COUNTDOWN TO 2015 - IPJ - The official journal of FIP

THE FUTURE OF PHARMACY

VOL 28, NO.1 - JUNE 2012

ma n a g e m e nt ’. 13 Mater n a l m o r t a l i t y r a t i o (MMR) por t r a y s t h e r i s k of ma t e r n a l d e a t h r e l a t i v e t o t h e num b e r of li v e bir t h s . 6 Fig . 1 sh o w s t h a t t h e le a d i n g c a u s e of ma t e r n a l d e a t h s wo r l d - XJEFJTEVFUPPCTUFUSJDIBFNPSSIBHF NPTUMZEVSJOHPS j u s t af t e r d e li v e r y, t hi s is la r g e l y p r e v e nt a b l e t hr o u g h sk i l l e d DBSFEVSJOHDIJMECJSUIGPMMPXFECZTFQTJT DPNQMJDB - UJPOTPGVOTBGFBCPSUJPO BOEFDMBNQTJB 0UIFS EJSFDUDBVTFT PGNBUFSOBMEFBUITBSFEVFUPFDUPQJD p r e g n a n c y, e m b o l i s m a n d c a u s e s r e l a t e d t o us e of a n a e s - UIFUJD*OEJSFDUDBVTFT BSFDPNNPOMZEVFUPJOGFDUJPVT d i s e a s e s su c h a s ma l a r i a , T B a n d HIV/AIDS . 1 4

WHO est im a t e s t h a t gl o b a l l y m a t e r n a l d e a t h s h a v e EFDSFBTFECZGSPN JOUP JO 5IFBOOVBMSBUFPGEFDMJOFJTXIJDIJTMFTTUIBOIBMGPG UIFUBSHFUFESFRVJSFEUPSFEVDFUIF..3CZUISFFRVBS- t e r s b e t w e e n 19 9 0 a n d 2 0 15 . 15 L im i t e d g a i n s h a v e b e e n m a d e in de v e l o p i n g co u nt r i e s t o w a r d s t h e ﬁr s t t a r g e t of MDG5 . T h e WHO Sout h -Ea s t Asia Regio n is a m o n g t h e lo w e s t ob s e r v e d , whi l e t h e r a t e of de c l i n e in t h e WHO Afric a n Regi o n co nt i n u e s t o b e p e r s i s t e nt l y sl o w. 1 6

T h e gl o b a l num b e r of de a t h s of chi l d r e n un d e r - ﬁ v e h a s re d u c e d f r o m 1 2 . 4 mill i o n in 19 9 0 t o 8 . 8 mill i o n in 2 0 0 8 , BSFEVDUJPO 1 2 , 1 7 Fur t h e r m o r e t h e un d e r - ﬁ v e m o r t a l i t y r a t e wa s e s t i m a t e d t o b e 6 5 de a t h s p e r 1 , 0 0 0 li v e bir t h s in 2 0 0 8 , whi l e in 19 9 0 t h e r e we r e 9 0 de a t h s p e r 1 , 0 0 0 li v e bir t h s . S ub - S a h a r a n Afr i c a a n d S o u t h Asia ill u s t r a t e t h e gr e a t e s t

MDG 4 fo c u s e s o n r e d u c i n g un d e r - ﬁ v e m o r t a l i t y r a t e s by t w o - t h i r d s by 2 0 15 . 5 MDG5 id e nt i ﬁ e s t w o t a r g e t s fo r a s s e s s - i n g p r o g r e s s in imp r o v i n g m a t e r n a l h e a l t h : r e d u c i n g t h e mat e r n a l m o r t a l i t y r a t i o (MMR) by t hr e e - q u a r t e r s b e t w e e n 19 9 0 a n d 2 0 15 , a n d a c h i e v i n g uni v e r s a l a c c e s s t o r e p r o d u c - t i v e h e a l t h by 2 0 15 . 6 It is imp o r t a nt t o r e c o g n i s e t h a t t h e m a g n i t u d e of t h e p r o b l e m s a r i s i n g f r o m t h e in c r e a s e in ma t e r n a l m o r t a l i t y a n d inf a nt m o r t a l i t y h a s a ne g a t i v e s o c i a l a n d e c o n o m i c im p a c t hin d e r i n g t h e p r o d u c t i v i t y a n d d e v e l - o p m e nt of a ny co u nt r y. T h e Unit e d Natio n s e m p h a s i z e s t h a t m a t e r n a l sur v i v a l h a s a p o s i t i v e im p a c t o n de v e l o p m e nt a n d hum a n r ig ht s . 7 Fur t h e r m o r e , t h e d e a t h of t h e m ot h e r sig n i ﬁ - c a nt l y af f e c t s t h e h e a l t h , gr o w t h a n d e du c a t i o n of t h e chi l d whi l e l e a v i n g co m m u n i t i e s b ur d e n e d by or p h a n e d c hi l d r e n . 7 - 9 Evid e nt l y, m o r e c a n a n d mu s t b e do n e t o s a v e wo m e n ’ s a n d chi l d r e n ’ s li v e s a n d p r e v e nt di s a b i l i t i e s t h a t co u l d p e r m a - n e nt l y a lt e r a wo m a n ’ s lif e a n d h e r f a m i l y ’ s f ut u r e . 1 0

Global causes of maternal and infant deaths Altho u g h m a n y co u nt r i e s h a v e m a d e sig n i ﬁ c a nt p r o g r e s s to w a r d s at t a i n i n g MDG 4 a n d 5 , a n imp r o v e m e nt in t h e wo r l d ’ s d e v e l o p i n g co u nt r i e s r e m a i n s s t a g n a nt whi l e in s o m e r e g i o n s m a t e r n a l a n d inf a nt m o r t a l i t y h a v e in c r e a s e d . 1 1 , 1 2 Mater n a l m o r t a l i t y is de ﬁ n e d a s ‘ t h e d e a t h of a wo m a n whi l e p r e g n a nt o r wit h i n 4 2 da y s of t e r m i n a t i o n of p r e g n a n c y, re g a r d l e s s of t h e sit e o r dur a t i o n of p r e g n a n c y, f r o m a ny c a u s e r e l a t e d t o or e x a c e r b a t e d by t h e p r e g n a n c y o r it s

Obstetric haemorrhage

Complications of unsafe abortion

Other direct causes

20% 32%

15%

13%

12%

Sepsis

Eclampsia

Indirect causes

Fig. 1: Global causes of maternal death

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