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True magnitude of stillbirths and maternal and neonatal deaths underreported

GENEVA – The day of birth is potentially the more dangerous for mothers and babies moment. Each year, worldwide, 303,000 women die during pregnancy and childbirth, 2.7 million babies die during the first 28 days of life and 2.6 million children are stillborn.
Most fetal and neonatal deaths can be prevented with quality care during pregnancy and childbirth. Almost all babies born dead and half of all newborn deaths are not registered with a birth certificate or death, and therefore never have been recorded, reported or investigated by the health system. As a result, countries often do not know the number of deaths or the causes of these deaths and therefore are unable to take effective and appropriate measures to prevent other babies and mothers die.

“We must ensure that all births and deaths are counted, and we can understand what to do to prevent future deaths, no matter where they occur,” says Ian Askew, Director of Research and Reproductive Health of WHO. “By reviewing the causes of maternal and infant deaths countries can improve the quality of medical care, taking corrective action and prevent millions of families to bear the pain of losing their babies or mothers.”

launching 3 new publications

Given the large number of maternal and neonatal deaths, WHO has launched three publications to help countries improve their data on fetal and maternal deaths and neonatal. The first publication, the “Application of the WHO International Classification of Diseases-10 deaths during the perinatal period” (ICD-PM) is a standardized classification system fetal and neonatal deaths.

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The system helps countries link stillbirths and neonatal deaths contribute to conditions in pregnant women, such as diabetes or hypertension. Previously, there was no rating system that could be used in all low-income countries, middle and high income in a consistent manner.

The second publication, “Make every baby Count: Audit and Review fetal and neonatal deaths,” is a guide to help countries review and investigate individual deaths so they can recommend and implement solutions to prevent similar ones in the future. It also incorporates ICD-PM classification in order to help countries complete at least a review of the basic deaths, a thorough investigation into the causes and circumstances of death.

“Every time a death is reviewed that has the potential to tell a story about what could have been done to save a mother and her baby,” says Dr. Anthony Costello, Director of Mother , of Children’s and adolescent health at WHO.

Official reports understate the true magnitude of maternal mortality by up to 30% worldwide and 70% in some countries. The third publication of the WHO, “Response time: a report on the global implementation of monitoring maternal mortality and response” helps countries strengthen its review process of maternal mortality in hospitals and clinics


the document also provides guidance for establishing a secure environment for health workers to improve the quality of care in clinics and an approach to the recording of deaths that occur outside the health system, as for example when mothers give birth at home.

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surveillance of maternal death and response (MDSR) is a relatively new research of maternal deaths in real time approach, a review committee maternal death (a group of experts) so that health centers and allow this corrective action. According to WHO standards, committees should meet at least twice a year, however, currently only 46% of countries are complying with this standard.

The studies on mortality and reviews is a key strategy to reduce preventable deaths of mothers and babies. It helps administrators of the health system to understand the causes of death, and contributing factors, so they are able to take corrective actions to improve the quality of care. It is an important mechanism for countries compliance with the objectives to reduce maternal and neonatal deaths set in the Millennium Sustainable Development and Global Strategy for Women, Children and Adolescent Health says.

WHO is also participating in an effort of several global partner to improve the quality of health information, including data on maternal and child health, through data collaboration Health. More than 30 global health organizations are contributing to the development of an easy to use package of guidance and tools designed to strengthen health information systems in countries.

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