Child and Maternal Mortality
in Islamic Countries
24
2.4. Differentials in maternal and child care utilization
In this report, we examine selected process indicators that are considered the key interventions
for reducing maternal and child mortality. Antenatal care, delivery care from skilled birth
attendance or at health facility, postnatal care, and family planning use are identified as the four
pillars of the safe motherhood initiative, which was launched in 1987 at the Conference of Safe
Motherhood in Nairobi, Kenya. Since then, these four indicators are extensively utilized as the
tracking indicators for maternal and child health care. Proportion of births attended by skilled
health personnel (skilled birth attendance) is recognized as a key indicator for tracking the SDG-
3 progress (SDG Indicator 3.1.2).
The GOBI (growth monitoring, oral rehydration therapy, breastfeeding, and immunization)
package of intervention is significantly credited for child mortality reduction during the last
three decades The UNICEF’s State of the World's Children report 1982-83 launched the
initiative, known as the child survival revolution, that heavily promoted GOBI. Although GOBI
was highly successful in reducing U5MR, it had less impacts on neonatal deaths. The reduction
of neonatal mortality requires additional curative and preventive care, such as resuscitation
management, thermal care, and infection prevention. The three major causes of neonatal deaths
are infections (sepsis/pneumonia, tetanus and diarrhea), pre-term births, and birth asphyxia.
Moreover, antenatal care and skilled assistance at delivery care are critical for the prevention of
the perinatal deaths. Many perinatal deaths are attributable to poor labor management and
infection transmission from mothers.
The nationally representative surveys such as the Demographic and Health Surveys (DHS) and
MICS have started to collected data on thermal care and hygienic cord care but not available for
all the study countries.
In this report, we focused on key indicators that are available for most OIC countries: ANC,
delivery by skilled assistance and/or at health facility, postpartum care for women and
newborn, family planning use, immunization coverage (BCG, DPT3, measles and Polio3, and all
recommended doses), treatment for diarrhea (with ORS), and treatment for ARI.
2.4.1. Differentials in antenatal care utilization in OIC countries
Large inequity in antenatal care from skilled providers exists in the countries that have
comparatively low (<80 %) ANC coverage – by both the socioeconomic status (wealth quintile)
and education level of women (Figure 2.7). In some of these countries, ANC coverage among the
poorest (lowest wealth quintile) women were almost 50% lower than the women in richest
wealth quintile. More than 95% of mothers in Indonesia, Senegal, Turkey, Uganda, Jordan, and
Gambia received ANC.