Thursday December 13, 2018

Why too many women die in childbirth in Developing Countries? How can we tackle Infant Mortality?

World Health Organization (WHO) says it's hard to believe that in 2015, almost 6 million children under age 5 and more than 300,000 mothers died from complications of childbirth.

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Monowara holds her 22-day-old grandson Arafat, as she walks through a mustard field on the outskirts of Dhaka, Bangladesh, Jan. 22, 2014. VOA
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Too many women die in childbirth, and too many babies die during delivery.

Dr. Flavia Bustreo at the World Health Organization (WHO) says it’s hard to believe that in 2015, almost 6 million children under age 5 and more than 300,000 mothers died from complications of childbirth.

Bustreo heads a new program to reduce these deaths by half within the next five years, and to end preventable infant and maternal deaths by 2030 in nine high-risk countries — Bangladesh, India, Ivory Coast, Ethiopia, Ghana, Malawi, Nigeria, Tanzania and Uganda. This will be done through a new “Network for Improving Quality of Care for Maternal, Newborn and Child Health.” It will have support from UNICEF and WHO, where Bustreo is the assistant director-general for family, women’s and children’s health.

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“The dynamics we are trying to create is to have the partners and players within each country to create their targets, so that they own those targets, and they are also responsible and accountable to their own population for delivery,” Bustreo told VOA in a Skype interview from Geneva.

World Health Organization’s Flavia Bustreo gestures during an interview in Geneva, Feb. 15, 2016. VOA

Countries are committed

The countries will provide training to health professionals so they can intervene in an emergency, whether it’s suctioning out amniotic fluid from a newborn’s airway so the baby can breathe, or stopping a women who has just given birth from hemorrhaging. Bustreo said a third of maternal deaths are linked to post-partum hemorrhaging, and most of the babies die on the day of their birth.

The countries in the network have high maternal and infant mortality rates, but Bustreo said they are fully committed to achieving these goals.

They need to build or modernize health care facilities so there’s a consistent supply of running water and electricity. A number of facilities lack these necessities. These vital resources mean babies can be incubated and kept warm and mothers who need cesarean sections can have this surgery.

A woman sleeps next to her newborn baby in a nursery in the Juba Teaching Hospital, April 3, 2013. Very few births in South Sudan are assisted by trained midwives.

A woman sleeps next to her newborn baby in a nursery in the Juba Teaching Hospital, April 3, 2013. Very few births in South Sudan are assisted by trained midwives.

Well-trained staff a priority

Health care facilities have to be upgraded or built with their own sources of electricity, and the people who staff these facilities need training so they can perform lifesaving procedures expertly. “If you have a woman who delivers in a health care facility, but that facility does not provide well-trained health care workers or does not provide good quality care, you don’t see mortality reduction,” Bustreo explained.

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In some regions, women traditionally give birth at home. The challenge is to get these women to give birth in clean, well-equipped health facilities. Bustreo said some of these women are afraid they will get infections or contract diseases.

The goal is ultimately to end preventable deaths of mothers and babies. But first, these countries are focusing on reducing maternal and infant death by half within the next five years.(VOA)

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Number Of Uninsured Children In The U.S. Rises to 3.9 Mn: Report

The report also expressed concern that strict immigration policies and enforcement were making many immigrant families leery of enrolling.

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Uninsured Children, U.S.
Abigail Gabriel, 8, hugs her mother, Erin, as a Pennsylvania Department of Human Services official talks about the Children's Health Insurance Program, CHIP, during a news conference, Dec. 7, 2017, in Pittsburgh. Abigail had health care under Medicaid. VOA

The number of uninsured children in the United States has increased for the first time in nearly a decade, placing it at 3.9 million in 2017, according to a report Thursday from Georgetown University’s Center for Children and Families.

Nationally, the number of uninsured children increased by an estimated 276,000 in 2017, from a historic low of 4.7 percent in 2016 to 5 percent last year. Experts say about 75 percent of the newly uninsured children are clustered in states that did not expand Medicaid such as Florida, Texas and Georgia.

Under President Obama’s Affordable Care Act, Florida and other states could take federal funding to help pay for health coverage for nearly 900,000 people, but the Republican-led Legislature in Florida voted against it. The vast majority of states have already expanded Medicaid and increased the number of residents eligible for its coverage.

Joan Alker, executive director for Georgetown’s Center for Children and Families, has written the report for the last eight years and said she’s never seen the rates of uninsured children go up in all 50 states, which happened last year.

Probiotics, Uninsured
Florida has one of the highest rates of uninsured residents in the country.

Better economy, low unemployment

She said that what is perhaps most concerning is that the uninsured rate among children increased despite an improving economy and low unemployment rate that allowed more children to get private coverage through their parents.

The study blamed the increases on the Trump administration’s repeated attempts to prompt an overhaul of publicly funded health care. There were major efforts to repeal Obama’s Affordable Care Act and cut Medicaid, and the children’s CHIP insurance funding also ran out and hung in the balance for months before Congress extended it.

“There was a lot of confusion among families as to whether these public coverage sources were available,” Alker said.

At the same time, the Trump administration slashed funding for advertising and enrollment counselors to help sign people up for these health insurance programs. The country’s enrollment decline was not just in Medicaid and CHIP, but also in Obamacare, or the federal marketplace where parents can purchase private health insurance and often receive a subsidy to help pay for it.

The report noted that many of the children who do not have health insurance are eligible for coverage but just aren’t enrolled.

Central American Migrants, democratic party,Uninsured
Central American migrants begin their morning trek as part of a thousands-strong caravan hoping to reach the U.S. border, as they face the Pico de Orizaba volcano upon departure from Cordoba, Mexico, Monday. VOA

‘More of a fluctuation’

Ed Haislmaier, a senior research fellow with the Heritage Foundation, a conservative think tank, said the figures were statistically insignificant.

He did agree that there were dips in Medicaid enrollment and through the Obamacare marketplace, but noted there’s no enrollment cutoff for Medicaid, meaning families can sign up their children year-round.

“It’s really more of a fluctuation. There’s no policy driver there,” he said, saying he didn’t think marketing cuts had any impact.

In Florida, the uninsured rate went from 288,000 in 2016 to 325,000 in 2017.

Refugees, asylum, uNINSURED
Honduran migrant Genesis Belen Mejia Flores, 7, waves an American flag at U.S. border control helicopters flying overhead near the Benito Juarez Sports Center serving as a temporary shelter for Central American migrants, in Tijuana, Mexico. VOA

Florida has one of the highest rates of uninsured residents in the country, and also has had the highest number of enrollees purchasing insurance through the Obamacare federal marketplace. However, Medicaid expansion in Florida is likely off the table for this upcoming legislative session. Incoming Gov.-elect Ron DeSantis, a Republican, is against it. His opponent, Democrat Andrew Gillum, campaigned heavily on his support to expand Medicaid coverage for more residents.

Also Read: Produce Industry In The U.S. To Step Up Produce Safety Due To Recent Outbreaks

The report also expressed concern that strict immigration policies and enforcement were making many immigrant families leery of enrolling, even if their children were eligible for health coverage. “We think it’s really this national unwelcome mat regarding public coverage,” Alker said. (VOA)