East Africa makes progress in reducing maternal and child deaths


Fewer people are dying from respiratory infections and malaria in many East African nations, according to a new scientific analysis of more than 300 diseases and injuries in 195 countries.

However, such progress is threatened by the large numbers of people who suffer from serious health challenges related to unsafe sex, childhood wasting, and unsafe water.

These and other significant health findings are being published in a dedicated issue of The Lancet as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). The study draws on the work of more than 1,800 collaborators in nearly 130 countries and territories.

“Many nations face significant health challenges despite the benefits of income, education, and low birth rates, while other countries farther behind in terms of development are seeing strong progress,” said Dr. Charles Shey Wiysonge, a GBD collaborator from South Africa who serves as a professor of clinical epidemiology at the Faculty of Medicine and Health Sciences, Stellenbosch University, in Cape Town. “Policymakers in all nations – from Afghanistan to Zimbabwe – can use this study to align spending to target the things that will make their communities healthier faster.”

In many East African nations, lower respiratory infection was the leading cause of death, resulting in 58,231 deaths in Ethiopia and 8,181 in Rwanda. On the other hand, HIV/AIDS was the top killer in Kenya, leading to 46,577 deaths in 2015.

But the conditions that kill are not typically those that make people sick. The top three nonfatal causes of health loss in East Africa overall were iron-deficiency anemia, depression, and low back pain.

Globally, life expectancy increased from about 62 years to nearly 72 from 1980 to 2015, with several nations in sub-Saharan Africa rebounding from high death rates due to HIV/AIDS. Child deaths are falling fast, as are illnesses related to infectious diseases. But each country has its own specific challenges and improvements, from fewer suicides in France, to lower death rates on Nigerian roadways, to a reduction in asthma-related deaths in Indonesia.

Findings for Eastern sub-Saharan Africa include:

  • Over the past 25 years, life expectancy has increased throughout the region. In 2015, the life expectancy was 64 in Tanzania, 61 in Uganda, 57 in Zambia, and 54 in Somalia.
  • While the world has made great progress in reducing deaths of young children, globally, 5.8 million children under the age of 5 died in 2015. Of that global figure, 189,636 of those deaths were in Ethiopia, 79,236 in Kenya, and 23,768 in Rwanda. While the number of young child deaths was highest in Ethiopia among these countries, it showed the greatest decline between 1990 and 2015.
  • Many countries in Eastern sub-Saharan Africa have reduced deaths of expecting or new mothers. For example, the number of maternal deaths in 2015 in Rwanda was 1,353, down from 2,142 in 1990. And in Tanzania, the ratio of maternal deaths fell from 544 deaths per 100,000 live births to 338 deaths between 1990 and 2015.

The report was released at an event co-sponsored by IHME, The Lancet, and the World Bank in Washington, DC. The study was established in 1990 with support from the World Bank. This year, researchers analyzed each country using a Socio-demographic Index, examining rates of education, fertility, and income. This new categorization goes beyond the historical “developed” versus “developing” or economic divisions based on income alone.

The six papers provide in-depth analyses of causes of death, maternal mortality, deaths of children under age 5, overall disease burden and life expectancy, years lived with disability, and the risk factors that lead to health loss.

In much of the world, giving birth is safer for mothers and newborns than it has been over the past 25 years. The number of maternal deaths globally dropped by roughly 29% since 1990, and the ratio of maternal deaths fell 30%, from 282 per 100,000 live births in 1990 to 196 in 2015.

“Development drives, but does not determine health,” said Dr. Christopher Murray, Director of the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in Seattle, the coordinating center for the GBD enterprise. “We see countries that have improved far faster than can be explained by income, education, or fertility. And we also continue to see countries – including the United States – that are far less healthy than they should be given their resources.”

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