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  • Understand the basic terms and definitions of indicators
  • Understand the main causes of mortality and morbidity through the lifecycle of women and children
  • Describe the social, economic, and cultural context of maternal and child health
  • Distinguish maternal health issues and interventions from other women’s health issues and describe the relationships between them
  • Identify low-cost, effective community-based approaches to interventions

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Global Context

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Maternal and child health (MCH) refers to the health status and health services provided to women and children. The traditional focus of the disciplines of MCH has been on women in their roles as mothers (childbearing and child rearing) and on children (primarily the healthy survival of infants and young children). MCH indicators are often used to measure the social, economic, and educational status of women as well as community-level access to primary care. MCH was the mainstay of international health and development programs until human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) became an epidemic in many parts of the world.

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Remarkable achievements have been made in reducing child and maternal mortality and morbidity. However, of the eight Millennium Development Goals (MDGs), the only three that will not be achieved by 2015 are those related to MCH: MDGs 3, promote gender equality and empower women; 4, reduce child mortality; and 5, improve maternal health.1

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There continues to be a large disparity in MCH indicators between high- and low-income countries. The highest levels of mother and child health can be found in European and higher income countries in Asia. These are also countries that provide high-quality and accessible health and social services. Infant mortality rates (IMR) of less than 4/1,000 are found in Singapore, Iceland, Japan, Sweden, Finland, and Norway, and maternal mortality rates (MMRs) less than 5/100,000 can be found in Estonia, Greece, Singapore, Italy, Austria, and Sweden. Although there has been great improvement in MCH indicators in low income countries in the last 10 years, the rates remain much higher. In 2000, 18 countries had MMRs higher than 1,000/100,000, but there were only 2 in 2010. These were 1,100/100,000 in Chad and 1,000/100,000 in Somalia. Sierra Leone, which had the highest rate in 2000 (2000/100,000), was reduced to 890 by 2010. There were eight other countries with very high MMRs (above 600)—all in sub-Saharan Africa (Sierra Leone, Central African Republic Burundi, Guinea-Bissau, Liberia, the Sudan, Cameroon, and Nigeria).2,3 Most of the countries with the highest mortality rates are also those experiencing war and conflict. Almost all (99%) of maternal deaths occur in low-income countries. The regions with the highest maternal deaths are Africa and the poorer parts of Asia (Table 4-1).2 Two countries, India and Nigeria, account for a third of global maternal deaths.2 Infant mortality disparities show the same trend, although not to the same extreme level. The highest infant mortality rates (IMRs) are found in the same countries with high maternal mortality, with the ...

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