healthy behaviours among adolescents, such as healthy diets, physical activity and avoidance of tobacco use, will contribute to reduction in noncommunicable diseases in the long term. To achieve this, WHO is now consulting Member States and partners to create an innovative package named “Healthy Transitions for Adolescents”. Additionally WHO’s “Care for Child Development” package provides guidance on early childhood development and nutrition.

WHO’s South-East Asia Region comprises the following 11 Member States: Bangladesh, Bhutan, Democratic People’s Republic of Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor-Leste.