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Maternal and Child Health June 30, 2014
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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
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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)
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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 illnesses - highlight precarious state of children
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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
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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.
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Every minute 20 children under 5 years old die, leading to over 10.6 million deaths a year.
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53% of childhood deaths are associated with malnutrition, as a direct or indirect cause.
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66% of child deaths each year are caused by diarrhea, acute respiratory infections, measles, malaria and perinatal illnesses.
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Maternal Mortality Risk of dying as result of pregnancy or childbirth – 1 in 30 000 in Sweden – 1 in 6 in Afghanistan and Sierra Leone Maternal mortality ratio (# of maternal deaths/100 000 live births) – US - 17 – Haiti - 680 – Malawi - 1800 UNICEF, 2004
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Maternal Mortality MM R UNICEF, 2004
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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
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Disparities at home
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What can be done 26¢ Measles vaccine Per dose Malawi boosted immunization coverage to 90 percent in 2002 from 50 percent in 1980. For the first time ever, no measles deaths were reported in 1999.
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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.
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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.
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