Reviewing maternal mortality in the context of low-income countries is crucial as it provides insight on global public health. The findings can be used to reduce health inequalities and disparities. High maternal mortality rates negatively affect low-income countries from an economic perspective. In such regions, mothers are an essential part of the working population since a single income is insufficient to support a family. By addressing maternal mortality rates, governments will be able to work toward global health equity. One of the sustainable development goals of 2030 is to lower maternal and infant mortality rates, especially in poor nations. The manuscript seeks to address the key maternal mortality determinants in low-income countries. It evaluates the available interventions and appraises their efficacy. Evidence-based recommendations are essential in addressing the high maternal mortality rates in low-income nations.
Literature Review
Healthcare accessibility is a key factor that predicts maternal mortality worldwide. Low-income countries have limited resources for providing reproductive care to mothers during childbirth. Researchers note that emergency obstetric cases contribute to high maternal mortality incidents (Kurjak, Stanojević, & Dudenhausen, 2023). Socioeconomic disparities also lead to high incidents of maternal mortality. In nations such as Haiti, public hospitals have limited supplies. Yet, most of the population lives below the poverty line. As such, mothers are at a high risk during childbirth. Investigators observe that some cultural beliefs contribute to high maternal mortality rates (Omer et al., 2021). In some parts of Africa, traditional beliefs prevent women from seeking prompt medical care during childbirth, contributing to high mortality rates. The quality of care offered during pregnancy and childbirth is a significant aspect in determining a mother’s health outcomes. It is common for women to fail to adhere to the necessary clinical guidelines in countries such as Bangladesh. Thus, healthcare accessibility is critical in predicting maternal mortality in poor countries.
Clinical factors have been associated with high maternal mortality rates in low-income countries. Researchers note that postpartum hemorrhage is a leading cause of death among new mothers (Ueda et al., 2022). It often stems from complications that occur during childbirth, such as retained placenta and uterine atony. Some mothers sustain infections such as sepsis during the process. This is often triggered by inadequate postnatal care and unsanitary conditions. It contributes to high maternal mortality rates, especially in economically impoverished villages. Unsafe abortions are common in low-income nations (Miller, 2021). Traditional reproductive laws prevent the provision of formal abortion services. Women resort to unsafe methods that easily lead to complications such as excessive bleeding. Pregnant mothers with high blood pressure have a higher risk of maternal mortality than their healthier counterparts (Bello et al., 2021). Most birth complications require the services of a highly experienced physician if the mother is hypertensive. Preeclampsia and eclampsia can easily lead to death if not addressed quickly. Overall, clinical factors associated with socioeconomic impoverishment increase maternal mortality rates.
Article Summary
The selected article, “Correlates of maternal mortality in developing countries: an ecological study in 82 countries”, explores maternal mortality in developing countries. The researchers employ an ecological study design to examine various factors: health indicators, economics, and social elements (Girum & Wasie, 2017). The study has a global scope, covering countries from a wide geographical span. The results show that social determinants such as culture, poverty, and education play a key role in maternal mortality. The researchers observe that healthcare access is critical in reducing maternal mortality. However, lack of resources is a major factor hindering access to the appropriate services. The paper concludes that antenatal care coverage depends on the provision of adequate resources. This is because there is a strong relationship between the quality of antenatal care, premature births, and low birth weight. Overall, the meta-analytical approach offers a comprehensive review of the factors which predict maternal mortality trends.
Intervention and Recommendations
Various strategies have been proposed to minimize maternal mortality in low-income countries. It is necessary to hire skilled birth attendants and nurses. Training traditional midwives will play a crucial role in minimizing maternal and infant mortality (MacDonald, 2022). The intervention has proven successful in different regions worldwide. All clinics should have adequate human and technical resources to handle obstetric emergencies. It will address some of the top causes of maternal mortality, such as obstructed labor and hemorrhage (Bauserman et al., 2020). Women in low-income nations should be provided with family planning services. These include contraceptives and the necessary education to avoid unwanted pregnancies. Building more clinics, equipping them, and hiring additional qualified staff remains challenging. This can be attributed to the dire economic situation in developing countries. Thus, minimizing maternal mortality requires holistic solutions that address the socioeconomic and cultural factors in developing countries.
Conclusion
Maternal mortality rate is a crucial factor for assessing public health. Unlike other statistics, maternal mortality is more critical since mothers are the primary carers of newborn children. They provide nutrition, social, and emotional care. Low-income countries have considerably higher rates of maternal mortality. Various factors contribute to this outcome: socioeconomic challenges, lack of trained birth attendants, outdated traditional birth practices, limited access to obstetric emergency services, malnutrition, and poor clinical sanitation. Solving these risks requires a multifaceted approach that addresses the lack of resources, cultural factors, and clinical shortcomings. Solving the inequality caused by high maternal mortality rates in low-income countries will positively impact public health.
References
Bauserman, M., Thorsten, V. R., Nolen, T. L., Patterson, J., Lokangaka, A., Tshefu, A., … & Bose, C. (2020). Maternal mortality in six low and lower-middle income countries from 2010 to 2018: risk factors and trends. Reproductive health, 17, 1-10. https://doi.org/10.1186/s12978-020-00990-z
Bello, N. A., Zhou, H., Cheetham, T. C., Miller, E., Getahun, D., Fassett, M. J., & Reynolds, K. (2021). Prevalence of hypertension among pregnant women when using the 2017 American College of Cardiology/American Heart Association blood pressure guidelines and association with maternal and fetal outcomes. JAMA Network open, 4(3), e213808-e213808.https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2777974/bello_2021_oi_210139_1619033879.06331.pdf
Girum, T., & Wasie, A. (2017). Correlates of maternal mortality in developing countries: an ecological study in 82 countries. Maternal health, neonatology and perinatology, 3, 1-6. https://doi.org/10.1186/s40748-017-0059-8
Kurjak, A., Stanojević, M., & Dudenhausen, J. (2023). Why maternal mortality in the world remains tragedy in low-income countries and shame for high-income ones: will sustainable development goals (SDG) help? Journal of perinatal medicine, 51(2), 170-181.https://doi.org/10.1515/jpm-2022-0061
MacDonald, M. E. (2022). The place of traditional birth attendants in global maternal health: policy retreat, ambivalence and return. Anthropologies of Global Maternal and Reproductive Health: From Policy Spaces to Sites of Practice, 95-115. https://library.oapen.org/bitstream/handle/20.500.12657/52826/978-3-030-84514-8.pdf#page=103
Miller, C. (2021). Maternal mortality from induced abortion in Malawi: What does the latest evidence suggest? International Journal of Environmental Research and Public Health, 18(19), 10506.https://doi.org/10.3390/ijerph181910506
Omer, S., Zakar, R., Zakar, M. Z., & Fischer, F. (2021). The influence of social and cultural practices on maternal mortality: a qualitative study from South Punjab, Pakistan. Reproductive health, 18(1), 97. https://doi.org/10.1186/s12978-021-01151-6
Ueda, A., Nakakita, B., Chigusa, Y., Mogami, H., Ohtera, S., Kato, G., … & Kondoh, E. (2022). Impact of efforts to prevent maternal deaths due to obstetric hemorrhage on trends in epidemiology and management of severe postpartum hemorrhage in Japan: a nationwide retrospective study. BMC Pregnancy and Childbirth, 22(1), 496. https://doi.org/10.1186/s12884-022-04824-7
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