The daily death toll in the developing world is 830 mothers and 16,000 children under 5. Half these children die in their first 28 days’ life through birth problems and flow-on from malnutrition.
The bulk of these deaths are in sub-Saharan Africa, where under-5 mortality is 12 times the rate in the developed world.  The good news is that infant mortality has halved since 1990, and since 2000 has been falling at 4% per annum.
Australia’s nearest neighbours PNG and Timor Leste both have third-world rates of maternal/infant mortality:
  • Maternal deaths per 100,000 live births in our region:
    • PNG  fell in 2015 to 215, a drop of 54% on 1990.
    • Timor Leste the drop was even more pronounced, to 94 or down 73% on 1990.
    • In contrast, Australia’s maternal death rate is only 6, down from 8 in 1990.
A crucial factor in reducing maternal mortality is ante-natal visits (preferably at least four). In Timor Leste the proportion of mothers getting such care is 55%, and in PNG, 29%. A second key factor is skilled help at birth, normally via trained midwives. The Timor figure is 29%, PNG 43%. These figures indicate deficiencies that if corrected, could have a powerful impact for lower death rates.
  • In terms of Under-5 mortality per 1000 live births:
    • Timor in 2013 had a rate of 55, down 68% on 1990, and
    • PNG 61 (down 31%).
Availability of birth control is another key factor in improving maternal and child health. For Timor, the availability is 22% and in PNG 32%. Bringing family planning services to all those wanting it, would cost around $US4 billion, but generate enormous benefits. These include:
  • 54m fewer intended pregnancies
  • 26m fewer abortions, of which 16m are currently unsafe and life-threatening)
  • 21m fewer unplanned births
  • 79,000 fewer maternal deaths and
  • 1.1m fewer infant deaths.
Tony then showed a film from PNG nationals outlining the challenges of maternal/infant death rates in PNG, with service delivery from the central government often deficient.
Neville John commented on the good work on maternal health being done through Rotary Foundation and various club efforts, including our own Dr Lou Butterfield who led a maternal health team to Mongolia. Other work on maternal health in Timor Leste is via the Rotary-supported Alola Foundation.