The World Health report 2005: 'make every mother and child count': WHO's flagship report, launched on World Health Day, April 7, focuses on saving the lives of mothers, babies and children.

• Auteur: Lynch, Bridget

World Health Day ... in the Americas

World Health Day was celebrated at the Pan American Health Organization in Washington, DC with a series of special sessions highlighting issues related to maternal and child health in PAHO priority countries (11 countries in the region with high levels of maternal and infant mortality):

* HIV/AIDS in mothers and children

* neonatal health

* the relationship between domestic violence and maternal and perinatal health.

PAHO fact sheets pointed out that a woman born in Latin America or the Caribbean is 27 times more likely to die as a result of pregnancy complications than a woman born in the USA; and a child born in Haiti is 17 times more likely to die before reaching the age of five than a child born in Canada.

While PAHO and WHO recommend that all pregnant women have access to skilled attendants at the time of childbirth, in Latin America and the Caribbean only 60% of mothers have access to such help.

Other important interventions which have been identified by PAHO for this region include essential prenatal care, the Integrated Management of Childhood Illness (IMCI) strategy and education about simple health, hygiene and nutrition practices for mothers and families.

The World Health Report

The full text of this publication is of high relevance to midwives across the world, as their broad spectrum of care can have impact on every aspect of mothers' and children's health. However, the most immediate concerns for midwives are contained in Chapter 4 of the report 'Attending to 136 million births'.

Causes of maternal death

The first part of it examines the main complications of childbirth, which claim an estimated 529,000 maternal deaths per year--almost all of them in developing countries--a global ratio of 400 maternal deaths per 100,000 live births. This figure will not be a surprise to most midwives, nor will the list of direct causes of death: haemorrhage, infection, eclampsia, obstructed labour and complications from (unsafe) abortion.

It is also noted that: 'Within one single country there can be striking differences between subgroups of the population. Rural populations suffer higher mortality than urban dwellers, rates can vary widely by ethnicity or by wealth status, and remote areas bear a heavy burden of deaths'.

Skilled professional care

The second part of the chapter turns attention to what can be done about the causes of maternal death, the majority of which are described as avoidable.

The...