Safe Motherhood Initiative: Definitions and PillarsDr. Olive Sentumbwe-MugisaFamily Health and Population Officer,World Health Organisation

Components of Reproductive HealthSafe motherhoodFamily PlanningUnsafe abortionSTIs including HIV/AIDSAdolescent HealthInfertilityMenopause and AndropauseCancers of the RH Organs( Cervix and breast)Gender Issues (Gender Based Violence, Obstetric Fistula, Female Genital Mutilation, Male Involvement)

Definition of Safe MotherhoodSafe Motherhood means that no woman, fetus or baby should die or be harmed by pregnancy or birth. Safe Motherhood begins with the assurance of basic safe living as a girl and a woman in society. Safe Motherhood is founded on freedom to choose when and whether to have children, and encourages active participation during health care. Safe Motherhood is founded on freedom from discrimination of any form. Safe Motherhood values the girl child, respects the freedom to choose when and whether to have children, and encourages active participation during health care.

Definition of Safe MotherhoodSafe Motherhood implies the availability, acceptability, and easy access to health care for a womans prenatal, birth, postpartum, family planning and gynaecological needsSafe Motherhood requires involvement and commitment from each community and the nation to fairly allocate resources that promote the health of all women and infants. Safe Motherhood means: social equity for women, maternal health care in Primary Health Care, Essential Obstetrics for all and Family Planning for all couples.

Why is maternal mortality an important issue? 1Pregnancy is not a disease, it is one of the most important moments in the life of a woman,perhaps one of the noblest achievementsThe birth of a baby is a moment of great joy for the mother, the father, the rest of the family, the village, the whole communityReproduction is key to society

*

IntroductionMaking motherhood safe for the worlds women calls for national governments, multi-lateral and bi-lateral agencies , non-governmental organisations (NGOs)and civil society to make maternal health a top priority There is a need to ensure that the necessary political and financial resources are dedicated to this effort. Safe motherhood is a vital, compelling and cost-effective economic and social investment. Promoting womens health improves not only individual health, but also the health and survival of womens families, labour force and the well-being of communities and countries.

Source: WHO estimates 2000The Health of the mother and newborn are entwined

Chart1

49.183017465143.159179111587

31.384062128535.35987284339

16.509691987718.181741467619

4.72163068175.39020533582.7

Stillbirths per 1000 births

Neonatal deaths per 1000 live births

Maternal deaths per 10'000* live births

Stillbirths and neonatal deaths per 1000 births

Maternal deaths per 10'000* live births

Sheet1

13

4

Sheet1

4243.1591791115

5335.359872843

7518.1817414676

995.3902053358

Skilled attendant at delivery

Neonatal deaths

Skilled attendant at delivery (%)

Neonatal deaths per 1000 live births

Sheet2

9799

6553

Antenatal care

Skilled attendant at delivery

Sheet3

49.183017465143.159179111587

31.384062128535.35987284339

16.509691987718.181741467619

4.72163068175.39020533582.7

Stillbirths per 1000 births

Neonatal deaths per 1000 live births

Maternal deaths per 10'000* live births

Stillbirths and neonatal deaths per 1000 births

Maternal deaths per 10'000* live births

The burdenFor women of reproductive age, pregnancy and childbirth are the leading causes of death, disease and disability, accounting for at least 18% of the global burden of disease in this age group.Yet pregnancy is perceived to be a normal event

African countries with greatest numbers of neonatal deaths

countryRange in neonatal deathsNumber of deathsRange in maternal deaths Nigeria1255,5001RD Congo2130,9002Ethiopia3119,5003Tanzania444,9008Uganda544,5006Kenya643,6004Cte d'Ivoire742,80016Angola840,1005Mali936,9009Niger1031,7007Ghana1129,20024Mozambique1228,50010South Africa1323,00027Madagascar1422,50021Burkina Faso1518,60011

When are the world 4 million newborn deaths occurring?Daily numbers of death in 37 countries during the first month of life - based on 38 DHS datasets (2000 to 2004) with 5,763 neonatal deathsAbout 30% of neonataldeaths are on the day of birthMore than 70% of neonatal deaths are in the first week ~ 3 million deathsBirth and first week is key: when most babies die when coverage of care is lowest for mothers and babies

Chart4

26.5292553191

18.5283687943

7.9233156028

8.7433510638

3.9893617021

3.5239361702

2.537677305

8.0895390071

2.0500886525

1.2854609929

1.7065602837

0.7535460993

0.8089539007

0.6205673759

2.9920212766

2.6484929078

0.3878546099

0.4100177305

0.4654255319

0.1883865248

1.3741134752

1.5957446809

0.3213652482

0.2548758865

0.3546099291

0.3324468085

0.2105496454

0.2881205674

0.4321808511

0.2437943262

0.5651595745

Africa

Days of life

Proportion of deaths

table_builder

Reporting of age at death in days:012345678910111213141516171819202122232425262728293031+MissingPercent early neonatalNumber of deaths 0-30 days

Period in years preceding the survey:0-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-19

Sub-Saharan Africa

Benin199638423531146475036281621818151162192417107091274321111125396137834314683211119435010301336642021248023272010313206685524011020102300112010012442121412720227-----1300322127021140211422317102141112500101001017869.369.969.771.7189245185140759

Benin2001243430121007880625127110121954722322558510131264011913841454619102158344725183151105553182020421047311051402757742300101010010104510001030142210501102-----1110310012-----20002101020100102125010010101278.982.479.772.179202224208128763

Botswana198826212147213775327982256627211181123433133110574331801001001132310602013-----00101339015-------------------------1000101001----------01001----------00101-----00101---------------81.37674.67877.571646829233

Burkina Faso1998/9958433022152323530191168251215612419271687171798511114191862715151552142518147112887351749204313929322184944222616157131564156882742028341210320264011659432138531902125120142111544131201001121048011102000232421110102-----62.558.960.955.859.7253284233203973

Burkina Faso2003741048266327494543331703150272413119463629130162513126616232297011192886722412225111118121343310532111810174536201126411349572517141495451010329332192401650005120033128428190313215211443011300031461121101228131464431722004224210-----0030367.163.668.264.865.73204913692811461

Burundi198726242414892220101063796326111686411265123683118711602414172010611101401023023061000121015-----1317684441005---------------00101-----73632010001-----01001--------------------0010101001----------67.866.862.358.364.813514010162438

Cameroon199131553620141132324218110910114012127738610532449662458411871124115354101023307313411021030100121003410652643007-----1010211103-----11002161210----------01102--------------------0001100101-----0011172.773.167.974.571.911117113493509

Cameroon1998422427261203248302613616171713639151184273531741247266713181115149490113613149455115203041351100010156962626131113004101033440100100103116350070233711104----------00011-----20002-----1010210103-----75.368.465.573.570.5154185144116599

Cameroon20046378635325745605443202234014169323916125961037261414964368932618352521100113052231831347271120421115200021161163414038003031002302102-----02327344214-----10202010110203510101022140010101001-----02204-----7974.472.174.174.9228294233189944

CAR1994/953747241912639432715124243323888132512126217595365767255351142726169773353132511101215910023-----20204111210740165114110130110211214012031000144221201023-----11103--------------------0001101001----------71.271.768.965.770196228154101679

Chad1996/97221917147259675133211314132201233830331411515121795316171511601318161561375140301571513169531078103513171374901203472114160191691144012864291003403136120021111478332134341330003011023130642117100014010501202-----452314----------5858.761.358.359.13313502971991177

Chad2004244743111254066233015918372424103122818187617810943222212662151316105320362416951012473345772314810739230062212651107111843363144626-----1002301013-----642213023050411600112020022120501001-----223070030300102-----0002264.365.667.366.465.8231336217162946

Comoros1996203019208916246955166821455519623314421411378523351310311359184353152453141010210001-----021140231601001004261030401001438102500202001011111401001112260002210113101130001112025----------71.172.446.252.459.876105104103388

Cote d'Ivoire1994565039331776571562721933592721140282636141041419135516161584597111281759413715479932901102321511012144310913104151012845811743011103120031011200213242211654116111021000111002111030010111002000110010110001-----0200274.668.2696369.22823642851731104

Cote d'Ivoire1998/991520141262271791367171043359841031620412583217408113212116765435012010012101400202010012100310430184221820204-----00011-----0002233006---------------22004-----2000201001----------02002-----62.562.75778.9641361057257370

Eritrea199519321520871434192189131210104516331111715525183326141201461647334143120110202115-----001350002259401948184351231730003063312002023030635041202002-----0232703003-----03003000220020200101----------71.166.854.169.165.3101181111106499

Eritrea2002314223101053362341314114118114416351615826324157125529334212915201357344112123063454171200312238-----1084223696223----------00202-----0520631033191000100101-----00145----------02002-----10315022610-----73.673.162.26469.314823014793617

Ethiopia200017721014912766311912561623663263522517351654646207161118186118242310758191234240553631162319152461317373016132065422801151341032411512051419947436148381902235110231700246300242223212591122218156710428002020220407601310001500270370102120427221212381515790200271.165.361.361.3655927915874732443

Gabon2000423634321432739219961513684385452362141454321530014394623011131110210214-----002022000242361541005-----0100102002-----0010102216----------------------------------------00303----------88.483.979.479.883.51221188976405

Ghana1988221815863716163322271197330131312846861193497752881241236914126416985283222941409211150002212014613105340110210001-----11002-----0031456441902114-----01001---------------010010100111002----------78.569.272.173.373.3181182165105633

Ghana1993302514138239564122158810136379154533894324957122947121152015106025341411305243110-----20215102145125628001120100101012----------11013971017100010010101102010010100110001----------11013----------73.268.970.965.470.115318012778538

Ghana1998111167354234301912668108331311121248275216222292650132121215412751150011200011-----021030010176672700011001010001100101----------433010---------------01001-----00213---------------10102-----83.672.167.763.471.99311010579387

Ghana2003312219158753493627165691283523151295874482463231447311699683240015102252101400101020021100164842200011-----00011-----01001010011211500022----------10002-------------------------10001-----83.184.682.776.782.215513010792483

Guinea 19991929196739078736330330353033128283534241221618211066121316145517302297819372628109913610386771030881132920013225110103155732176161313473202702002114060011253111024131010124000111120410001----------00101----------00101100017570.171.666.5712823393022371161

Kenya198954503532170383524231211214106421410127434767235111812316291219137300213112152111531004003140100116138114710012----------00034-----0010152119----------3000300101----------10001--------------------67.579.670.270.171.7191149128110578

Kenya1993556060372123332381712012261210598813838523313313310131410151719126301103022161321701102-----1000115111154201012-----0100110001-----011132214100001110001----------22004----------0002234209-----0200273.573.576.373.974.4159179171111620

Kenya1998685252282001424241879135109381041283543271621015175180141315106441010202003002020010100112001028149941-----00101-----00101-----2000245321302013----------20002-----000115510112100303126-----0100175.768.276.877.274.215314414297537

Kenya2003818452442603129252010519715849185910429236196263172120486168393122802024253212110021010303003107742801103--------------------200021800910001----------30003-----3100410102-----03104----------82.277.376.682.779.7201169143110623

Liberia1986118956840321443431151231829171377282412208612167145078973167432046463521148977932444013232281110512205001022328268854022800404100460002203003301161187103600102-----00033000110001101001010020100100102030143213968.566.961.162.565.43413202441791084

Madagascar199246383720142284022595171811450131824388146534636216357418484945251664334120100102618100010011301103798428201861156----------010130100164331576311700011----------001010010110001-----0100101214-----011035658.45445.654.921523416897713

Madagascar19976052372717647365126159211417356131110740133412269542436792650474040177022373001421349030031200301011671216171976481001321003001010010151411238341811002----------201030100100011112141003491311639----------61.154.863.151.558.1267238208151864

Madagascar2003/200454814730213453630712010864299121412479591235551171502834364329143----------62109-----10103-----22641471617646-----10002-----0200214016555318------------------------------02002-----03003----------69.668605764.7192226187101706

Malawi19925037493717422572520124241530979152715136911816743557018886223223123219733441406621424401000022000231020381712205622306013041000102002000112121766922236021110002000111002300022-----04206000124021730003-----70.965.466.757.565.6191242222154809

Malawi2000125131977042481745242249444831241463443303113831211610791824251178912141651646141281949866286733197114425201251251832116193433161034331122002441501001102100122234121213196500301455101153008-----3101511304641314621091010823010001-----66.667.265.771.267.35125254042881729

Mali1987182012186945855828216630199641922131267101111639131414849131328106419433217111591353248301559772811146202031002326631741012834201020010110001-----3540120400401001----------322072000200101021030300300123-----0011170.165.864.764.966.2175296243143857

Mali1995/961251321017543313316411874490414955401853767514319924423019114374530261393342533516341736250226212427199171314114520232513811655177645220430668772845413420140121041114740531205005179864025621514511130216000332554170200203003103041100216551701023-----70.36966.566.468.26137856584702525

Mali200121622615812372311523512679555518069332336177674424925345322135203529231072258264014756755843231283742251321016165471132251583841317891233212104869325336143251622442121302643301021407341929790822113230160120321004616316300360100130305012038543211311715311068.172.366.571.669.774910327945093083

Mauritania2000/017668564224258463329166221081454141910649934522671112556662341317225711315737322814240290002201012-----12159555521--------------------052310231171000100101-----0101210001-----010010100202316-----0100186.178.273.263.376.2221205175161762

Mozambique1997931561078343990441526175692019181263147219107129144383181464065311542604515161783119435012464115100010320520102974222358219----------20204-----22217239317-----0120201607010011100011-----10113041056334245-----331077668.766.682.872.43994342891761298

Mozambique200361104695528955847244255377049181746147413518310212255819241612701015182062579776703003174933964423871012623027540717000661518221771143114106912003-----31004-----387927111142280100102002-----1011301012-----301042211681111332----------63.462.165.156.962.13975884403331757

Namibia19924454272114623231715791298938644317102373810124001613166741101241000204105-----2000200101545418---------------00011----------11114-----10001-----00101-----10001-----1000113116-----1000176.577.377.577.477.11221287768394

Namibia20002948302313020126846357418536316162513020362112610781338-----0100101001---------------621412---------------20002-----00303---------------10001-------------------------0200200111-----76.586.281.973.479.978896265295

Niger1992476325251613742492215017311777228362011956231695381581041152314156624281919901924201376105114308161064104117564621113172542201410131256263351113500810034141067151084179482801406021031100345109-----430070111311116545317111461142-----53.954.454.150.753.62944282751961192

Niger19986448361816639805834211292721241012032242197121917856181917197318331517832831171490201276451211138447128935324412597324101473342927271799710522424118423091241901225101079361015563521104241171301541308200130022406219211260325910001-----55.459.159.359.158.23604373182371352

Nigeria199010463544426542462418130302835171112439262711729301717931424149616816635224232261221022137523148732193417211165145025121371618201467497424013053001540138-----974323859830210030100100202301141010301012223512100016613631-----1220470.560.65959.762.83523943142321291

Nigeria1999 (1)46522915142452831201241199534151512125416665331510107425125729172012105911441029117332448321721025220040111339782721047022040001111103111034014933311000011010010211410102-----010010111301001201041540100030370.466.570.758.567.2217198145122682

Nigeria20034971453620078825134245212617137726261914851511910451013231863161294416131610456841195867262348172710108641180020219912125151004190711100012371109-----2461121210653300101000111110300202011020200202003140040622104105222-----74.170.470.970.471.52893422451821057

Ondo State198677001423260150750012741012450097300103201681600242301621003220041000102013-----5100631004-------------------------01001------------------------------10001--------------------70.765.81005068.1827914166

Rwanda1992378680212241930261692203116138035362819119169874171510537777526283323181023121363322128255113200132101400404161614115769472600101-----01203-----2322107101120-----100010100111003-----1111500101-----323211----------64.368.769.961.366.8219313252140924

Rwanda200012614291704284361402917328282412912230262110013161454861425271252322365332301512155426743115645419411170223602002171512751134110-----2001311103-----23038129643000101-----40004011020100110102111031110312216111033310871.571.671.971.171.53484152772041244

Senegal19861177631413728171231815974916221396081494351891124010594281830129691819131868451042310792282102524028100012533131010943322116-----00101-----230492312800011-----0001111204----------020020100121003000110010161.653.758.54856.3198203147102650

Senegal1992/93393428241252124261889201710956162418167437832192391051141717856162418167472423146861146274752182111523005041053321912128739-----1010200011-----58301644331420103-----030032202600134-----2000201102333211023161000163.25760.760.360.1193256191146786

Senegal19975244291514031322817107222019117129281920961711944010161454612201220631619231371181677476811113566842311002214285021801042162015141059120131200300213100123312993411700101011020110210012-----1120410001000110100101001-----65.865.660.56263.8262261213148883

South Africa19981221171667281933261051411111045477624414311263010251097467250033640037614113-----10001001017835230104500001-----0101201001210032241900203----------10001--------------------01607-----1102468.476.872.269.571.7969110487378

Sudan19908783673927646373517135171781052173213157791222251487635101496393534302712651341364361911173225211923016120143311866341921014210141010200303322291200311136101020211403216-----00101002022110413206-----0100169.473.868.462.569.4288275206152921

Tanzania1992495431251606958542720826362421108322218980147633171214245391184239302613808521605821508151411002120141001230151510691431800202-----0130401123311161075224-----01012100110011210001001015742181110492354414541140002265.560.562.559.362.33093182291541009

Tanzania1996476358271953540332413220182022801721151367713452976122286434162642302011815511122307141061020321014100022224191681511210100012200312024210032210443701530003-------------------------515213-----15118438000331000158.96264.167.162.5235268225144873

Tanzania1999395114141182621624771014343111813241301612228156113131991051015172022601101-----02103200021299333-----0100100101-----01001200028622180100100101----------10001-----0413801102611512401001-----65.365.147.968.362.91371617072440

Tanzania20041038651452854932432514827261988014301411698951231644156672211725222085521192123721204-----03003100012618171070210460001101001----------0060699763110012-----20002010020100200101550090210264351803104-----72.772.970.265.270.9285267203149904

Togo1988414741221511923511586544198171011467773242822145331129496286836231550115313120010103104002134020668231903104011020200210001011131200300101----------00101-----01001-------------------------72.772.869.97372.212115110374449

Togo19981191381175843241453022138714208482815202387815733511678317652211181093912710433411284562171110222115010781510727582243309100027210901011132160232802002-----1000100202-----00202-----0100120013----------81.282.781.177.281273290253162978

Uganda19885960362618234373412117182158521125141511213116433801129394243527211295111261162902124120020010101001132146443020520002-----03115-----020021032216-----30003----------00101-----00011-----00022----------68.172.873.967.170.821422914789679

Uganda1995698262482612632282411018161395512181024281165316342158622182726241997271222343421404117010011020431206691613441020322318---------------102031500701001-----210030001201102-----13003010013100400011-----72.971.264.369.269.6202235194133765

Uganda2000/01929559432894127261110519151310581012118418795295720134424142731161689112054163143123920002100120210318181516672201508019-----11204001231000133218-----1000220002-----10001-----020020010102002100011000272.570.171.364.870.3247239170126781

Zambia199263411221138402417585302110127415119742169923612762282322931403019120123051020320125001012111610023242317467011021001201102200020100101001161077400100100011-----21003-----1000121115100010233810001-----67.457.548.755.259.326420213394693

Zambia19965443422115938331514100231810176922161756071174288651205311112933302711921306211366202910001231060010136292115102001010100100101020021000103115101111840-----10001-----0100101001-----13014-----20519----------62.859.156.451.858.5249219174122765

Zambia2001/02 (2)604234261622320171777211314351101313743810292973331511259533323201293010433107411291100200213100022819109672010310001-----1100200101-----14106232----------10102----------1000101002001010200200101-----53.358.263.866.758.9244174135103656

Zimbabwe19882819181479211618106589572957421846131446011100202721136472111512115011021000103003-----6121073501001----------00011----------13341100011-------------------------00011001011200301001-----78.757.861.562.765.1891097859335

Zimbabwe1994243031211061417201163935825655723321393232107323151112611400111300101111040001110001-----611973312003-----10001----------0300345721900101-----010120100110102-----11002000110003310001-----7162.172.166.667.994989582370

Zimbabwe1999342615209625131535610573242713131210520003101021166164020013----------01001----------883727-----00101--------------------24106----------01001--------------------0200202102-----1000175.770.277.954.370.5100765254282

North Africa/West Asia/Europe

Armenia200071169321010179463101052906651724411230215020130352100110300011643114100010200201001-----02013011130111401001-----02428--------------------0100110001-----01001-----2100302012-----68.967.274.775.471.535646142201

Egypt198850613917166534445471892229211890232332261041491564519341714841927191277761391291194636642184493217151110430003322341214141121261214142514671110414118113270100181177330323811013-----00101244414110022200400303-----10114----------6051.247.343.450.43324433963271499

Egypt19924467633621048473938171213021158723432627120911943216101222619171915605717212311046324100161071433371892532231024551723501055942352623156931217010340211401103147618100235121900022001027531160001110113-----000010350902002-----60.647.945.847.949.72834684103271489

Egypt199556867863282561086651281293041291293741273113614162317691419312792101526358555130162154501991073447682461012736587222684726021361067141218222173132185332121142830003111412125024208234413-----00023326515-----0100101002-----20103----------62.858.452.550.755.53445415544981937

Egypt2000484838331675095765227224243032110413728301361312171355412129374625185343791331584134471024144716910416382424112456174123100026810201628740430732017012030010155118290001103407020020210312238100010123510002201041101310102-----67.260.853.342.254.42713834274441524

Jordan199024221013705049292915815161512579221110531035322198443404059151820217420327300476455191251831004330065110319649222031275020604015001022641130211402034-----10013100010200200101----------00112----------71.169.854.461.665.1178177138124618

Jordan19972514231173302136241116131353867910328684267153152103611912104211316200023442133121731004010025122101332920103110020103401001232410020020001101001-----12104-----11203--------------------0100169.963.574.970701209812686429

Jordan200212201915661522272387151513186112144535104512058011413004714963621205110132310701214211150011223017032171110301101-----00022110232110301001000011010100011-----0001110023001011000110001-----75.373.67574.574.5941179183385

Morocco198731383730136343834191251517141157263628141046121183788332261068303443373514913191665447301486802251231124221034119455418202524148302204332081010210102111711544442111113381010200303020240100111013310152400600303----------5151.551.254.451.8247309260171987

Morocco1992212524168632282323106761712421523281783681217107322255810281725303610811169114723117448117101131234100110235521511211816661121500011112041112562551811002201031101301203110351000110012002241000101214----------58.95452.84853.3163189197171720

Morocco2003-2004 (3)4649717424027212418905813833222126249384610294485212179198213123831109829121372536160120314251120002124299192314661102312104110130121487105292203711237210031210503025110023030600314--------------------71.556.361.464.963.1159192252228831

Tunisia1988161791658253427141008977311218198577536213675216442161181612472342110115744321342118222282000201001780621101021000101102-----261615-----100010102320002010120010110001-----0001100112----------65.87170.458.666.811713110899455

Turkey19932725132591243829441359161111459242218724206126895281333106282321790311422228649928011240402601348210142157832015170123601213100014131919551210410113010120012322418-----10102120030001100101-----1000173.558.851.357.959107198168191664

Turkey1998192722269420202714801415410421271315477251152303820136211616351010100213026514000220311511113-----4569251100200335001560100113329-----1010301114-----01348-----0013401101-----132410-----0200285.669.464.556.167.688106110127432

Yemen1991/92536864362216093543924518192211692024181678121259385773213681191941251410078472706018519753631105077317234111111614115215322287710416210031011320002613252622308101350100101102052070100101002-------------------------68.75963.964.963.42493892771741090

Yemen199787108807735289160100864363947313315046514545187101413114815201714661071283723535452182510151142441514112120146632341247662300202171915166730443226132420171000113026030031220312488366723351110001120310414821401001001012021500123245212033161101469.865.959.160.963.94256195024511997

Central Asia

Kazakhstan1995313713407315337417062412022150200200011052070102320002013162000210001010012010301001----------102031000152108--------------------20002-----02003-------------------------41.653.86786.66128273121106

Kazakhstan1999171726117167141037461718777526122053300622004201150210300101302370010101102----------00213-----0110101001010112300500011----------01001--------------------010012201520102-----8379.584.282.382.349546041203

Kyrgyz Republic19971187834182412660611752986672754331515351501203751014002020230400223002230201300101-----0041502023----------22003353515---------------------------------------------0202400022-----79.777.269.570.774.761785848245

Turkmenistan200012111885023222620921613413451719181367410492764371940227139493510202212166714180041503216013150100163521621014220260220301001592419-----22003100011100224005-----0111312114----------01124-----66.261.973.572.167.9123128101100452

Uzbekistan199643111011131695031063226989317032128228205010600101111033320702025----------002021000110203100011010230205-----20406----------00011----------02002--------------------00223-----7881.272.590.479.557465335190

South & Southeast Asia

Bangladesh1993/94 (4)799485553145975684925128213025104294735331441620261679113847231191032232994277176552291630262910011232013676181174210158841776103031491138591111361026201975583117215413464621184114275621313842861256291131604318630213112160420600012244010103274687253100463.853.556.853.356.33646125534321961

Bangladesh1996/97 (5)528065592564667595923172221116128373443142141520206819202618837193228872241504215431520155472018650714131347710793371512104515431379652891218145273351736161657542131116265721441752952852020125100110152851106130054125123101601102125412-----60.259.456.359.858.82874384573981581

Bangladesh1999/2000 (6)7882847932349684854219111812226330494429153131913146013202419768141828678284547128101915176039171846486143264106269441329399727739422810713384663195255185310322314311255821168142906841811216002132644150101201405212050313810001100020011171.266.556.856.661.92834064304331553

Bangladesh2004 (7)92104988237545484359194131419125829434439155101621176371920267311518154810243131965131610441346133968263381327155122355731947111033886729514313587322512195312112751158444205356191021401315031261002323501012238014270101201102-----72.268.665.16567.42853654013831435

Cambodia200054727255253598886602933638262712636484230157111035299171611538827243271677624610581337268925461010302101515461510123122061720232181003032221722105002027121023100101-----00101100011641120100121205230162000225131143108-----7065.462.356.963.53034283993411472

India1992/93 (8)7468777536643040434491456349173118428222922291629133127124111341501891511556441191692131716731312261881817261151851611365961621961791667036465646025383136130109458415553291794965626824323272224961916332392104174175123576730371691209176531940233211531186296587728230626282923106241828208943621511955301727241885446520363214822192511019161157617141047010011203569.867.265.666.967.3294138153449296213167

India1998/9963383868562027764055465073581816170245258185859246289246247102996121146125487116153160178608111128147147533861191421204679815314512652333665656212518189107329363334231273852595920813333218971614179561111461491165214822195491112104218191412635711133534484433158132921279012152019652053106119431131017545231382253134410221317112214713144801011122432117472.769.769.671.4240231943082267411351

Indonesia19871723171471338968512421812231063825272282311711321819152172191316136141888060269811113336168938518108416810428438519400592110619111018744230380131502316002025137429251193422111010211002206613020022110400022-----22318----------52.448.75053.150.72223913472681227

Indonesia199110011411410843783889655322163236231062629414013615241224761631354112113332022887112213213145610751435121217155723162110713651125912116382121597810341117332283111363074143041911114101988463451130314800022000119482230140510506322290110321210832-----010015958.554.854.756.64585986445722272

Indonesia1994123144151117535109105105103421293620191041949383614215914744202932241053217422211242112144125423153162863151216165916637298862361612416226781211119810491118167524611120512723611182629401571462249715820203053010410405337922010011684195226140021222207-----0122567.961.756.651.9595106307116312481

Indonesia199710211393934008410583743462232254712617173527956149837151818378841221377441599586281411893374171442813195460052718521701451011111374221712326440117541515142181113574652117331411003-----11012223111800213100010812122100301417----------71.366.258.162.163.83504704875221828

Indonesia2002/20038783989236164115967434914345328128281337231001311910441614412462849231740408418211170191451623781617125311114145716033612014141139110315280112421115030250300331444252302810001101020011113921400001014490002200033-----0411217-----77.269.770.560.668.92893994264091523

Nepal1996881301161084423950533517824291516843932351712312191313571223222077102226258318222419839181917636121613471071393985552361491644786626186620161211747512442537113245634186141122945205531149786303321914218224193120631115001120110100212-----0110163.865.16464.864.43524694403601620

Nepal200192124131101447223837301289201815622035241594151781352151519146291016134812141294681715135375147333913126107810355136529156618455822414131142654519135312141001503036312221912014596020251310111024213101111422116223071021300022----------68.964.866.767.766.82643993782961337

Pakistan1990/914773652821368756027230173618879254935811782214115417308116514242212722021292191134213198738103241618186598464211119929350311323715151511344910162616211032411001124611632601068312050100111002411280130420002-----00202263315-----3000363.364.763.851.362.13094763492031337

Philippines199334444824150383144281421998743517191152858325115773026211120142920821140604151016151331026013151210443401002102-----02103101022000202203130260010100101----------000111001321002-----1013512002-----75.27573.567.273.1155157185122620

Philippines19983549512716322303624112128873518131475373341861476325023117142522670202513411024309-----2012501102435214124280003300112001010401420002021151000210066-----00101-----10202-----0010101022----------827770.663.973.4129153172123576

Philippines200332233430120264626221208510326119121042511210714415210148158134301124211030114550106102021101354301116007010010010100202-----11114021030020210001100131010210102-----10112-----0300300011-----7671.67776.575.212112111195447

Sri Lanka1987132313136311242012664159103771381139423412872622003373423121020402227021040010101034-----6323140513900112-----200020000102113013372110300001-----03003-----1000101012-----11104----------74.374.773.476.774.8641117876329

Thailand198718293122100812173472149101345513102553626317357102515152236172924770323921114134111914116211040011203205517416-----01102-----100010030310113----------1000100101-----0001104104-----02103-----0002274.665.563.268.867.173115152158498

Vietnam1997142314186914271313672103319912933311316544317030367615103830407011021251800101020790101200303021480100103046-----2000213238-----01001--------------------103040010100101---------------7778.557.359.968.4591028372315

Vietnam2002151727218061828217425772100528100110307911136023101501102120020365140010101415-----0101211204--------------------272111-----0001100011-----01001-----0003300202--------------------89.270.877.573.475.827628884262

Latin America & Caribbean

Bolivia19894966434119939393528141162319177516101614555838241049225013610282045382112471285312333107410120001251501101011101634321065829-----1210512215-----45201019341600011-----4000410012----------10102-----10001-----0100164.360.6657064.5211267200170848

Bolivia199462687154255334619331311529221783151514166056592561012836348520302937221175141453710237333090001142321000001144953291091442021034021622216-----033714383215100232110512003102240110220002110022010311248----------61.768.461.866.964.8222262245213942

Bolivia1998403433221295572545123228262698914212111684993256685255362153441382914134741811338163112-----2320704115151268427713936110130010201024-----224615108232302002010010110210102----------12205-----144211-----1020365.363.363.159.263233270247174923

Bolivia200378129111773954875105793062024513212731363219118512943012171815613394193574566222631108220035913451201013121101311003914221357111021216210001010131111310045143412131598450221400729000110001101001100121221610001063110----------71.368.170.260.567.52764344773781566

Brazil1986 (9)141423106135333126124913113361381163852331324128333210665320575320214391332902327221050051632329447319213051353112110401102232170010123107002130010120113-----103042210500101171214952366621-----61.158.654.160.458.213212915584500

Brazil1991 (10)11182313652456494317236511591114641114152140116330493610929221152102147421411122270431830327000333413173742041021371240217112150231620851400011-----10213041060100101001101010100101114735319-----63.674.758.550.661.689144158143534

Brazil1996263541321352229252510037128305151063681642012238152210269725145414011342236120113514411002114041284491181124820014043613010340232600011013140112401001000113210601001100121000101013140272022680.56966.561.368.183136146133498

Colombia198613161717641115612443364165676256131100022412216000551494184001501113000112010302124-----01326-----110021000101001201030110210102010011001200101-----00011-------------------------75.678.769.771.773.851566260229

Colombia1990142922279187811333524145318161320604217221151113621204181201500011011021000201012-----003030001100011----------0211418001010012300404-----1000110001---------------01001-----1000182.37161.474.671.438756069243

Colombia199530332329116172422147799632798853038431854451824219101245316151005610001-----0013311114012042026101001203003111031000115208-----110020001111002001121000100011---------------226110-----81.384.783.570.380.2931068286367

Colombia20003238332813091057313844185104929124171227122211630003232391200231127-----11013100010202400212-----00404----------11024210030010111001-----00101----------00101-----03003----------80.382.483.583.582.466866368284

Colombia20055992948332829384328138231311855121726237842541549712180141321015174748230634143160113131833341303014040041810321211042120502057000113751160401501416201362010311003100121110311103-----01405----------81.873.278.58078170235238188831

Dominican Republic19861220258645858423319111185741171114125510692271011105364723163455175104219417921022151213891441842309412195230911013251193110500303443314010231011400123101230010120102-----011123002611012----------70.377.371.163.271.2174170151109604

Dominican Republic19912419242592219173380541142411108295831251211241181650134152122313921014215513021143000323409101031112600202037090010212015121140007801539----------22004-----01002-----0100100203----------74.669.865.878.272.39188109123410

Dominican Republic199633242313922021202789818111653122111105445401272261723751722138144311423110210472102500023400041013513329020024002611238020022112630014108190110220013-----000011000210203-----00202----------73.481.972.27174.7118113107109447

Dominican Republic19996427190294150010110146-----01001010010100102014--------------------03003---------------10001-------------------------00011---------------------------------------------87.754.297.282.379.1815131854

Dominican Republic200271655139227594754592202717201175123627219671162044761015383717181061153372711712761611248112046222124010613105541211301141321720315121151061803115111361100200213100120100100213001011021410023001010111379.884.975.383.380.8234223225208888

Ecuador1987-----374036321456127934169101146344314458421454215891411427655231151810236104271212601001011139111374002002231061002301001002242110401326100011010201102-----100011010202002---------------65.464.155.661.661.510711712499447

Guatemala1987 (11)475237311672634312311412171544861112736372113798529213066573213833172432112321814218131160110210001152252410001120031001201001532313100011202510102-----20002-----0020221003-----10001----------68.777.180.676.375.515017013493547

Guatemala1995928594773484960543419813212066010202095976522013101174103341049106295131884431331032221010001117090020211113109151550101013110516321114106585133111113314180101320114321050010100101103040303635201030037020027875.47270.374237272287198994

Guatemala1998/99282253389381919159134119263569238411140793190101226361781110332003144321901001030140010122003411542311103110021001200102154616010011001301102510070100100011-----50005001012130710001-----68.556.859.47464.71161108895409

Haiti1994/9519182013701216201664386523111215745381719444922477524913141450111912196147421724131112238221050321621205711138391102411215020021001210102101021056223010010100100101102031011321025101130001123117-----49.649.852.450.550.6115148139125527

Haiti2000181517958515254271852018149612930211999686323106134341551123353412398952824137013433106110971729311631901224482000314812209502001247312272100320126221042120431312204800101-----031050020201001001020002200404-----0100172.852.248.236.852.2207257282200945

Nicaragua1997/982331292610941455137174111867422117161570387423381214222612335617613783504115034292343121324903215100015101083221003013251422102011411237-----34712252020410011101021000100112011120001101102000112020477.670.566.463.469.2135186168153641

Nicaragua20013238575017710203912824251223121485386013103497228424197418213637201341900347301154013831239000125271328011121131500436001111200400101179218-----1120425211002014000330011202113-----000110100170.468.472.663.168.6107120166147540

Paraguay19901719101360211515961660416455417231073230841039354922321282151922206032170100103014010014022900303000110010101001-----0100111339201030130301013-----0200200112--------------------75.465.354.858.264.176796359276

Peru198613141211502922201889101196368971253213943401111619132061150961193520136221050010110113021142288208988330010101012-----011132200441321001034000110011201012----------00011--------------------61.356.457.343.55511111010392416

Peru1992475654452024452414318020251214721622161973674320613663137742112252118751121211366315111376522131171121601203465318102026157111114314082430911103874321340191310510304100123520902114-----00101-----10113----------66.961.955.766.662.4214293253201961

Peru199611610610078401678969682921635242610235443228139581483610121312482931025233727331201920261581834217571032422151044111016119558421301732271070121411114101031211554842145134262331832127100012410831004111032101402103042613-----003036769.56467.2673754364003441555

Peru20006992110108379365765532112227253110514213627989161154231012133822105191516492410412181524681145104312322210362240841229961593910321239931200213216434313020130119323158519122814002021300512519103040330703611010327611993600022-----66.863.461.762.563.22323564383851412

Trinidad & Tobago198722181115665745212103634551711136031041202521317011131010210102-----1010200011012140121420002--------------------30104-----10001-----00101-----00101-------------------------75.69061.186.878.645403638159

Source: ORC Macro, 2006. MEASURE DHS STATcompiler. http://www.measuredhs.com, September 28 2006.

Reporting of age at death in days:

Distribution of reported deaths under 1 month of age (PERCENT EARLY NEONATAL) by age at death in days and the percentage of neonatal deaths reported to occur at ages 0-6 days, for five year periods of birth preceding the survey.

Footnotes:

1) Data collected for women 10-49, indicators calculated for women 15-49

2) GPS dataset is incomplete

3) The Morocco Survey will be a collaboration between MEASURE DHS+ and PAPFAM of the League of the Arab States

4) Data collected for women 10-49, indicators calculated for women 15-49

5) Data collected for women 10-49, indicators calculated for women 15-49

6) Data collected for women 10-49, indicators calculated for women 15-49

7) Data collected for women 10-49, indicators calculated for women 15-49

8) Data collected for women 13-49, indicators calculated for women 15-49

9) Data collected for women 15-44

10) Northeast region

11) Data collected for women 15-44

Source: ORC Macro, 2006. MEASURE DHS STATcompiler. http://www.measuredhs.com, September 28 2006.

All

Reporting of age at death in days:0123456789101112131415161718192021222324252627282930Percent early neonatalNumber of deaths 0-30 days

Period in years preceding the survey:0-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-45-910-1415-19Total 0-190-45-910-1415-19Total 0-19

Sub-Saharan Africa

Benin2001247810221011410435223150001020-11-210078.982.479.772.179202224208128763

Burkina Faso20037449311916161122113132417532513124311262267.163.668.264.865.73204913692811461

Cameroon200463452323614618123122111010-03-1001000-7974.472.174.174.9228294233189944

Chad2004244018121722152010414225113-10-6000020-20064.365.667.366.465.8231336217162946

Eritrea200231331416673931311-106--0-0310-0--0-173.673.162.26469.314823014793617

Ethiopia20001771193251161884033162545432003221210001502271.165.361.361.3655927915874732443

Gabon200042271586533011-0244-00-00--------088.483.979.479.883.51221188976405

Ghana20033153623764941200160-0-0010--1-----83.184.682.776.782.215513010792483

Kenya2003813119189628302110100----211--3-31-082.277.376.682.779.7201169143110623

Madagascar2003/2004544510995134--6-1-27-1-015------0-069.668605764.7192226187101706

Malawi200012581443431189649672131942401212055-31661066.667.265.771.267.35125254042881729

Mali2001216115516125202256281011881833214234820263030868.172.366.571.669.774910327945093083

Mauritania2000/01765822149654113200-15----0210-01-00086.178.273.263.376.2221205175161762

Mozambique2003615537611019105739825015141-3-31100-10-32863.462.165.156.962.13975884403331757

Namibia200029203510210-00---6---2-0---1-----076.586.281.973.479.978896265295

Nigeria2003497821261510166652280195007-21200100001074.170.470.970.471.52893422451821057

Rwanda20001264328221361236276400171-21-2120-400111171.571.671.971.171.53484152772041244

Tanzania200410349271481617522-0126200--091-200050672.772.970.265.270.9285267203149904

Uganda2000/0192411910854271432101820-1013-12-1-00072.570.171.364.870.3247239170126781

Zambia2001/02 (2)60232110871533341012821-10-14--1--100053.358.263.866.758.9244174135103656

North Africa/West Asia/Europe

Armenia2000710302300006100-0000-0----01-0-268.967.274.775.471.535646142201

Egypt20004850244113444341922401003005000011012167.260.853.342.254.42713834274441524

Jordan200212151512105172120202010-0120010-010175.373.67574.574.5941179183385

Morocco2003-2004 (3)46275228428112012191110821210130--71.556.361.464.963.1159192252228831

Central Asia

Turkmenistan200012231617464131260000622005-2112-01--66.261.973.572.167.9123128101100452

South & Southeast Asia

Bangladesh2004 (7)9245132910711105133154855552851001210072.268.665.16567.42853654013831435

Cambodia2000545936361198321024211117022070-011022227065.462.356.963.53034283993411472

Indonesia2002/2003876414281316217111481100102003211010000-77.269.770.560.668.92893994264091523

Nepal20019222920151591287310514461103152141221068.964.866.767.766.82643993782961337

Philippines20033226811572802051151000-1001111-1-07671.67776.575.212112111195447

Vietnam200215620101001000-01----2-00-0-00--89.270.877.573.475.827628884262

Latin America & Caribbean

Bolivia200378482031512335301011911101111300000111071.368.170.260.567.52764344773781566

Colombia2000329351123213-1100-0--1201-0--0-080.382.483.583.582.466866368284

Colombia2005592923124482403330012200300221111-081.873.278.58078170235238188831

Dominican Republic200271592712773107111641531211011010001179.884.975.383.380.8234223225208888

Haiti20001851202961015551312320824222230-00000072.852.248.236.852.2207257282200945

Nicaragua200132104126387310343050100101-120000-70.468.472.663.168.6107120166147540

Peru20006936221493215121422491011400110111001666.863.461.762.563.22323564383851412

23941672715789360318229730185116154687356270239353742171241442923323019263922519024

26.529255319118.52836879437.92331560288.74335106383.98936170213.52393617022.5376773058.08953900712.05008865251.28546099291.70656028370.75354609930.80895390070.62056737592.99202127662.64849290780.38785460990.41001773050.46542553190.18838652481.37411347521.59574468090.32136524820.25487588650.35460992910.33244680850.21054964540.28812056740.43218085110.24379432620.5651595745

45.0576241135

All

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Africa

Days of life

Proportion of deaths

Afr

Reporting of age at death in days:012345678910111213141516171819202122232425262728293031+MissingPercent early neonatalNumber of deaths 0-30 days

Period in years preceding the survey:0-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-4Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-19

Sub-Saharan Africa

Benin20012410078271104722851040114141910344183105182427351752301010511042502--1312--2212010513010010101278.982.479.772.179202224208128763

Burkina Faso200374327491703113119130166616701167221111143321145311213425175452939265513328113211411331121221461724210-----0030367.163.668.264.865.73204913692811461

Cameroon20046325745202239323596261443626181001528327142522113418031302--07314--12010511040101--02204-----7974.472.174.174.9228294233189944

Chad200424125401591810312761743226215532095103342314392626571136326--1303--613050602022501--270302-----0002264.365.667.366.465.8231336217162946

Eritrea2002311053314114441682615729312957312163171318--1023623----02--063191101--05----02--15022610-----73.673.162.26469.314823014793617

Ethiopia2000177663119366321735120716611875842401623613301654211532420547431902110706342291126718020401311570102421212381515790200271.165.361.361.3655927915874732443

Gabon2000421432796154382361451534323031214--022241545--0102--0106----------------03----------88.483.979.479.883.51221188976405

Ghana2003318753165635235872461441693245152401021162201--01--01011502----12----------10001-----83.184.682.776.782.215513010792483

Kenya2003812603110519491842919617248393804212121303102803--------221911----33--3412--04----------82.277.376.682.779.7201169143110623

Madagascar2003/2004542134512010299479235171834143----69--13--214746--12--0216518------------02--03----------69.668605764.7192226187101706

Malawi200012542481249441463413831791878951641949286197252518361910341224410021221212500451158--351461469103010001-----66.667.265.771.267.35125254042881729

Mali20012167231155555123361249251352010722147562312813210471183817832148253316221216410273490813260324616360135038211311715311068.172.366.571.669.774910327945093083

Mauritania2000/017624258166225414499226255234571137314290202--19521--------010271101--0211--010206-----0100186.178.273.263.376.2221205175161762

Mozambique2003612895525537174611831058197010625730033392382627517061571146913--34--32711280102--1302--3426832----------63.462.165.156.962.13975884403331757

Namibia200029130204631851611306261038--0101------612------22--03------11----------0200111-----76.586.281.973.479.978896265295

Nigeria20034920078245217726851545106316416456195262172108180219515190100379--212123301011302020203140104105222-----74.170.470.970.471.52893422451821057

Rwanda20001264284317328912210013486271222361512267156194706021751110--2313--28123001--44020112131316111033310871.571.671.971.171.53484152772041244

Tanzania200410328549148278014698231156211785592724--03112670260101----0693112--22020201590261803104-----72.772.970.265.270.9285267203149904

Uganda2000/019228941105195810418295134142789154143922120318672509--14031138--1222--11--020102100011000272.570.171.364.870.3247239170126781

Zambia2001/02 (2)60162237721511043829715195312934374912031228672311--1201--1432----12----1102010200101-----53.358.263.866.758.9244174135103656

Africa15381083451458230202144503107679833392723414211122487811191122151115281438

Source: ORC Macro, 2006. MEASURE DHS STATcompiler. http://www.measuredhs.com, September 28 2006.

Reporting of age at death in days:

Distribution of reported deaths under 1 month of age (PERCENT EARLY NEONATAL) by age at death in days and the percentage of neonatal deaths reported to occur at ages 0-6 days, for five year periods of birth preceding the survey.

Footnotes:

1) Data collected for women 10-49, indicators calculated for women 15-49

2) GPS dataset is incomplete

3) The Morocco Survey will be a collaboration between MEASURE DHS+ and PAPFAM of the League of the Arab States

4) Data collected for women 10-49, indicators calculated for women 15-49

5) Data collected for women 10-49, indicators calculated for women 15-49

6) Data collected for women 10-49, indicators calculated for women 15-49

7) Data collected for women 10-49, indicators calculated for women 15-49

8) Data collected for women 13-49, indicators calculated for women 15-49

9) Data collected for women 15-44

10) Northeast region

11) Data collected for women 15-44

Source: ORC Macro, 2006. MEASURE DHS STATcompiler. http://www.measuredhs.com, September 28 2006.

Afr_graphs

Reporting of age at death in days:012345678910111213141516171819202122232425262728293031+MissingPercent early neonatalNumber of deaths 0-30 days

Period in years preceding the survey:0-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-40-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-190-45-910-1415-19Total 0-19

Sub-Saharan Africa

Benin2001247810221011410435223150001020-11-2100010010101278.982.479.772.179202224208128763

Burkina Faso200374493119161611221131324175325131243112622-----0030367.163.668.264.865.73204913692811461

Cameroon200463452323614618123122111010-03-1001000-02204-----7974.472.174.174.9228294233189944

Chad2004244018121722152010414225113-10-6000020-200-----0002264.365.667.366.465.8231336217162946

Eritrea200231331416673931311-106--0-0310-0--0-1022610-----73.673.162.26469.314823014793617

Ethiopia20001771193251161884033162545432003221210001502212381515790200271.165.361.361.3655927915874732443

Gabon200042271586533011-0244-00-00--------0----------88.483.979.479.883.51221188976405

Ghana20033153623764941200160-0-0010--1-----10001-----83.184.682.776.782.215513010792483

Kenya2003813119189628302110100----211--3-31-0----------82.277.376.682.779.7201169143110623

Madagascar2003/2004544510995134--6-1-27-1-015------0-0----------69.668605764.7192226187101706

Malawi200012581443431189649672131942401212055-31661010001-----66.667.265.771.267.35125254042881729

Mali200121611551612520225628101188183321423482026303081311715311068.172.366.571.669.774910327945093083

Mauritania2000/01765822149654113200-15----0210-01-000-----0100186.178.273.263.376.2221205175161762

Mozambique2003615537611019105739825015141-3-31100-10-328----------63.462.165.156.962.13975884403331757

Namibia200029203510210-00---6---2-0---1-----000111-----76.586.281.973.479.978896265295

Nigeria2003497821261510166652280195007-2120010000104105222-----74.170.470.970.471.52893422451821057

Rwanda20001264328221361236276400171-21-2120-4001111111033310871.571.671.971.171.53484152772041244

Tanzania200410349271481617522-0126200--091-200050603104-----72.772.970.265.270.9285267203149904

Uganda2000/0192411910854271432101820-1013-12-1-000100011000272.570.171.364.870.3247239170126781

Zambia2001/02 (2)60232110871533341012821-10-14--1--100000101-----53.358.263.866.758.9244174135103656

Africa1538108345145823020214450310767983339272341421112248781119112215111528143857635761

26.68748915518.79229567937.82578518137.94724969633.99097692173.50511886172.49869859458.72809300711.85667187231.16258892941.70050321010.57261842790.67673086930.46850598654.0603852162.46399444730.19087280930.20822488290.41644976570.13881658861.35346173871.92608016660.15616866220.19087280930.38174561860.26028110360.19087280930.26028110360.485858060.242929030.6593787958

00.2668748915

0+10.4547978483

70.7124761409

Afr_graphs

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Africa

Days of life

Number of deaths

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Africa

Days of life

Proportion of deaths

Almost all are due to preventable conditions4 million newborn deaths Why?

Definition of maternal death The death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.WHO-International Statistical classification of Diseases and related Health Problems,tenth Revision,1992 (ICD-10)*

Where maternal deaths occur*

It can be done, and it has been doneIt is not a matter of money only MMR, deaths/100,000 live births 1960 1970 % declineMalaysia 250 150 66%Sri Lanka 260 150 73%Thailand 420 260 62%Kerala state (India), figures of 2006, MMR of 95 when for the whole of India is 254

Currently,Malaysia-28, Sri Lanka-47, Thailand-44*

Causes of maternal deaths: percent distribution

Four Pillars of Safe MotherhoodSAFE MOTHERHOOD

EMERGENCY OBSTETRIC CARE

FAMILY PLANNING

CLEAN/SAFE DELIVERY, NEWBORN CARE AND POSTNATAL CARE

ANTENTAL CARE

BASIC MATERNITY CAREPRIMARY HEALTH CAREEQUITY FOR WOMEN

Family PlanningFamily Planning is the practice of spacing children that are born using both natural (traditional) and modern (artificial) birth control methods. Birth spacing promotes the health of the mother, children and the father. There are two types of birth control methods: natural and modern (artificial). The modern methods are further sub-divided into short-term, long-term and emergency contraception methods.

Antenatal CareAnte-natal care is defined as a planned programme of medical management of pregnant women directed towards making pregnancy and labour a safe and satisfying experience with an outcome of a healthy baby and mother.

Safe DeliveryRefers to ensuring that the mother experiences a clean and safe delivery This area refers to both normal vaginal birth and other modes such as C/S and vacuum extractionA Skilled attendant is recommendedProvision of emergency Obstetric and newborn care when needed.

Postnatal CarePostnatal care: This is health care given to a mother and baby after childbirth up to 6-8 weeks.

Emergency Obstetric CareThis is urgent medical care given to a woman for complications related to pregnancy, labour, delivery and puerperium.Basic EmOC includes parental (administered by IV) antibiotics; parental oxytocic drugs; parental sedatives for eclampsia; manual removal of placenta; manual removal of retained products; assisted vaginal delivery. Comprehensive EmOC: includes surgery (caesarean section); anaesthesia; and blood transfusion in addition to all of the basic EmOC

Newborn CareEnsure normal breathingThermal care-keeping baby warmCord careImmunisation as per scheduleAppropriate infant feeding/breast feeding

Evidence from the LancetCause-specific effect of intervention packages delivered at different periods

Family and Community Practices for promotion of New Born and Maternal heathEarly initiation of and exclusive breastfeedingKeeping the neonate warmHygienic cord and skin care Routine postnatal care through home visits at critical momentsHome care for LBW infant -Skin to skinEarly recognition of danger signs by caregivers and prompt care seeking Antenatal visits, TT vaccination, IPTITN use by pregnant women, mothers and infantsFamily Planning Delivery by a skilled workerMaternal NutritionMale involvement

The components Family Planningexpansion of service delivery points;improvement of communication through community based and social marketing approaches;training of service providers to enhance technical skills and improve attitudes;guaranteeing the availability of family planning commodities and supplies at all levels;improvement of family planning logistics management (LMIS/HMIS);enhancement of political and community support and participation in family planning activities;improvement of record keeping;strengthening of the follow-up, supervision and referral systems.

Antenatal CareInformation, education and communication on risk factors and warning signs and symptoms during pregnancy.prevention and management of anemia;provision of iron and folic acid supplement;screening for pre-eclampsia and diabetes;Examination of the mother to evaluate the pregnancy;early detection and referral or management of mothers with high risk pregnancies;immunization against tetanus;syphilis screening and treatment;HIV information, testing, treatment and referral;prevention and management of malaria;ARVs for prevention of mother-to-child transmission of HIVInfant feeding counselling

Delivery CareInformation on signs of labor, what to expect and what to doMonitoring labour and documentingReferral if it becomes necessaryClean supplies / Warm clothingDrugs required for pain relief and deliveryCommunication with the family members especially the spouseHIV testing and counselingInfant feeding options

Post Natal care and newborn careInformation on danger signs , what to expect and what to doImmunization for both mother and babyInfant feeding options Maternal wellbeingResponsible fatherhoodFamily planning optionsResumption of sexPost Natal Clinic

Current statusOnly 48% of Women attend the recommended 4 times during ANCOnly 52% of women deliver in health unitsOnly 14% of HFs offer EmOCOnly 23% of women get post partum care during the first 2 days following child birth

ChallengesInsufficient awareness on danger signs, safe motherhood in generalLow status of women- decision makingInadequate male supportPoor Education levelPoor health seeking behaviorHigh/ uncontrolled fertility

Why we must take action and The costs involvedWhile the needless suffering and death of a woman when giving life to the next generation is sufficient cause for action in itself, there are also other significant social and economic considerations.Families lose her contribution to household management and provision of care for children and other family members;Children suffer most: when a mother dies, surviving children are 3 to 10 times more likely to die within two years than children who live with both parents; motherless children are likely to get less health care and education as they grow up.

Communities lose a vital member whose unpaid labour is often central to community life;The economy loses her productive contribution to the work force

What Can Be DoneEven in low resource settings, improving maternal health is possible. What is needed is a strong political commitment. Governments, international agencies, NGOs and other development partners need to make concerted efforts to safeguard maternal health by;Reallocating investment in health care to support the most cost-effective interventionsInvesting in maternal health care services and making them available, especially in poor and rural areas

Framework for Promotion and Implementation of Community-based interventionsInformation and Education Materials: danger signs, birth preparedness and emergency planMobilisation of key stakeholders and community leadersSupport to existing community organizations and structures: associations, NGOs, etc.

Proposed ways to accelerate the change of the situation Government StewardshipParliaments and similar institutions should step into the processThe importance of functioning health systemsIntegrated approachIntroduction of mandatory regular analysis of maternal deaths Active involvement of civil societyLocal research to inform the people and local institutions/entitiesAdditional resources and International Solidarity*

Framework for Promotion and Implementation of Community-based interventionsCommunity component in referral systemOrganisation of transport (common transport mechanisms) Communication systems (telephone, radio communication)Community-based financing schemesCommunity-based surveillance system for the health of the mother and newborn (birth and death registrations, audits)

Strengthening the referral systemEmergency transportationCommunication

The Safe motherhood day and commemoration weekAnnual events have been held in Soroti, Kamwenge ,Kayunga Mayuge etc.27th OctoberPatron is the first ladyA national report is usually producedWe are in preparation for this yearDistricts are encouraged to conduct district specific activities

For Change to Happen

We need to follow it up

Accountability at all levels*

WHO, Rivers of life

Thank you!

***Data from DHS surveys in 47 countries, 10,048 neonatal deaths. A very high proportion of deaths occur in the first hours and days after birth. Prevention of these early neonatal deaths will require improvements in care at the time of birth and improvements in care in the early neonatal period.*******