"The Ronan Report" provides insight about the activities at the Western Maryland Health System in Cumberland, Maryland, and about the changes taking place in healthcare today from a CEO's perspective.

Tuesday, November 26, 2013

Improving Maternal and Child Health Around the World

In the December issue of The Rotarian, there is an interesting article on the work that the Rotary Foundation is doing around the world.  The article looks at the experiences and vital statistics related to mothers dying during pregnancy, infant mortality and births attended by skilled health personnel. 

In looking at simply mothers dying during pregnancy or childbirth, the results are staggering in six of the eight countries studied.  In Afghanistan, the risk of dying during pregnancy or childbirth is 1 in 32.  In Botswana it’s 1 in220; Brazil 1 in 910; Cambodia it’s 1 in 150; Finland it’s 1 in 12,200; India 1 in170; Rwanda it’s 1 in 54 and in the US it’s 1 in 2400.  So what’s the difference between first (Finland) to worst (Afghanistan)?  The government in Finland provides every expectant mother with a gift of baby clothes, diapers, bath supplies and bedding, including a mattress.  The only requirement is that they seek prenatal care before their fourth month of pregnancy.  In Afghanistan, the reason for their high maternal mortality rate is war.  A ten-day walk to some hospitals while in labor; vast areas with land mines; health professionals have fled the Taliban rule and they have the highest maternal mortality rate ever recorded in the world at 6,507 per 100,000. 

I applaud Rotary for their work and scratch my head as to why the US rate is so high considering how much we spend on health care annually.   According to the article, our maternal mortality rate has doubled since 1987 with some of the reason being better reporting, but we have to do more with both pre and post-natal care.  We are the only developed country that does not mandate paid leave for women after they give birth.  In Finland, it’s 18 weeks paid at 70%; actually in each of the other six countries, except Botswana, they all have mandated paid maternity leave ranging from 90 to 120 days paid at 100%.   Clearly, there are some lessons to be learned.

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