Developing countries account for 99% of all maternal deaths, with nearly three fifths of the maternal deaths occurring in sub-Saharan Africa alone. The cumulative lifetime risk of maternal death is as high as 1 in 16 pregnancies in some countries in sub-Saharan Africa, compared to 1 in 2800 in most developed countries.
The importance of antenatal care during pregnancyDuring the 1990s, there were noticeable increases in the use of antenatal care in some developing countries, particularly Asia. However, in sub-Saharan Africa, antenatal care use increased only marginally over the decade. In Ethiopia for example, only 27% of women receive 1 antenatal visit and 10% receive 4 visits.
Improving the coverage, frequency and quality of antenatal care is an essential step to improving maternal and neonatal health indicators because many effective interventions can be provided during pregnancy. One of the most cost-effective and simple antenatal interventions is immunisation against tetanus. In areas where malaria is endemic, intermittent presumptive treatment of malaria can reduce incidence of low birth weight, stillbirths, and neonatal and maternal mortality. Rubella vaccination reduces stillbirths and avoids congenital rubella syndrome. Diagnosis and treatment of reproductive tract infections reduce the risk of premature labour, as well as the direct perinatal deaths caused by syphilis. The antenatal period also presents an important opportunity for identifying threats to the unborn baby’s health, as well as for counselling on nutrition, birth preparedness, parenting skills and family planning options after the birth.