Trend The main cause of death was haemorrhage


From years 2000 to 2015 there was
a general trend of a reduction in maternal mortality. This was investigated by
the UN who included this cause in their 2000 initiative Millennium Development
Goals. At present the level is at 216 deaths per 100,000 live births which is
an average reduction of 2.3% per year since 2000 when the level stood at 385. On
universal comparison this trend highlighted the link between better healthcare (and
better access to this healthcare) and the low mortality rates of developed
countries compared to developing – where 99% of maternal deaths occur today. The
main cause of death was haemorrhage and so without access to quality healthcare
the developing countries were unable to prevent these deaths and more (UNICEF
2017) (WHO 2015.)

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Firstly there is a problem with
data collection in terms of its quality and how it is measured. In order to
target the maternal mortality rate it is required to know what these numbers
are and in what scenarios these deaths they take place. Often the worst
affected countries are those will little data as they are usually in a state of
crisis whether it be natural disaster, war or a health epidemic. Other data
shortfalls leave subsets of populations overlooked in the face of an overall
low maternal mortality rate nationally. This was seen in the case of Australia with
indigenous populations where maternal mortality rate was double that of
non-indiginous, as found by a study purposely examining this subsection in society
(WHO 2015).

HIV epidemics are a prominent
problem with countries deemed at having made no progress since 2000. The burden
this takes on the nations resources has a knock-on effect into availability of
maternal care. These countries also can have the added hindrance of national
strife and other crises simultaneously with the HIV epidemic. To tackle
maternal deaths these issues must be acknowledged and addressed in combination
with any approach these factors are what prevents progress (WHO 2015).

Keeping abreast of the observed
shift in cause of maternal deaths is also a challenge. While maternal mortality
rates may have declined there can then be an increase in proportion of later
obstetric complications and causes of death that pregnancy has exacerbated. The
approach to improvements will need to be adapted to shadow this shift to more these
indirect deaths and obstetric complications (WHO 2015).


To address the data problem
countries can implement programmes such as the Confidential Enquiry into
Maternal Deaths (CEMD) for correct classification of maternal deaths in the country’s
national statistics. As a prelude to this the Maternal Death Surveillance and
Response (MDSR) can be used to build the data network. This would be helpful in
keeping track of the current data and any emerging shifts. The efficiency of
this could be augmented by going digital in the approach such as with the Open
Smart Register Platform. Programmes such as these provides frontline healthcare
workers with means to record and monitor the health of those they treat. Access
to healthcare, increasing proportion of healthcare dedicated to women and health
insurance schemes have also shown to have an impact and so should be more
widely utilized (WHO 2015) (Filippi et al 2016).

Maternal mortality is closely
linked to poverty. Access to family planning has a strong link with long term
economic advancements and in so a path out of poverty at a national level. With
family planning there are less children to care for, the births are spaced to
better allow for the survival of the children that are born and women are able
to advance their education and enter the paid workforce. The Sustainable
Development Goals 2015 emphasises the global recognition of the importance of
this issue as is also highlighted by the fourth International Conference on
Family Planning, that focuses on reducing population to eliminate poverty. Here
the conference observed a majority voicing the importance on long term reversible
contraceptive devices as they key to success. By making this a prominent
approach it would facilitate long term change, the economy also and be less
sensitive to epidemics. (Canning and Schultz, 2012)