1. Maternal and Child Health

2. Maternal & Child Health
Different from Women’s Health and Child’s Health
“Maternal”
Health of mothers and children highly inter-related: pregnancy, nutrition, lactation, primary care provision, health seeking, advocacy for education etc
Maternal educational status consistent predictor of infant survival

3. Leading Causes of Under Five M & M in Developing World
Infectious Diseases leading cause of death among children (about half)
Undernutrition
Potentiating effects on infectious diseases
Related to poor learning and cognitive function
Perinatal (extreme prematurity, stillbirth etc)

4. Infectious Diseases in Under 5’s
Many vaccine preventable
Expanded Program of Immunization (EPI) established 1974
Has significantly reduced polio, neonatal tetanus, and measles
Parasitic diseases-treatment available for almost all
Malaria major killer in sub-saharan Africa (1 million per year) and morbidity extensive ---> severe anemia, undernutrition
Helminth infections ---> anemia, undernutrition, cognitive
HIV/AIDS
Acute lower respiratory tract infections (number 1)
Diarrheal diseases - highlight precarious state of children

6. The assets of the top 3 billionaires are more than the combined GDP of all of the least developed countries and their 600 million people

7. At least 1/5 of the world’s population (1
At least 1/5 of the world’s population (1.2 billion people) live in absolute poverty, surviving on US$1 or less a day, and a total of 50%, half of the world’s population, live on US$2 or less a day
70% of people living in absolute poverty are women.

8. Every minute 20 children under 5 years old die, leading to over 10
Every minute 20 children under 5 years old die, leading to over 10.6 million deaths a year.

10. 53% of childhood deaths are associated with malnutrition, as a direct or indirect cause.

11. 66% of child deaths each year are caused by diarrhea, acute respiratory infections, measles, malaria and perinatal illnesses.

16. Maternal Mortality Risk of dying as result of pregnancy or childbirth
1 in in Sweden
1 in 6 in Afghanistan and Sierra Leone
Maternal mortality ratio (# of maternal deaths/ live births)
US - 17
Haiti - 680
Malawi
UNICEF, 2004

17. Maternal Mortality
MMR
UNICEF, 2004

18. More Disparities Urban vs Rural Afghanistan: MMR 418 in Kabul
MMR 6507 in rural Ragh
Wealthy vs Impoverished
Peru
Richest quintile – MMR 130
Poorest – MMR >800

19. Disparities at home
Joia’s story
Najeeha’s story

20. 26¢ Measles vaccine Per dose
What can be done
26¢ Measles vaccine Per dose
Malawi boosted immunization coverage to 90 percent in 2002 from 50 percent in For the first time ever, no measles deaths were reported in 1999.

21. $1.20 Tetanus vaccine 3 doses for mother
What can be done
$1.20 Tetanus vaccine 3 doses for mother
Bangladesh increased coverage for mothers to 86 percent in 1998 from 5 percent in 1986; during the same period, the death rate fell to 4 per 1,000 live births from 41.

22. 33¢ Oral rehydration salts Per dose
What can be done
33¢ Oral rehydration salts Per dose
In Mexico, since the introduction of oral rehydration therapy in 1984, mortality rates for diarrheal diseases fell by 60 percent in less than a decade.