26. Maternal and Perinatal Conditions
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Editors/Authors: Wendy J. Graham, John Cairns, Sohinee Bhattacharya, Colin H. W. Bullough, Zahidul Quayyum, and Khama Rogo
Disease / Condition
Adolescent & Childhood Diseases
High Blood Pressure
Maternal & Neonatal Conditions
Maternal mortality and the neonate component of child mortality are particularly persistent health challenges in South Asia and Sub–Saharan Africa, which account for nearly all such deaths. Of the estimated 210 million pregnancies each year, close to 60 million end in death?most often of the baby, usually as a result of complications experienced by the mother. Maternal deaths are frequently caused by such conditions as hemorrhage, sepsis, hypertensive disorders, or obstructed labor, whereas perinatal deaths are usually attributed to low birth weight, birth asphyxia, or infection.
Maternal and perinatal conditions represent the single largest contributor to the global disease burden; thus, reducing the burden is an international priority. Interventions include population–based interventions to promote healthy behaviors and reduce mistimed pregnancies; nutritional interventions to address undernutrition or micronutrient deficiencies in women of reproductive age; and a continuum of care for mother and baby, including birth preparedness, involvement of the father, primary level care, access to emergency obstetric and hospital care, and delivery and postpartum care. The most successful interventions are those that are employed in combination.
Reducing maternal and perinatal mortality can produce a virtuous cycle of benefits: safe motherhood may help reduce poverty by freeing up resources otherwise diverted to health crises, which in turn stimulates economic activity, which then can feed back into improvements in maternal and perinatal health. In order for interventions to be cost–effective in developing countries, they need to focus on critical entry points to the health system, particularly primary care and prenatal care. Increasing the number of women in contact with these services is likely to lead to an increased proportion of deliveries with skilled attendance. Moreover, strategies to improve safe motherhood may be a means of achieving wider health service improvements.
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- 26.1 Maternal and Perinatal Focus Conditions and Risk Factors for These Conditions
- 26.2 Estimates of Maternal Mortality by Region, 2000-1
- 26.3 Early Neonatal Deaths by Gender and Cause, 2001(thousands)
- 26.4 DALYs for Perinatal and Maternal Conditions by Gender, Selected Regions, 2001 (thousands)
- 26.5 Care Packages at the Primary and Secondary Levels
- 26.6 Comparisons Undertaken for CEA
- 26.7 ICERs per Million Population, South Asia and Sub-Saharan Africa (U.S. dollars)
- 26.8 Costs and Effectiveness of Intervention Packages per Million Population, South Asia and Sub-Saharan Africa
- 26.9 Sensitivity Analysis Results, South Asia and Sub-Saharan Africa (incremental cost per DALY averted, US$)
- 26.A1 Costs Per Inpatient Bed Day, South Asia and Sub-Saharan Africa (U.S. dollars)
- 26.A2 Assumed Effectiveness of Interventions (percentage of DALYs, deaths, and years of life lost averted)