Uganda makes slight progress on maternal, child health-UN Report

MATERNAL HEALTH

Uganda has recorded ‘slight progress' in reducing child and maternal mortality, according to new child and maternal mortality estimates released by UNICEF and the World Health Organization.

However, the estimates released on Thursday indicate that the country still ranks among the top 40 countries in the world for high maternal, newborn and child mortality rates.

The estimates on Uganda are derived from recent surveys with data on maternal and child health, including the Uganda Demographic and Health Survey 2016 and the 2011 survey.

The former shows that Uganda had 368 deaths per 100,000 live births - about 15 pregnant women dying every day due to direct causes like hemorrhage and hypertensive disorders.

The figure is lower than the 438 deaths per 100,000 live births recorded in the 2011 survey, highlighting marked progress. 

"The country has registered good progress towards the reduction of child mortality. The UDHS 2016 revealed that less children die before their fifth birthday-64 under-five deaths per 1,000 live births in 2016 compared to 90 deaths per 1,000 live births in 2011," the UN report says.

Infant deaths also reduced from 56 deaths per 1,000 live births in 2011 to 43 deaths per 1,000 live births in 2016, the report observes.

However, the UN estimates show there has been ‘no progress' in taming newborn deaths (newborns dying during the first 28 days) with a stagnant figure of 27 deaths per 1,000 live births in 2011 and 2016. 

For children who survive the first month, infectious diseases such as pneumonia, diarrhea and malaria account for the most deaths globally.

In older children, injuries, including road traffic injuries and drowning become important causes of death and disability.

Maternal deaths are caused by obstetric complications such as high blood pressure during pregnancy and severe bleeding or infections during or after childbirth, and increasingly due to an existing disease or condition aggravated by the effects of pregnancy. 

The global target for ending preventable maternal mortality (SDG target 3.1) is to reduce global maternal mortality ratio (MMR) to less than 70 per 100 000 live births by 2030.

The world will fall short of this target by more than 1 million lives if the current pace of progress continues.

The SDG target (3.2) for ending preventable deaths of newborns and children under age 5 is to reduce neonatal mortality to at least 12 per 1000 live births and under-5 mortality to at least 25 per 1000 live births.

In 2018, 121 countries had achieved the under-five mortality rate target. Of the remaining 74, 53 countries will need to accelerate progress to reach the SDG target on child survival by 2030.

The new estimates were produced by the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) led by UNICEF and includes WHO, the World Bank Group and the United Nations Population Division.

UN IGME was formed in 2004 to share data on child mortality improve methods for child mortality estimation, report on progress towards child survival goals and enhance country.

The estimates show that more women and their children are surviving today than ever before, with countries making effort to provide safe, affordable, high-quality health services.

The new estimates reveal that 6.2 million children under 15 years died in 2018, and over 290 000 women died due to complications during pregnancy and childbirth in 2017.

Of the total child deaths, 5.3 million occurred in the first 5 years, with almost half of these in the first month of life.

Children face the highest risk of dying in the first month, especially if they are born too soon or too small, have complications during birth, congenital defects, or contract infections. About a third of these deaths occur within the first day and nearly three quarters in the first week alone.

The estimates also show vast inequalities worldwide, with women and children in sub-Saharan Africa facing a substantially higher risk of death than in all other regions.

Level of maternal deaths are nearly 50 times higher for women in sub-Saharan Africa and their babies are 10 times more likely to die in their first month of life, compared to high-income countries.

In 2018, 1 in 13 children in sub-Saharan Africa died before their fifth birthday- this is 15 times higher than the risk a child faces in Europe, where just 1 in 196 children aged less than five die.

Women in sub-Saharan Africa face a 1 in 37-lifetime risk of dying during pregnancy or childbirth. By comparison, the lifetime risk for a woman in Europe is 1 in 6500. Sub-Saharan Africa and Southern Asia account for around 80% of global maternal and child deaths.

Since 1990, there has been a 56% reduction in deaths of children under 15 years from 14.2 million deaths to 6.2 million in 2018. Countries in Eastern and South-Eastern Asia have made the most progress, with an 80% decline in under-five deaths.

Belarus, Bangladesh, Cambodia, Kazakhstan, Malawi, Morocco, Mongolia, Rwanda, Timor-Leste and Zambia are some of the countries that have shown substantial progress in reducing child or maternal mortality.

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