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