Maternal, Neonatal, and Child Health - Term Paper Example

Maternal, Neonatal and Child Health Student’s Name: Institutional Affiliation: Date Assignment is due: Maternal, Neonatal and Child Health Abstract Maternal, neonatal and child heath is an issue that should be addressed more now than before. This paper will examine the issues that surround maternal, neonatal and child health including the possible explanations for the prevalence of the plight, the evidence available about what needs to be done and whether it has been done and the challenges that are faced by a country trying to implement changes and the debates on the issue. Global statistics of the deaths of mothers and newborns will reveal that the problem is devastating and especially in third world countries. Issues like human rights, society, culture, knowledge and healthcare facilities are some of the problems that will be explained and possible explanations. From these, evidence needed to combat maternal mortality will be derived and the building of facilities will be the applied strategy. Bangladesh will be chosen as the country to use as an example to illustrate how violence, distance and ignorance are challenges facing the country and the debate on whether the community will be receptive. The conclusion will be that the issue needs to be addressed using long term strategies. Introduction Maternal, neonatal and child health has been elusive for the world to achieve fully for many years. Maternal death describes a pregnant woman’s death regardless of what stage of pregnancy she is at and the location of the pregnancy (World Health Organization, 1998). This death is as a result of or related to pregnancy or how the pregnancy is managed. Neonatal health describes the death of a baby in the first twenty eight days of life (Wilkinson, 1997). One of the leading causes of death of children who are below the age of five in developing countries is neonatal death. This is especially so in countries with a high number of people living below the poverty line. Families living this kind of life often deliver in their homes contributing to maternal mortality too. Statistics show that one mother dies in every minute in the world (National Consultation Meeting, 2007). This adds up to about 1500 deaths at the end of every day. The death annually is about half a million. Over the past decade or so, this number has not reduced. This is more frustrating because though these deaths may not be predictable, they are preventable. This has been the subject of many global development discussions and improvement of maternal, neonatal and child health was made a millennium development goal in 2000. It has been predicted that most countries in the Asian and African continent may not be able to meet this goal if immediate action is not taken towards the cause. According to the numbers of maternal and newborn deaths globally, 44 percent of the deaths of mothers happen in Asia as do 54 percent of the deaths of newborns. Another additional risk to the deaths of maternal, newborn and child mortality is that most women in third world countries do not have access to contraceptives that can help them prevent unwanted pregnancy which would lead them to having families they can sustain comfortably (Khan & Jamal, 2003). Possible Explanations for the Failure to Advance Maternal, Neonatal and Child Health There has been an increasing trend of women enjoying more human rights. Developed countries have are witnessing this in higher percentages than developing ones. The experiencing of more rights comes with them receiving more care from the state or government. One of the most important services that women who enjoy human rights have is access to medical care and facilities. Economic freedom and empowerment socially go hand in hand with getting more medical services (Tinker & Koblinsky, 1993). Despite these developments, there are other cultural, geographical and social issues that reverse all the efforts that have been made to give women more power and access to services. These problems often perpetuate inequalities in the societies that these women are in. gender inequalities are lead to more cases of maternal, neonatal and child deaths and poor health. These inequalities are in the areas of health, economic status and education. These three areas influence the health and when they are not adhered to adequately; the effects on health are devastating (World Health Organization, 1997). Most women are still assumed to take on domestic roles in the society with men being given roles that pertain to them making money for the family. Some norms in the society prescribe child rearing roles to the women. The women often have no choice but to go with it. Most women who live in poverty decide to deliver their children at home where they do not have access to skilled attendants and their babies do not receive appropriate post natal care (MotherCare, 1998). Almost half of the children who are delivered at home die within the first twenty four hours of their lives. The causes of death for the children born in these conditions can be prevented or dealt with if the mother had given birth in a good healthcare facility. Some of these causes are: the child may get an infection, the child may be asphyxiated at birth (they may not be able to breathe) and the child may be too light. For the women and babies who often survive childbirth that takes place at home, they often develop crippling disabilities that make people in the society avoid them (MotherCare, 1998). Anything related to reproductive responsibility is not considered a role for men. This makes it harder for women to use contraceptives effectively since this role too is often left to them. Not using contraceptives will lead to unwanted pregnancies, some of which may be harmful to the health of mother and children. For instance, women who are beyond the age of 40 often face a lot of risk to them and their babies because of their age. It would be wise for them to keep from getting pregnant (Tinker & Ransom, 2002). However, men seldom help in this area. The child or mother may die or have serious health issues. Another reason is that lack of contraceptive use may lead to having larger families than they may be able to handle. This will lead to lacking funds for basic needs, school and medical care. Poverty leads to lack of basic needs like food, water and shelter. A pregnant woman who is malnourished is more likely to have a baby who is underweight (Khan & Jamal, 2003). This is one of the causes of neonatal deaths. For instance, Bangladesh has such cases. In addition, traditions and lack of information also prevent most women from seeking the medical care that they need. In addition, most of them do not understand the need for rest and the nutrition they need to keep healthy during and after pregnancy. Also, some families are still reluctant to seek help in case of an emergency since they lack the knowledge to notice if a situation is an emergency or not. Even if people do know that it is an emergency, women in third world countries have to travel long distances to get to hospitals that have neonatal care facilities. Maternal Health: What Needs To Be Done Based on the possible explanations for failure to advance maternal health, it is clear that women need to be educated about the issue more than before. In addition, the structure of the society needs to incorporate maternal issues into discussions so as to make the topic a common one and an easy one to talk about. Information should be provided in abundance to everyone in the community and healthcare facilities need to be increased and brought closer to these women. Women need to be given information about the risks that are involved about delivering at home and the benefits if delivering in a healthcare facility (World Health Organization, 2004). Also, the topic of contraception and family planning should be made an agenda for men and women and not just the women. The roles that have been defined be societies for each gender should take a back seat if they will lead to the death and poor heath of women and children. Based on the magnitude of the problem, urgent action needs to be taking place. This has happened in some areas and in others, it has not. One of the reasons why the problem persists in developing countries is that the particular evidence is applied but not all that is available. For instance, the focus of most programs that have been applied was on training birth attendants and utilizing prenatal screening to identify women who may be at risk while all pregnant women face the risk of developing complications (Kwast, 1995). Also, evidence available has been used to focus more effort on antenatal care of pregnant women. However, the evidence has not been applied to improve the conditions during delivery even though most of the deaths happen during delivery. Failure to focus more on this is because of statistics on the deaths that happen during deliveries are not as profound. Recommendations for improvement of maternal health are that obstetric care should be included in the programs for improving maternal health. They should have provisions for blood transfusions, antibiotics and caesarean sections. Medical treatment should be advocated for and better facilities should be made available because reducing maternal death is more dependent on treatment. Prenatal care should include counseling on how to care for the pregnancy, post natal care, care of the baby, possible complications and their symptoms and also, effective family planning (Kwast, 1995). Bangladesh Bangladesh is one of the third world countries that have made progress in reducing the number of child deaths over the past few years. At the beginning of 2004, it reported about 88 deaths out of every 1000 new born children (UNICEF and Government of Bangladesh, 1999). In 2007, the number reduces to 65 deaths per 1000 live births (UNICEF and Government of Bangladesh, 1999). Despite the encouraging statistics, neonatal mortality is still the leading cause of death in children who are under five years in Bangladesh. About one hundred and twenty thousand babies die every year. Thought the overall trend is improving, the number has stagnated for the most part indicating no major progress in this field. The other part, prevention of maternal mortality, has not had much improvement and is progressing slower than the issue of reducing neonatal deaths. For every 100,000 women that give birth, 320 of them die. This adds up to 12,000 deaths every year (NIPORT, 2003). Though there are pans that have been put into place to deal with this plight in Bangladesh, challenges are also faced while trying to implement these strategies. One of the major challenges is poverty. Most people in Bangladesh earn or live on less than one dollar every day. This makes it difficult for them to access neonatal facilities and hospitals that may be far from where they reside. Another challenge is that healthcare facilities in the country are often inadequate in terms of the services provided. Neonatal and post-natal care for both mother and child are provided by staffs that are not skilled enough in this area (World Health Organization, 2004). Any health care service should be delivered by professionals because failure to do so leads to detrimental results. Also, they are very few referral facilities if any at all. The health care services in Bangladesh are not available or provided in equal basis to all the citizens of the country. There is also poor coordination between the programs that deal in maternal and neonatal health so that they are not provided together making the attempts to improve both areas futile since they are connected. Neonatal health care provision has had very little attention in the past. Caregivers need to have the effective knowledge about the care needed for a newborn baby and the mother. This knowledge includes having a clean environment for delivery and making sure that the material needed is clean too. Also, they need to know the best way to deliver the baby safely (World Health Organization, 2004). In addition, there should be material and the correct information about wrapping the baby warmly and safely. Also, they should know about stimulation using touch and resuscitation of the baby and mother. Another challenge of dealing with maternal healthcare is violence. In Bangladesh, fourteen percent of the deaths of pregnant women are related to violence. The social structure in the country makes the women reluctant to go visit clinics or hospitals after violence. The emerging debates on this issue in Bangladesh include the division of labor for women who work in rice plantations. Pregnant women are not exempted from wok that may harm them like beating rice when it is hot. In addition, some people argue that the problem of maternal and neonatal deaths is brought about by the inadequacy of heath care services and policies that fail them. On the other hand, this problem is attributed to the attitudes of people in the area. People need to change their view of maternal, neonatal and child health for the change needed to be created. Though healthcare facilities may be available, it is the attitudes of families that influence whether they use them or not. However, the availability of trained and skilled workers together with good health facilities is important too (BMHFW, 2000). Conclusion In conclusion, the statistics available on the number of maternal, newborn and child deaths are overwhelming showing that more action needs to be taken in order to improve the situation. The need for effective healthcare facilities and services is imminent and so is the knowledge about the issue to the society as a whole. Though the problem affects mothers and children, addressing it will take the effort of the whole community. Bangladesh is a good example of how the society adds to the problem. 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