Progress in Global Maternal Health

Epidemiology - Person, Place and Time

Epidemiology -- Person, Place, Time

Identify the specific goal you have chosen, describe it in detail, and discuss why you chose to focus on this goal and how it related to population health, both locally and globally.

The specific goal I have chosen is improvement of maternal health. I chose to focus on this goal because reproductive health is an issue for most women whether they live in developed or developing countries -- and because reproductive health is an issue over which the medical and healthcare communities can have relatively high degrees of influence. Reproductive health is inextricably related to income at levels of a household, a community, and a nation. The figures representing women who died during pregnancy or childbirth are high (roughly 289,000 globally in 2013), but they are down by about 45% from 1990 levels ("MDG 5," 2014). This is a clear indicator that progress is being made in this area. Moreover, a relation exists between a lack of effective methods of contraception and maternal deaths ("MDG 5," 2014). That is to say, a focus on contraception can impact the rates of both unwanted pregnancy and of maternal deaths during pregnancy and childbirth.

2.What strategies have been identified to address this goal, and what progress has been made? (General Overview)

The most fundamental strategy for improving maternal health is to directly address the care that is provided to women. While there are enormous cultural-structural and social issues that must also be addressed to make maternal care more equitable, less comprehensive and expensive strategies can have important effects. For instance, in Tanzania, the Kigoma Regional Hospital reduced maternal death in childbirth by 80% over a 4-year period through the implementation of simple, low-cost interventions that radically improved the care provided to women giving birth in the hospital (Coeytaux, 2010). Two important strategies to save women's lives are to make abortion legal and affordable, and to make contraceptives legal and affordable. Consider that, abortion is legal in Tunisia and an integral part of the national family-planning program, but its neighbor Algeria has not (Coeytaux, 2010). Both countries have birth practices and contraceptive use that are similar (Coeytaux, 2010). But women in Algeria are twice as likely to die from complications of pregnancy than are Tunisian women; this difference is attributed to access to safe abortions (Coeytaux, 2010).

3.How do some of the "Indices of Health Disparities" listed on page 11 of your text relate to the MDG you have chosen?

Very strong relations can be seen between the indices of health disparities and the MDG 5, to improve maternal health ("WHO," 2014). Consider that the maternal mortality rate in WHO European Region is 21 compared to 1000 (out of 100,000 live births) in Afghanistan, Chad, and Somalia. Consider, too, that 99% of maternal deaths each year occur in developing countries ("WHO," 2014). Approximately 16 million teenage girls are associated with 11% of births each year, and 40% of new HIV infections occur in this youthful population ("WHO," 2014).

4.Give an example of a key index or indices relevant to the assessment of progress towards meetings this goal.

The following are statistical measures of maternal mortality: Maternal mortality ratio, which is the number of maternal deaths during a given time period per 100,000 live births during the same time period ("Trends," 2010). Maternal mortality rate, which is the number of maternal deaths in a given period per 100,000 women of reproductive age during the same period of time ("Trends," 2010). Adult lifetime risk of maternal death, which is the probability of dying from a maternal cause during a woman's reproductive lifespan ("Trends," 2010).

5.How does the goal you have chosen relate to the "predictions of global health patterns" and the "predictions of the leading causes of diseases or injury worldwide" as discussed on page 9-10 of your text?