1. THE STATE OF THE WORLD’S CHILDREN 2009
Maternal and Newborn Health

2. Maternal mortality ratio per 100,000 births
Uttar Pradesh
517
India: 301
Kerala
110
per 100,000 live births
Less than equal to 150
More than 300
Missing Data
Source: SRS

3. Medical causes of maternal deaths in India
Other
Conditions
34%
Haemorrhage
38%
Abortion 8%
Sepsis 11%
Obstructed
Labour 5%
Hypertensive
Disorders 5%
Medical causes of maternal deaths in India
Source: SRS

4. Age at marriage
Percentage of women aged married before age 18
Early marriage leads to early childbearing thereby enhancing maternal health risks
Source: NFHS

5. Nutrition among women
Percentage of ever-married women age with any anaemia and
Body Mass Index (BMI) below 18.5 kg/m2
High percentage of women with anaemia and low BMI results in higher risk of low birth weight and peri-natal deaths
Source: NFHS

6. Antenatal care
Percentage of ever-married women age years having at least one ante-natal care
There has been a significant increase in ante-natal care in the last 7 years. Further increases are seen in the latest DLHS results
Source: NFHS

7. Deliveries at institutions / by skilled birth attendants
Institutional births have shown significant improvement in the DLHS results
Source: NFHS

8. Birth spacing
Average (Median) number of months since preceding birth
Intervals between 2 consecutive births in India have remained low, adversely affecting mothers’ health and children’s chances of survival
Source:

9. Post natal care for mothers
Percentage of women having at least one postnatal care within two days of delivery
Only 37% of women received postnatal check-ups within the recommended period of two days of delivery
Source: NFHS

10. Share of under-five mortality in India
Infant deaths within 7 days of birth
40%
Neonatal deaths
50%
Infant deaths
76%
Infant deaths between
7 days of birth and within 28 days
10%
Infant deaths between 28 days
and within one year of birth
26%
Child deaths between one
year and within five years of birth
24%
Source : SRS 2007

11. Medical Causes of Neonatal Deaths
Diarrhoea
Asphyxia
Preterm
Tetanus
Other
Congenital
Infection
Source: Lawn JE Cousen SN for CHERG (Nov 2006)

12. Birth weight
Percentage of children with reported birth weight less than 2.5 kg
Based on reported birth weight data: 30% in NFHS 2 and 34% in NFHS 3
Every year at least six million children in India are born with low birth weight which gives them a disadvantaged start in life
Source: NFHS

13. Initiation of breastfeeding within an hour
Percentage of children born in the last three years who started breastfeeding within one hour of birth
Only one in four children in India are breastfed within 1 hour of birth
Source: NFHS

14. Proposed action framework
Central premise “.. Essential services for mothers, newborns and children are most effective when delivered in an integrated package at critical points in life cycle, in a dynamic health system, in an environment supportive of women’s rights”

15. Continuum of care
Critical points for service delivery: Adolescence, Pre-pregnancy, Pregnancy, Birth, Post-partum, Neonatal, Infancy, Childhood
Essential Services: Basic health care, quality maternal-newborn care, adequate nutrition

16. Continuum of care
Key delivery modes: Household & Community, outreach, health facilities
Supportive environment: Quality education, women’s status, age at marriage and childbirth

17. Key actions
Create a supportive environment by promoting gender equality
Enhance girl’s education
Increase age at marriage & childbirth

18. Key actions Ensure continuum of care across time and locations
Improve quality of reproductive health services
Enhance nutrition of adolescent girls
Ensure adequacy of antenatal care
Ensure skilled assistance during pregnancy & childbirth
Provide access to quality Basic and Comprehensive Emergency Obstetric & Newborn care when required
Expand post-natal care for mothers & newborns
Promote safe water & hygiene practices at households and in facilities
Initiation of breastfeeding within one hour of birth

19. What will make it happen
Building synergy and partnerships
Generating and sustaining strong political leadership for health of women and children
Mobilizing resources for maternal and newborn health
Empowering families and communities for promoting health and accessing healthcare