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Country action is needed for maternal and child health in Africa

June 21, 2010

Sub-Saharan Africa has only 11% of the world's population, yet more than half of the world's maternal, newborn and child deaths, and two-thirds of the world's AIDS deaths. New data reveal that the pace of mortality reduction is accelerating. With only 5 years remaining before the Millennium Development Goals (MDGs) should be met, urgent action in countries is needed -- not global statistics and competitions over estimates.

Two new articles in this week's PLoS Medicine analyse the current status of maternal, newborn, and child health in Africa, and identify which interventions hold the greatest potential in varying countries to prevent the nearly 4.7 million mothers, newborns, and children deaths that occur each year in sub-Saharan Africa. The publication of these two articles launches a PLoS Medicine series on maternal, newborn, and child health in Africa, which will continue through 13 July 2010. Based upon consultations with 60 scientists and policy makers from nine countries and using local and regional data, the series' authors provide a snapshot of maternal, newborn, and child health in the region, review evidence-based solutions, and identify high-impact opportunities for reducing maternal and child mortality.

In the first paper, Dr. Joy Lawn from Save the Children and colleagues report that rapid progress is being made for some health challenges but the five biggest challenges for maternal, newborn, and child health in sub-Saharan Africa are complications of pregnancy and childbirth, newborn illness, childhood infections, malnutrition, and HIV/AIDS. Many scientifically proven interventions are available but most are underused in African countries, say the authors. For example, across the region 71% of pregnant women receive at least one antenatal care visit with a doctor, nurse, or midwife. But less than half of all births are attended by skilled personnel, less than a third of mothers and babies receive routine postnatal care, only 29% of children with pneumonia receive antibiotics, and less than a quarter of women have access to contraception.

No country can scale-up and implement all possible interventions at once; priorities need to be set. The second paper in the series, by Professor Robert Black and colleagues, reports the results of a priority setting analysis using the Lives Saved Tool (LiST). Estimates of mortality reduction for 42 sub-Saharan African countries show that nearly 4 million deaths would be averted if well known interventions such as emergency obstetric care, breastfeeding counselling, kangaroo mother care for preterm babies, and treatment for diarrhoea and pneumonia reached 90% of families. A detailed analysis of nine diverse African countries found that feasible increases in the coverage of high-impact outreach interventions could save 486,000 lives and would cost an estimated additional US $1.21 per capita. Feasible increases in the coverage of facility-based interventions could save 105,000 lives at an estimated additional cost of US $0.54 per capita.

As the MDG target of 2015 approaches, the authors of the series conclude that each day 13,000 African mothers, newborns and children die. Progress is being, made especially in a few leading countries, but "even more lives could be saved if countries used data to increase coverage and quality of care in the short term. Local and national governments, policymakers and donors should be encouraged to make better use of science and data to inform effective action now," say the authors.
-end-
Details of the two papers:

These two articles and an editorial will be published on Monday 21st June on www.plosmedicine.org. Further articles in the series will be published weekly until Tuesday 13th July and will also be collected together on the PLoS Medicine blog, Speaking of Medicine: http://wp.me/prKR9-vp

Series image: http://www.plos.org/press/pmed-07-06-series-image.jpg (Please credit 300td.org at flickr.com if you use this image)

Article by Joy Lawn and colleagues:

Funding: This work was supported by the US National Academies. The time of JEL and KJK was supported by the Saving Newborn Lives program of Save the Children, through a grant from the Bill & Melinda Gates Foundation. The funders played no role in the decision to submit the article or in its preparation.

Competing Interests: The authors have declared that no competing interests exist.

Citation: Kinney MV, Kerber KJ, Black RE, Cohen B, Nkrumah F, et al. (2010) Sub-Saharan Africa's Mothers, Newborns, and Children: Where and Why Do They Die? PLoS Med 7(6): e1000294. doi:10.1371/journal.pmed.1000294

IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000294

PRESS-ONLY PREVIEW OF THE ARTICLE: www.plos.org/press/plme-07-06-lawn.pdf

CONTACT:
Author details:
Joy Lawn
Save the Children US
Cape Town, South Africa
joylawn@yahoo.co.uk

Press contact:
Dinah Lord,
Saving Newborn Lives/Save the Children,
Washington DC,
USA
Tel: +1 202 640 6663
Email: DLord@savechildren.org

Article by Robert Black and colleagues

Funding: This work was supported by the US National Academies of Sciences. The time of JEL and KJK was supported by the Saving Newborn Lives program of Save the Children, through a grant from the Bill & Melinda Gates Foundation. The time of REB, NW, and IKF was supported by a grant from the Bill & Melinda Gates Foundation to the US Fund for UNICEF. The funders played no role in the decision to submit this article or its preparation.

Competing Interests: The authors have declared no conflicts of interest.

Citation: Friberg IK, Kinney MV, Lawn JE, Kerber KJ, Odubanjo MO, et al. (2010) Sub-Saharan Africa's Mothers, Newborns, and Children: How Many Lives Could Be Saved with Targeted Health Interventions? PLoS Med 7(6): e1000295. doi:10.1371/journal.pmed.1000295

IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000295

PRESS-ONLY PREVIEW OF THE ARTICLE: www.plos.org/press/plme-07-06-black.pdf

CONTACTS:
Author details:
Robert E. Black
Edgar Berman Professor and Chair
Department of International Health
John Hopkins Bloomberg School of Public Health
rblack@jhsph.edu

Press contact:
Tim Parsons
Director, Public Affairs
Johns Hopkins Bloomberg School of Public Health
615 N. Wolfe Street, E8527
Baltimore, MD 21205
Tel: 410-955-7619
tmparson@jhsph.edu.

PLOS

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