Child and Maternal Mortality
in Islamic Countries
5
human rights that demands accountability at all levels – at clinical facilities, community settings
and national policy levels – for ending preventable maternal deaths.10 Realization of the “right
to health” and ensuring universal access to emergency obstetrical and preventive maternal care
are the foundations of human rights principles that must be integral to maternal health
programs for successfully reducing maternal mortality in all segments of populations,
irrespective of their economic or societal status.11 Discrimination against women’s access to
care is recognized as a key factor for high maternal and child mortality in many developing
country settings. 12 Gender inequality, women’s economic status and low educational level are
considered the key factors for discrimination against women’s access to care.13 In recent years,
women’s respectful care during delivery is also recognized as a critical factor for improving
women’s desire to deliver at health facilities and an integral part of human rights.14,15
The US National Research Council’s meeting on the “Consequences of Maternal Mortality” in
2000 identified a number of intergenerational adverse impacts of maternal deaths on children,
family members, and on communities and society.16 Maternal mortality increases risks of
children’s death, injuries, malnutrition, social isolation, reduced education and increased child
labor participation.
Child mortality also increases women’s risks of high fertility, which is well recognized in child
survival hypothesis that postulates that improved child survival increases motivation for family
planning, which accelerates fertility decline. 17. With less exposure to repeated pregnancies,
women reduce the risk of maternal mortality. Family planning is considered one of the four
pillars of safe motherhood initiative for reducing maternal mortality; the other three strategies
are antenatal care, delivery care with skilled attendance and postnatal care. The Lancet paper
has shown that contraceptive use reduced almost 44% of global maternal mortality. 18 In
summary, there is a reciprocal relationship between maternal and child mortality that has
tangible intergenerational impacts.
1.1.3. Ways forward to successfully achieving the Sustainable Development Goals-3
Although majority of the low- and middle-income countries failed to achieve the MDG-4 and 5
by 2015, these countries made significant progress in reducing child and maternal mortality. In
2015, under a broader poverty alleviation and developmental goals, the UN countries target 17
Sustainable Development Goals (SDG), of which SDG-3 aims to “ensure healthy lives and
promote wellbeing for all at all ages.” This report focuses on the prospects of achieving SDG-3.1
and SDG 3.2 for maternal and child mortality reduction, respectively, specifically by the 38 OIC
member countries who are registered in the COMCEC Poverty Alleviation Working Group. SDG-
3.1 targets to reduce the global maternal mortality ratio to less than 70 per 100 000 live births
by 2030, and SDG 3.2 aims to end preventable deaths of newborns and children under 5 years
of age: all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live
births and under-5 mortality to at least as low as 25 per 1,000 live births by 2030.19
As the global development agenda broadens from the reduction of mortality to include
development, accelerated progress remains to be made in reducing maternal and neonatal
mortality. The MMR must decline at an annual rate of 7.5% to achieve a global MMR of 70 deaths
per 100,000 live births, a rate of decline more than double the rate achieved during the 2000-
2015 period. The World Health Organization’s strategic program Ending Preventable Maternal
Mortality (EPMM) set a target that no country to have an MMR greater than 140 deaths per
100,000 live births by 2030. Neonatal and under-5 mortality must also continue to rapidly