The Global and Local Factors Influencing Maternal Mortality Ratios: Barriers and Recommendations for Success
Alexandra DiOrio, Dr. Andrea Crivelli-Kovach

Abstract
Maternal death is defined as the death of a female of reproductive age during pregnancy, labor or within 42 days of termination of pregnancy from causes that are related to or aggravated by pregnancy and relevant care. Maternal deaths are measured by maternal mortality ratios per country and are reported as the number of maternal deaths per 100,000 live births. Each year an estimated 500,000 women die worldwide from complications due to pregnancy or labor and about half of these women live in Sub-Saharan Africa. The rationale for conducting this study is to address the prevalent and preventable issue, maternal death and to assess barriers to the achievement of the 5th Millennium Development Goal. Purpose: To explore maternal mortality worldwide and in Sub-Saharan Africa, to analyze health risk factors, social/environmental factors, tracking techniques, intervention techniques and policy factors both worldwide and in Sub-Saharan Africa and make recommendations for Sub-Saharan Africa aimed at reducing maternal mortality rates and achieving the 5th Millennium Development Goal. Methods:The design is a comparative literature review and policy analysis. Variables were chosen based on their relation to the outcome, maternal health. Studies reviewed came from peer-reviewed journals found in Arcadia University’s Landman Library. Key words and phrases were used to identify relevant articles. Relevant data was extracted from articles such as demographic information, sample size, intervention being tested or chronic condition being observed and impact on the outcome, maternal health. Recommendations were then made for improving the likelihood of success for the Millennium Development Goal 5. Policy Analysis: An assessment of policies implemented in Sub-Saharan Africa indicated that previous declarations and initiatives have failed within the last 40 years due to lack of funding and enforcement, resource scarcity, lack of government involvement and corruption.A lack of resources has created barriers to access for all of the population, in particular women who face gender inequality and discrimination. Lack of resources, enforcement and funding increase the disease burden and decrease access to care in Sub-Saharan Africa. A lack of education and gender inequality adds additional barriers for women and girls that ultimately influences maternal mortality rates in these countries. Recommendations: Using the Africa Health Strategy: 2007-2015 as a model, policy reform is necessary with elements of female empowerment through education and access to health care including control over social aspects of their lives such as marriage, family planning and cultural rituals such as female genital mutilation. The policy must be comprehensive and have a strong regulation and accountability system so that when decisions are made in the government, they are enforced at the community level. Lastly, communication is vital to policy reform; the system must have effective communication that allows the community level to communicate about needs not being met to the government. Unfortunately, capacity and lack of resources are challenges to decreasing maternal mortality, however effective use of resources can prove beneficial.

Full Text: PDF     DOI: 10.15640/jsspi.v2n3a3