Despite multiple and concerted health policy and programme interventions particularly in lower- and middle-income countries (LMICs), maternal mortality remains unacceptably high . Globally, it is estimated that 230 million pregnancies occur annually leading to an approximated loss of 800 women’s lives each day due to pregnancy or childbirth complications. As of 2017, global maternal mortality stood at 211 per 100,000 live births and although this represents a 38% drop since the last 2 decades, it translates to a paltry 2.9% decline per annum which is slower than necessary to meet the Sustainable Development Goal 3 (SDG) target of 70 per 100,000 live births . Maternal mortality is a major public health problem in LMICs and thus, serves as one of the key indicators of a country’s standard of living and health care quality.
In sub-Saharan Africa, 1 in 38 pregnancies end in mortality compared to 1 in 4,300 pregnancies in Europe and Central Asia . Although maternal mortality has declined significantly in Ghana in the last 2 decades, moving from 740 to 319 per 100,000 live births between 1990 and 2015, the rate of decline is also inadequate to achieve country-level targets. Nevertheless, the causes of most maternal deaths in LMICs such as Ghana are preventable or treatable, given pregnancy processes are largely physiological.
Author(s) Details:
John Azaare
Department of Health Service, Policy Planning, Management and Economics, School of Public Health, University for Development Studies, Tamale, Ghana.
Kasim Abdulai
Department of Clinical Nutrition and Dietetics, Translational Nutrition Research Group, University of Cape Coast, Cape Coast, Ghana.
Robert Bagngmen Bio
College of Health and Well-Being, Kintampo, Ghana.
Recent Global Research Developments in Social Factors Affecting Maternal Health in India
Underrepresented Populations in the United States:
Emerging data highlight the impact of social determinants of health (SDOH) on pregnancy outcomes in understudied, underrepresented, and underreported (U3) populations [1] .
Factors such as access to safe food, housing, education, emergency services, and stressors like interpersonal racism, poverty, unemployment, residential segregation, and domestic violence can affect reproductive health outcomes in these populations.
Maternal Mortality in the U.S.:
Despite progress, maternal mortality remains high in the U.S.
Women of color are three to five times more likely to die from pregnancy-related causes than white women.
Chronic exposure to social/cultural stressors may lead to pregnancy complications like miscarriages, preterm birth, and preeclampsia.
Structural and Intermediary Factors in India:
In India, economic status, caste/ethnicity, education, gender, religion, and culture significantly impact maternal health service use and maternal mortality [2] .
Intermediary factors include place of residence, maternal age at childbirth, parity, exposure to mass media, and maternal health messages.
Rural Women’s Perceptions:
Rural women’s perceptions of maternal health issues are explored through focus group discussions and interviews [3] .
References
- Girardi, G., Longo, M. & Bremer, A.A. Social determinants of health in pregnant individuals from underrepresented, understudied, and underreported populations in the United States. Int J Equity Health 22, 186 (2023). https://doi.org/10.1186/s12939-023-01963-x
- Hamal, M., Dieleman, M., De Brouwere, V. et al. Social determinants of maternal health: a scoping review of factors influencing maternal mortality and maternal health service use in India. Public Health Rev 41, 13 (2020). https://doi.org/10.1186/s40985-020-00125-6
- Lowe M, Chen D-R, Huang S-L (2016) Social and Cultural Factors Affecting Maternal Health in Rural Gambia: An Exploratory Qualitative Study. PLoS ONE 11(9): e0163653. https://doi.org/10.1371/journal.pone.0163653
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