How Much To Save A Life?

Nearly 4 million newborn babies die each year, three quarters of these babies die within the first week of life and one to two million babies die during the first day after birth. A minimum of half a million women die every year as a result of pregnancy or childbirth complications. More than 99 percent of the deaths occur in developing countries, the vast majority in Africa and Asia.

Ann Veneman, executive director of UNICEF says “On average, each day around 1,500 women die from complications related to pregnancy and childbirth.” Simple measures like exclusive breastfeeding and keeping the baby warm could save almost one half of those lives. In Malawi when a mother dies community members sit down with health care workers to analyze the events leading up to her death, then they try to fix it.

Performing these important audits and other non-medical postnatal care, such as home visits by community health workers during the first 7 days after a birth is saving the lives of newborns and mothers in developing countries. Saving mothers is critical, because babies whose mothers die in the first 6 weeks of their lives are more likely to die in the first two years of life than the babies whose mothers survive. A study in Afghanistan found that about three-quarters of infants born to mothers who died also died within the two year time frame.
Joy Lawn, senior research and policy advisor with Save the Children-US, says other developing countries have begun to adopt these measures and best practices to bring down the number of newborn and maternal deaths. Postnatal care is a major gap in almost all such countries and is the time of most newborn and maternal deaths. She said data from Bangladesh showed that a home visit on the first and or second day after birth could reduce neonatal deaths by two thirds. The first seven days of life is also the critical period for initiating high-impact life-saving behaviors, including exclusive breastfeeding.

The average lifetime risk of a woman in a least-developed country dying from complications related to pregnancy or childbirth is more than 300 times greater for a woman living in an industrialized country, according to UNICEF. No other mortality rate is so equal. At least 21 percent of maternal deaths take place in just three countries:
Democratic Republic of Congo
Ethiopia
Nigeria

In Niger, West Africa, the highest lifetime risk of maternal mortality is one in 7

Highest neonatal mortality rates (per 1,000 live births)
Liberia                                  66
Cote d ’Ivoire                       64
Iraq                                       63
Afghanistan                          60
Sierra Leone                        56
Angola                                  54
Mali                                     54


Source: UNICEF

Fixing it
For babies and mothers facing complications as neonatal sepsis or postpartum hemorrhage, lives could be saved just by a community care worker checking up on the mother after being discharged from giving birth. The community health worker in Malawi follows up on the mother before and after the delivery, and is in constant touch with the clinic should complications develop.

Highest lifetime risk of maternal death
Niger                    1 in 7
Afghanistan          1 in 8
Sierra Leone         1 in 8
Chad                     1 in 11
Angola                  1 in 12
Liberia                  1 in 12
Somalia                 1 in 12

Ethiopia, a drought stricken country in the horn of Africa with one of the highest maternal death rates in the world, now also trains community health workers. It still has a long way to go as only 6 percent of births are attended by skilled healthcare workers. Kenya and India offer cash to mothers to attend antenatal clinics, while UNICEF assists in training community health workers in Malawi, who are now on the governments payroll.

Developing countries do not have far to look. Prioritizing investment in postnatal care has achieved dramatic results in Sri Lanka, where on ongoing civil war is being fought. The country has scaled up health services for mothers and infants and has managed to cut it’s maternal mortality rates in half every 6 to 11 years by adopting sound strategies, allocating sufficient resources, and making a political commitment to improving the health of mothers and children.
More than 98percent of births in Sri Lanka take place in hospitals now with a skilled nurse or doctor and 99 percent of pregnant women make use of antenatal care services.
The successes are not the result are not the result of medical interventions alone; efforts to empower women through education and employment have also played a significant role in lowering maternal and newborn death rates, according to UNICEF.
Other countries have begun to take notice. Between 19958 and 2005, skilled birth attendant coverage increased from 54 percent to 62 percent in the developing world, while antenatal care rose from 60 percent to about 75 percent. Still for all this around 50 million births in the developing world, or around 40 percent of all births, remain without skilled health personnel.