Overview Maternal & Child Mortality in Palestine Maternal Mortality Challenges Child mortality Dr. Hadil Ali-Masri OBGYN Consultant, PhD Ministry of Health State of Palestine
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Overview
Maternal & Child Mortality in Palestine
Maternal Mortality
Challenges
Child mortality
Dr. Hadil Ali-MasriOBGYN Consultant, PhD
Ministry of HealthState of Palestine
Maternal & Child Mortality in Palestine
Palestine
Egyptindependent.com
Maternal & Child Mortality in Palestine
Palestine
Maternal & Child Mortality in Palestine
Palestine
Population 3 million Surface area 5655 km²
West Bank
Maternal & Child Mortality in Palestine
Palestine
Population 3 million Surface area 5655 km²
West Bank
Population 2 million Surface area 365 km²
Gaza
Maternal & Child Mortality in Palestine
Palestine
World Bank report , 2018
• 29% of Palestinians live in poverty
Maternal & Child Mortality in Palestine
Palestine
World Bank report , 2018
• 29% of Palestinians live in poverty
• 2.5 million are in need of humanitarian assistance
Maternal & Child Mortality in Palestine
Maternal Mortality
Maternal & Child Mortality in Palestine
Maternal Mortality
38
32
28
23,7 24,1 24,7
15,713,8
5,9
16,7
0
5
10
15
20
25
30
35
40
2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
Maternal Mortality Rate
per 100 000 live births
Maternal & Child Mortality in Palestine
Maternal Mortality
38
32
28
23,7 24,1 24,7
15,713,8
5,9
16,7
0
5
10
15
20
25
30
35
40
2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
55% reduction from 2009 to 2018
Maternal & Child Mortality in Palestine
Maternal MortalityGaza vs. West Bank
Maternal & Child Mortality in Palestine
Maternal MortalityGaza vs. West Bank
2018
Maternal & Child Mortality in Palestine
Maternal MortalityGaza vs. West Bank
19,114,8
Gaza
West Bank
2018
Maternal & Child Mortality in Palestine
Maternal MortalityAge distribution
36.4%
36.4%18.2%
20-29 30-39 40-49
Maternal & Child Mortality in Palestine
Maternal MortalityTime of death
36.4%
54.5%
9.1%
Antepartum
Postpartum
Intrapartum
Maternal & Child Mortality in Palestine
Maternal MortalityTime of death
36.4%
54.5%
9.1%
Antepartum
Postpartum
Intrapartum
Vaginal 58.8%
Cesarean 41.2%
Birth Route
Maternal & Child Mortality in Palestine
Maternal MortalityDeath cause
category
73%
27%
Driect Causes Indrirect Causes
Maternal & Child Mortality in Palestine
Maternal Mortality
16.7% 16.7%
10%
6.7%
13.2%
PostpartumHemorrhage
PulmonaryEmbolism
Septic Shock Preeclampsia Other
Causes of direct death
Maternal & Child Mortality in Palestine
Maternal MortalityBUT!
76%
24%
Unavoidable
Avoidable
Maternal & Child Mortality in Palestine
Maternal Mortality Interventionstaken to
reduce MMR
Maternal & Child Mortality in Palestine
Maternal Mortality Interventionstaken to
reduce MMRActive monitoring of maternal mortality
(2009)
Maternal & Child Mortality in Palestine
Maternal Mortality
Active monitoring of maternal mortality(2009)
Reporting FlowStrategy
Interventionstaken to
reduce MMR
Maternal & Child Mortality in Palestine
Maternal Mortality
Active monitoring of maternal mortality(2009)
Complete MMR Survey
Interventionstaken to
reduce MMR
Maternal & Child Mortality in Palestine
Maternal Mortality
Active monitoring of maternal mortality(2009)
Complete MMR Survey
Interventionstaken to
reduce MMR
Maternal & Child Mortality in Palestine
Maternal Mortality
Active monitoring of maternal mortality(2009)
Complete MMR Survey
Interventionstaken to
reduce MMR
Maternal & Child Mortality in Palestine
Maternal Mortality
Formulation of updated national evidence-based guidelines
Interventionstaken to
reduce MMR
Maternal & Child Mortality in Palestine
Maternal Mortality
Formulation of updated national evidence-based guidelines
Monitoring of near-miss maternal cases
Interventionstaken to
reduce MMR
Maternal & Child Mortality in Palestine
Maternal Mortality
Formulation of updated national evidence-based guidelines
Monitoring of near-miss maternal cases
Integration of contraception and family planning
Interventionstaken to
reduce MMR
Maternal & Child Mortality in Palestine
Maternal Mortality
Increase healthcare access
Interventionstaken to
reduce MMR
Maternal & Child Mortality in Palestine
Maternal Mortality
Employment of intrapartum interventions
Increase healthcare access
Interventionstaken to
reduce MMR
Maternal & Child Mortality in Palestine
Maternal Mortality
Employment of intrapartum interventions
Medical equipment preventive maintenance policy
Increase healthcare access
Interventionstaken to
reduce MMR
Maternal & Child Mortality in Palestine
Maternal Mortality Plannedinterventions to
reduce MMR
Forming an MMR technical committee
Maternal & Child Mortality in Palestine
Maternal Mortality Plannedinterventions to
reduce MMR
Forming an MMR technical committee
Integration of preconception care protocol
Maternal & Child Mortality in PalestineChild Mortality Under five Child
Mortality Rateper 1000 live birth
Maternal & Child Mortality in PalestineChild Mortality
1517
21
16 16 15 1412,2 12,1
13,4
0
5
10
15
20
25
2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
Under five ChildMortality Rate
per 1000 live birth
Maternal & Child Mortality in PalestineChild Mortality
13,214
18,8
13,512,9 12,6
10,9 10,5 10,711,7
0
2
4
6
8
10
12
14
16
18
20
2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
Infant Mortality Rateper 1000 live birth
Maternal & Child Mortality in PalestineChild Mortality
Infant Mortality WBCauses-2018
77.8%
10.4%
7.5%4.3%
Perinatal Period conditions
congenital malformations
Congenital Heart Disease
Other
Maternal & Child Mortality in PalestineChild Mortality Interventions
taken to reduce Infant
mortality
Maternal & Child Mortality in PalestineChild Mortality Interventions
taken to reduce Infant
mortality- Expanded immunization program
Maternal & Child Mortality in PalestineChild Mortality Interventions
taken to reduce Infant
mortality
- Raising awareness on breast feeding
- Expanded immunization program
Maternal & Child Mortality in PalestineChild Mortality Interventions
taken to reduce Infant
mortality
- Raising awareness on breast feeding
- Expanded immunization program
- Integration of antenatal screening protocol
Maternal & Child Mortality in PalestineChild Mortality Interventions
taken to reduce Infant
mortality
- Raising awareness on breast feeding necessity
- Expanded immunization program
- Integration of neonatal care strategy “Every Newborn Action Plan”
- Integration of antenatal screening protocol
Maternal & Child Mortality in Palestine
Maternal & Child Mortality Challenges
Maternal & Child Mortality in Palestine
Maternal & Child Mortality Challenges
- Under reporting
Maternal & Child Mortality in Palestine
Maternal & Child Mortality Challenges
- Under reporting
- Poor medical record note
Maternal & Child Mortality in Palestine
Maternal & Child Mortality Challenges
- Under reporting
- Poor medical record note
- Poor education among women
Maternal & Child Mortality in Palestine
Maternal & Child Mortality Challenges
- Restrictions on access to medical care due to political situation
Maternal & Child Mortality in Palestine
Maternal & Child Mortality Challenges
- Restrictions on access to medical care due to political situation
- Shortage of skilled healthcare attendants
Maternal & Child Mortality in Palestine
Maternal & Child Mortality Challenges
- Restrictions on access to medical care due to political situation
- Low morale among healthcare attendants due to a high work load and small salaries
- Shortage of skilled healthcare attendants
Thank You
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