Child and Maternal Mortality
in Islamic Countries
127
Improve health information systems
HMIS is weak in most countries. In the absence of a good HMIS system with updated, reliable,
complete information, it is difficult to track births, deaths, and health system deficiencies. Often
surveys are conducted every 5 years and are conducted for national-level estimates. Subnational
estimates are needed for taking actions at a local level. It is possible to track changes in real-time
and generate information at the lower sub-national level from the functional HMIS. Countries
should prioritize to improve HMIS and collection of data on maternal and child deaths.
Invest in female education
As a long term investment and strategy, we also consider that improving female education is
critical for reducing maternal and child mortality. A large inequity in maternal and child health
care was observed by education level, wealth quintile, and urban-rural areas. Educationwas also
a key factor for inequity in socioeconomic status and urban-rural residence. Our analyses
suggest that the elimination of inequity due to education may increase maternal and child health
care more than two higher in many settings. Bangladesh, despite economically disadvantaged,
has improved maternal and child health remarkably in the last few decades. Improving female
education- in all socioeconomic classes - was an attributable factor. Inmany of the OIC countries
that have high maternal and child mortality and low utilization of MNCH care, female education
level is low. Country strategic plans and development partners should consider investing in
female education. Education is also likely to improve women’s empowerment and decision
making for health care for themselves and their children.
Lack of permission was cited as one of the main causes of not delivering at a health facility.
Improving women's empowerment is likely to reduce such barriers.
Investment in education will also help towards poverty alleviation by enhancing job
opportunities for women.
4.3 Conclusion
Although a large number of initiatives have been taken since the late 1980s to improve maternal
mortality globally, many of the developing countr1ies still have very high maternal mortality
levels that were prevailed about 100 years ago in developed countries.
Maternal deaths are primarily caused by five direct causes: post-partum hemorrhage,
eclampsia/severe pre-eclampsia, sepsis, obstructed labor and abortion related complications.
Effective preventive and treatments are available for all these complications. Consequently,
close to 90% of maternal deaths are preventable. Nevertheless, about 810 women die from
maternal complication every day. Overall, the progress in maternal mortality is very slow:
between 2000 and 1997, MMR reduced by only 38%. As the historical data on the trends of
maternal mortality suggest, many developed countries almost eliminated preventable maternal
deaths within 15 to 20 years in 1940s.88 Why that is not happening in low- and middle-income
countries?
Health systems are weak in many LMIC countries. Maternal mortality reduction needs a well-
functioning health system with equitable access to skilled birth attendants and emergency
obstetrical care. Both maternal and perinatal deaths are highest during delivery and the
immediate postpartumperiod. Inmany countries, still, a large number of women, predominately