Child and Maternal Mortality
in Islamic Countries
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Section IV. Discussion
Although the global maternal mortality burden has declined by 43% between 1990 and 2015,
the progress of maternal mortality reduction was much slower in the OIC countries: the
reduction was about 29%. Similarly, the rate of child mortality reduction was much slower in
OIC countries – 41.2% compared to 58% globally. Almost half of the world's under-5 child
deaths (46.4%) occur in OIC countries.
This study was undertaken to examine the trends in maternal and child mortality, assess the
prospects of achieving SDG-3.1 and 3.2 goals, examine the differentials and inequity in maternal
and child health care, and functioning of health systems and barriers to health services residence
in selected OIC countries where DHS data are available.
4.1 Challenges ahead
The OIC countries have made significant progress in reducing maternal and child mortality and
improving the utilization of maternal and neonatal care in the last two decades. However, a large
number of countries will be not able to achieve SDG-3.1 and 3.2 goals at the current pace of
progress. With accelerated progress, these countries have the potential for meeting the target.
Improving and assuring universal access to life-saving and preventive maternal and child health
care will be critical for attaining success. Ensuring universal access to maternal and child care
are the foundations of human rights principles.
Improving equity remains a major challenge in OIC countries. Large inequity persists in MNCH
care almost in all the studied countries. Without reducing inequity in MNCH care, the countries
cannot achieve universal health care and SDG-3.1 and 3.2 goals. There is a significant shortage
of trained health professionals in remote and low-performing areas, including rural areas.
Assuring equitable distribution of skilled health workers is a major challenge for improving
MNCH services in all corners of the country.
Many study countries have achieved a high level of antenatal care and skilled birth attendants
during delivery. However, maternal mortality levels are still very high in several of these
countries. The quality of services and care is considered poor in these settings. Maternal and
perinatal mortality may not be reduced without improving the quality of care. Good governance,
leadership, and accountability are critical for initiating and maintaining a high standard of care.
While facility delivery has increased in many countries, concurrently also cesarean section rates
have increased dramatically. This crisis has been termed as epidemic.79,80 Reducing unnecessary
cesarean section is imperative for reducing out-of-pocket expenses and maternal complications.
In many countries, such as Bangladesh, out-of-pocket expenses are increasing and as high as
more than 70% of total health expenditure.
Every death counts. However, reporting of maternal and child deaths is a major problem for
tracking progress in the absence of complete vital registration and functional health information
systems. Without improving HMIS and CRVS, it will be not possible to reliably tracking progress
towards universal MNCH health coverage and SDG-3.1 and 3.2 goals.
Out-of-pocket expenses for health care are very high with an increasing trend in the case-study
countries. Concurrently, national expenditures on health are far below the WHO's
recommended level. Without improving financing, the countries may not achieve MDG-3 goals.