Child and Maternal Mortality
in Islamic Countries
3
Section-I. Introduction
1.1. Background
1.1.1. Problem statement
1.1.1.1. A high burden of preventable maternal and child deaths in low resource settings
Although considerable progress has been made, still more than 99% of maternal deaths occur
in developing countries and are preventable. The global maternal mortality ratio (MMR)
reduced from 385 deaths per 100,000 live births in 1990 to 216 deaths per 100,000 live births
in 2015, a 44% decline. The estimated number of maternal deaths, i.e., deaths attributable to
pregnancy, delivery, and postpartum complications, declined globally about 43% from
approximately 523,000 to 303,000 per year during this time. 1 Yet this decline fell far short of
achieving the Millennium Development Goal – 5 (MDG-5) of a 75% reduction in MMR globally
by 2015. The overall progress of maternal mortality reduction was even much slower in 57
countries included in the Organization of Islamic Cooperation (OIC) countries. The estimated
number of annual maternal deaths in OIC countries declined from 202,200 maternal deaths in
1990 to 149,500 in 2015, a decline of about 29%, compared to 43% globally.
Globally, the estimated annual numbers of under-5 (U5) mortality declined from 12.58 million
deaths in 1990 to 5.62 million deaths in 2015.2 The under-5 mortality rate (U5MR) dropped
globally by 58% from 93.2 per 1,000 live births in 1990 to 39.1 in 2015. However, it also fell
short of the two-thirds decline, a target set by the Millennium Development Goals-4 (MDG-4).
Almost 15,000 children under-5 years die every day.
The rate of child mortality reduction was also much slower in OIC countries. In OIC countries,
the overall reduction of U5 mortality was only 41.2% – from 4.45 million deaths in 1990 to 2.61
million deaths in 2017. Almost half of the world’s under-5 child deaths (46.4%) occur in OIC
countries.
Much of the decline in under-5 mortality was the result of declines in deaths during the post-
neonatal period, after the first 28 days of life. Child mortality between 1-4 year was primarily
achieved through GOBI (growth monitoring, oral rehydration, breastfeeding and immunization)
interventions and improved case management of pneumonia and malaria. These “child survival”
interventions, however, are not enough for reducing neonatal deaths, i.e. deaths in the first 28
days of life. Neonatal deaths now account for approximately 45% of all deaths to children under-
5 and are concentrated in developing countries. Its associated mortality, i.e., the neonatal
mortality has declined at a much slower rate. In developed countries, three out of every 1,000
newborns die during the neonatal period; the risk is seven times higher in developing countries
where the neonatal mortality rate is 21 neonatal deaths per 1,000 live births. In addition to the
world’s 2.7 million neonatal deaths, 2.6 million stillbirths occur every year, accounting
collectively for more than 5 million deaths during the perinatal period each year.3
1.1.1.2. Low utilization of effective maternal and child survival and health interventions
Proven and cost-effective interventions are available to prevent maternal, newborn and child
deaths.4 However, the utilization and coverage of maternity care interventions are very low in