Shocking Inequity

(These women are Traditional Birth Attendants in Kenema District, Sierra Leone. They are greeting me with a traditional welcome.)

Much of my work here in Sierra Leone is centered around reproductive health care and child health care. Public health programs in the “developing world” provide services to women of reproductive age such as family planning, antenatal care, assisted births and postnatal care, as well as for children under the age of five for malnutrition, malaria, pneumonia and diarrhea (the leading causes of death). There is a wealth of evidence that health interventions in these areas for these two demographics have the greatest impact on the population’s health.

Simply put, they are life saving.

The figures comparing mortality rates for Sierra Leone to the United States are shocking.

The under five mortality rate, which tells us how many children under five die within a timeframe, is expressed per 1,000 live births. It answers the question: for every 1,000 births that occur, how many children under the age of five perish?

In the United States it is 7. In Sierra Leone it is 156.

Another significant indicator is the maternal mortality ratio, which tells us how many women die from pregnancy, childbirth, or in the postpartum period (42 days). This indicator is expressed per 100,000 live births. It answers the question: for every 100,000 births that occur, how many women are dying from pregnancy or childbirth?

In the United States it is 28. In Sierra Leone it is 1,165.

Globally, having children is one of the most dangerous experiences a woman encounters. It is the second leading cause of death in women of reproductive age (ages 14 to 44) (HIV/AIDS is the number one cause of death).

99% of ALL maternal deaths worldwide occur in “developing” countries.

This is shocking inequity.

*Mortality data is from DHS and UNICEF.

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