Maternal Health in developing nations !!

Everyday about 29 000 children (under 5 years of age) die worldwide; the majority of these deaths occur in the developing world¹.

India contributes to a fifth of these deaths².

Almost 25% of children born in India have low birth weight compared to 7.6% in the US³.

Premature birth and low birth weight are the leading causes of death during the peri-natal period³.

It is estimated that 40% of birth weight is due to heredity and the remaining 60% is due to environmental factors³....

This is where Maternal Health really matters!

Research has shown that the adolescent mothers are more likely to give birth to babies with low birth weight. In India, almost half of 20-24 year old women (44.5%) are married before the age of 18 and 22% of all 20-24 year old women have given birth by age 18 years¹. Early age of pregnancy is also associated with increased likelihood of neonatal death and stillbirth and increased child and infant morbidity and mortality¹.

http://www.ipsnews.net/2013/10/teen-pregnancy-rooted-in-powerlessness/

Some of these bad outcomes are a result of physical immaturity of the young mothers and exacerbation of the effect of chronic malnutrition by competition for scarce nutrients between the mother and foetus¹. This also increases poor maternal health outcomes, including pregnancy complications and maternal mortality which further increase the likelihood of poor infant and child health outcomes¹. A study in 2004 found that 33% of married women (aged 15–49 years) are too thin (ie, BMI <18·5 kg/m²)⁴. In addition some large scale surveys found that the prevalence of anaemia in pregnant women ranges from 74.3% to 96.2%⁴.

Extensive data has shown that adolescent women are more likely than those marrying in adulthood to remain poor, uneducated, and within rural communities, and to have low access to health care, all factors that contribute to increased risk for infant and child morbidity and mortality¹.

In fact women who get married and begin childbearing at a younger age are more likely to have a greater number of children which is linked to increased likelihood of poor maternal, infant, and child health outcomes³.

Despite this the sexual health programs especially ones targeting adolescents are almost nonexistent in India⁶! In 2011, it was found that just 32% of females between 15-19 years and only 61% of females between 20-24 years of age of were using contraceptives⁴.

Isn’t this surprising?

Remember- “It’s a life cycle approach where the health of an adolescent girl impacts pregnancy while the health of a pregnant woman impacts the health of the newborn and the child⁵”

1.  Raj A, Saggurti N, Winter M, Labonte A, Decker MR, Balaiah D, et al. The effect of maternal child marriage on morbidity and mortality of children under 5 in India: cross sectional study of a nationally representative sample. BMJ. 2010;340:b4258.

2.  Singh A, Pathak PK, Chauhan RK, Pan W. Infant and child mortality in India in the last two decades: a geospatial analysis. PLoS One. 2011;6(11):e26856.

3.  Valero De Bernabe J, Soriano T, Albaladejo R, Juarranz M, Calle ME, Martinez D, et al. Risk factors for low birth weight: a review. Eur J Obstet Gynecol Reprod Biol. 2004 Sep 10;116(1):3-15.

4.  Paul VK, Sachdev HS, Mavalankar D, Ramachandran P, Sankar MJ, Bhandari N, et al. Reproductive health, and child health and nutrition in India: meeting the challenge. The Lancet. 2011;377(9762):332-349.

5.  <1._RMNCHAStrategy.pdf>.

6. http://www.wilsoncenter.org/event/maternal-health-india-emerging-priorities-new-delhi-boston-washington-dc