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Title |
Maternal, neonatal, and child health in southeast Asia: towards greater regional collaboration |
Author(s) |
Cecilia S. Acuin, Geok Lin Khor, Tippawan Liabsuetrakul, et al - Personal Name
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Subject |
Maternal Health |
Publisher |
Lancet |
Publishing Year |
2011 |
Specific Detail Info |
Although maternal and child mortality are on the decline in southeast Asia, there are still major disparities, and
greater equity is key to achieve the Millennium Development Goals. We used comparable cross-national data sources
to document mortality trends from 1990 to 2008 and to assess major causes of maternal and child deaths. We present
inequalities in intervention coverage by two common measures of wealth quintiles and rural or urban status. Case
studies of reduction in mortality in Thailand and Indonesia indicate the varying extents of success and point to some factors that accelerate progress. We developed a Lives Saved Tool analysis for the region and for country subgroups to estimate deaths averted by cause and intervention. We identified three major patterns of maternal and child mortality reduction: early, rapid downward trends (Brunei, Singapore, Malaysia, and Thailand); initially high declines (sustained by Vietnam but faltering in the Philippines and Indonesia); and high initial rates with a downward trend (Laos, Cambodia, and Myanmar). Economic development seems to provide an important context that should be coupled with broader health-system interventions. Increasing coverage and consideration of the health-system context is needed, and regional support from the Association of Southeast Asian Nations can provide increased policy support to achieve maternal, neonatal, and child health goals. |
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