I received an email yesterday morning from close friends that read, “It’s a BOY! Arrived at 5:13am. 7 lbs 4 oz 19 3/4 inches. More to come!” Congratulations to Linds and Chip, two phenomenal parents! As I have spent half of the last year in the developing world, it got me thinking about my friends who give birth every day in Nepal.
Two of the Millennium Development Goals, eight goals to be achieved by 2015 that provide concrete, numerical benchmarks for tackling extreme poverty, focus on child and maternal health. Goal #4 is to reduce by two-thirds, between 1990 and 2015, the under-5 mortality rate. In Nepal, the current mortality rate for infants is 5% and for children under five is 6.5%. A well-coordinated scale up of highly effective child survival interventions, such as vitamin A distribution, immunization and pneumonia treatment has contributed to the fact that the mortality rate among children under five years has been halved during the past 10 years. The largest challenge today is addressing mortality among newborns, now accounting for 54 percent of all deaths among under-five children. The U.N. contends that community based interventions addressing major causes of neonatal deaths should be expanded as quickly as possible.
Goal #5 is to reduce, by three-quarters, the maternal mortality ratio. The U.N. reports that maternal mortality has fallen in Nepal by about 50 percent from the mid-nineties, from 539 to 281 cases per 100,000 births. In January 2009 the Government made delivery and management of obstetric complications free of cost in all public health facilities. However, the fact remains that only 1 out of 5 births are attended by a skilled birth attendant, linking also clearly to the high mortality rates of newborns. The government now provides 400 rupees, just under $6, to all mothers who visit maternity centers four times and fully utilize the pre and post maternity services provided to them.
I write this blog because a year ago, I was unaware of the challenges that face women when giving birth in developing countries. It is not to downplay the challenges for women to give birth in the U.S., but to offer a point of comparison. According to TIME, our maternal mortality ratio was 17 per 100,000 live births in 2008, less than .02%. I believe that it’s important for us to know the real story so that we can do something to make a change.