40
3.
Maternal mortality ratio reduced by 10 percent.
High maternal mortality rates are a devastating problem in the
developing world.
Research has recently indicated that community
interventions can be very effective in addressing maternal
mortality; further research, and expansion of such interventions
will be undertaken in FY 1999 in addition to in country programs.
The impact of global iron supplementation programs directed at
pregnant women, based on improved distribution of supplements and
motivation for compliance will also be determined.
Using an
approach which empowers women and meets the needs of mothers and
infants, NGOs in partnership with USAID, will continue to expand
geographic access and promote technical excellence in antenatal
care, safe birthing practices, treatment of obstetrical
complications, and postpartum, post abortion and newborn care.
Sub Saharan Africa:
Data on maternal mortality is notoriously
poor.
However, we do know that most maternal deaths are due to
obstetric emergencies, hemorrhage, poor nutrition for pregnant
women, and complications from abortion.
The estimated proportion
of deaths to women due to pregnancy and childbirth complications
in sub Saharan Africa is the highest in the world, averaging 980
deaths per 100,000 live births, ranging from 1,800 in Sierra
Leone to 50 in Mauritius and 230 in South Africa.
Given the poor
quality of the data, we will not be able to measure a change in
maternal mortality over this reporting period.
However, by the
end of FY 1999, increases in the proportion of births attended by
trained providers, increased use of contraception, and improved
nutrition for pregnant women in a number of countries will result
in a reduction in maternal mortality over the next ten years by
10%.
Asia and the Near East:
Many countries have very high maternal
mortality ratios, due to the low status of women, lack of trained
birth attendants, poor nutrition, and mistimed and unwanted
pregnancies.
In recent years, expanded attention to maternal
health has resulted in an increase in the proportion of births
attended by trained providers.
Increased use of contraceptives
has improved child spacing and impacted on the use of abortion,
thereby reducing the number of complications.
These investments
will continue, and neonatal mortality rates, as a proxy for
maternal mortality, are expected to decline by 2% between 1997
and 1999.
Latin America and the Caribbean:
Reduction in maternal mortality
continues to be a priority in the region as a whole, as estimated
maternal mortality ratios on average are 140/100,000 live births,
but range from 27 in some countries in the Caribbean to 650 in
Bolivia and 1,000 in Haiti.
However, targeted program
interventions have demonstrated that considerable progress is
possible in reducing maternal mortality, and during this
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