Stacie Stender | October 2015
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Presentation at the Global Maternal Newborn Health Conference, October 20, 2015

Background: Two-thirds of all the deaths globally are not recorded in civil registries with cause-of-death information.  Low- and lower-middle income countries, countries with the highest rates of maternal and newborn mortality, are the majority. The lack of data and incongruous definitions leads to conflicting estimates of causes of mortality, including the contribution of infectious diseases (ID). Universal health coverage, a human right, requires a person-centered and integrated health approach that addresses all risks for the woman – whether obstetric, accidental, or incidental.

Methodology: Vertical approaches to caring for clients contribute to delayed access to appropriate diagnosis and treatment of illnesses.  It is essential for governments to integrate ID-related prevention, testing, and treatment activities, where epidemiologically relevant, into primary care platforms. Programmatic best practices and challenges will be discussed in the context of available evidence related to epidemics of IDs, emphasizing the importance of ‘knowing your epidemic to respond accordingly’.

Results: Of the ten leading causes of death of women 15-49 years globally, 5 are due to IDs: HIV/AIDS (1), TB (4), lower respiratory infections (8), diarrhoeal diseases (9) and malaria (10). There are tremendous geographic variations: the leading causes of death among women of reproductive age in Indonesia, Mozambique, Burkina Faso, and Peru are TB, HIV, malaria, and lower respiratory infections, respectively.  Six of the ten leading causes of death among newborns 0-6 days globally are IDs.

Conclusion: Often the same MNH providers see women for ‘well care’ as those presenting with symptoms of illness; however the process of diagnosing regionally relevant diseases is not well integrated into the basic package of MNH services.  IDs beyond HIV and malaria are not often considered despite documented evidence of contribution to mortality. Commitment from the global community to ensure quality, disaggregated data is essential to ensure implementation of context-specific solutions.