Leveraging mobile technology to reduce barriers to maternal, newborn and child health care: a contribution to the evidence base

Significant progress has been achieved worldwide in recent decades to improve the health of women and reduce the number of children who die before their fifth birthday (UN 2010). The efforts of governments in low and middle income countries (LMICs) and their development and funding partners have coalesced around the twin Millennium Development Goals (MDGs) 4 and 5 and steadily contributed to breaking the vicious cycle of poverty and poor maternal newborn and child health (MNCH) even in some of the poorest countries in the world (WHO & UNICEF 2012). In 2013 the world’s maternal mortality ratio (MMR) was estimated at 210 deaths per 1 live births down from 380 in 1990. Despite this progress more than 275000 women worldwide die annually from preventable complications related to pregnancy and childbirth. Most of these deaths occur in sub-Saharan Africa (62%) and Southern Asia (24%) (UN 2014). Another major development related to maternal health has been the gradual increase in the use of contraception in LMICs largely as a result of improved access to safe affordable and effective methods. In sub-Saharan Africa the contraceptive prevalence rate among married women doubled between 1990 and 2012 from 13% to 26% yet unmet need for family planning remains high standing currently at around 25% (WHO and UNICEF 2012). On the newborn and child health front the achievements have been remarkable and the prospects brighter since the mid-2000s. Globally the under-five mortality rate almost halved between 1990 and 2012 from 90 to 48 deaths per thousand live births and correspondingly the number of under-five deaths dropped by nearly 6 million (UNICEF 2013). With the exception of sub-Saharan Africa and Oceania all regions recorded a steep drop in their under-five mortality rates (UN 2014). The overall sluggish decline in sub-Saharan Africa notwithstanding a number of countries in the region like Malawi (the main focus of this Supplement) have already met or are on track to meeting the target for MDG 4 (UNICEF 2013). While the pace of progress is remarkable around 6.6 million children continue to die each year before their fifth birthday of causes that can be addressed with known interventions (UN 2014). (excerpt)