Monday, May 11, 2015

The Costs of Maternal Mortality to Families and Communities

The loss of a mother harms her surviving family members, and her children’s health, education, and future opportunities.
• Maternal death is linked to high neonatal mortality: of the 59 maternal deaths in the study, only 15 babies survived the first 60 days of life.
• Surviving children in some cases were withdrawn from or forced to miss school, because economic
 disruptions made it difficult to afford school fees. When children did continue their schooling, often their grief and new household responsibilities negatively affected their schoolwork.
• A mother’s death suddenly increases the tasks and responsibilities that her surviving husband, mother and mother-in-law have to shoulder. For the grandparents, in particular, this means  that once again they have to shoulder the burden of childcare.

The cost of fatal pregnancy and childbirth complications is a heavy economic burden.

• Regardless of household wealth, families that experienced a maternal death reported spending  approximately 1/3 of their total annual consumption expenditure to access pregnancy and child-birth care, between 3 and 6 times more than households where a woman gave birth safely.
• This approaches what WHO calls a ‘catastrophic’ cost (40% of disposable income), and suggests that some families may avoid or delay emergency care because of difficulty in covering the costs  of transport and services.
• In nearly half of all cases, families needed to look outside the household for money to pay for maternity care — in many cases from sources in their communities, but sometimes by borrowing from a moneylender or even selling household property.

When a woman dies, her funeral costs are a crippling hardship for her family.
• Across all wealth levels, families’ funeral costs exceeded their total annual expenditure on food, housing, and all other household consumption.
• On average, economically active members took a month off from work during the funeral period. Given the already high costs of the funeral, this lack of economic activity is an additional burden for the household.

The sudden loss of a productive woman disrupts the family’s economy and its daily life.
• Many of the women who died were also economically active, many working on their own or family farms, or running their own market stalls, shops, or other small businesses. The loss of their labour or income caused significant economic disruption.
• Many families reported losing crops or being forced to leave their land uncultivated because
 of the loss of the woman’s labour or reduction in work by surviving family members. Others were pushed further into poverty when they had to hire casual labourers to work their fields.

Across the developing world, a woman dies every two minutes from complications of pregnancy and childbirth. This new study from Kenya — conducted in an area of high poverty, high maternal and newborn mortality, and low access to quality health services — clearly demonstrates the devastating impact of these needless deaths on the well-being of families, the survival of newborns, the health and opportunities of surviving children, and the economic productivity of communities.
In Kenya and other countries with high burdens of maternal mortality, these findings must
catalyse renewed and strengthened efforts to:
• Ensure universal access to reproductive, maternal, newborn, and child health care
• Improve the quality of health services, including emergency obstetric care
• Strengthen referral services
• Improve financial and social support for women and families facing maternal health crises

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