Maternal and child mortality
Reducing maternal and child mortality does not require large investments of money, as low-cost technologies can be just as effective. The availability and affordability of essential medical devices used to prevent, diagnose and treat complications of prematurity and pregnancy can not only improve lives, but prevent the death of millions of women and children every year.
Ensuring the good health and wellbeing of women and children is essential for raising strong future generations. Global maternal mortality rates have declined by almost 45% in the past 25 years due to improved maternity care, but over 300,000 women still die annually as a consequence of complications during pregnancy or childbirth.
The statistical difference between developed and developing areas is stark, with 99% of all maternal deaths occurring in developing countries. While developed countries like Finland and Iceland have maternal mortality rates as low as just three deaths per 100,000 live births, in developing countries such as Sierra Leone this reaches rates of 1,360.
Difficulty in accessing skilled medical care or adequate resources for treatment affects mothers and children alike. Child mortality estimates suggest that some 2.6 million newborns – or 7,000 per day – died all over the world in 2016, with the majority of the deaths occurring in Southern Asia (39%) and sub-Saharan Africa (38%).
Closing this health and wellbeing gap between developed and developing countries requires a deep level of commitment from the international community. In order to achieve the sustainable development target set by the United Nations’ 2030 Agenda, the current number of maternal deaths must be reduced by more than two thirds in the next 12 years (from a global average of 216 to less than 70 deaths per 100,000 live births). More ambitiously, the Agenda aims to eradicate the preventable deaths of newborns and under-fives by 2030. The lives of 10 million children (half of them newborns) could be saved by 2030 if all countries achieve the SDG target on child survival.
As a first step towards reaching these goals, a full understanding of the causes of these deaths is required, along with identifying the technologies and solutions necessary to prevent them from happening. In cases of maternal death, the most common direct causesinclude post-partum haemorrhage (excessive bleeding), infection and hypertensive diseases (high blood pressure). It is estimated that hypertensive diseases (pre-eclampsia and eclampsia) account for about 10% of all maternal deaths. Hypertension can be diagnosed and prevented using simple technologies like blood pressure meters, or more advanced methods such as Doppler ultrasounds, which can be used to estimate blood flow and a wide range of conditions of pregnancy.
Low-tech and low-cost technologies could also save the lives of three million babies every year. Neonatal mortality is largely attributed to infections, birth asphyxia (suffocation) and complications of prematurity, such as hypothermia (low body temperature). Newborns, particularly if malnourished, can struggle with cold stress even at warm air temperatures, due to low subcutaneous fat, which acts as a natural layer of insulation. Furthermore, conditions associated with hypothermia and thermal stress can be easily prevented and treated using simple devices, like infant warmers.
Technology-based solutions for child and maternal mortality
The global burden of maternal and child mortality can be reduced by adequate care, with the vast majority of such deaths being preventable, if facilitated by medical technologies handled by skilled professionals. Essential health tools used to diagnose and treat disorders in pregnancy and hypothermia in infants include ultrasounds, thermometers, and infant warmers – all of which rely on metals such as iron, aluminium, zinc, nickel and copper.
Ultrasound is an imaging technique that enables the visualisation of internal body structures. It uses sound waves to generate images, also known as sonograms, by sending pulses of ultrasound into the tissue. Different tissues reflect different degrees of sound, with these varying echoes recorded and displayed as an image to the operator. Medical ultrasound is a helpful tool used to diagnose a wide range of conditions, for both the mother and the baby. These include placenta previa, abruption, incomplete abortion, causes of bleeding, multiple gestations, and ectopic pregnancies. A basic ultrasound comprises a transducer probe, CPU, pulse controls, LED display, a keyboard, a disk storage device and a printer. The probes used to send the pulses into the tissue contain piezoelectric crystal, while the CPU and keyboard contain metals such as gold, silver, platinum, palladium, copper, nickel, tantalum, cobalt and aluminium. The LED display also contains many elements, including arsenic, barite, bauxite, boron, copper, gallium, indium, and lead.
A body temperature below 36.5C in newborns is classified by the World Health Organisation (WHO) as within the gradation of hypothermia – a condition that can lead to pathologies such as infections and respiratory distress. Infant warmers are medical devices used to keep the body temperature of babies stable and within the healthy band of 36.5 to 37.5C. These technologies can range from high-cost full-featured incubators (equipped with automated temperature and humidity control, vital signs monitor, etc.) to inexpensive radiant warmers (equipped with a heat lamp and an electric blanket). NeoNurture is an incubator-type infant warmer with a twist: it is entirely made of repurposed car parts. Specially designed for low-resource settings, the incubator is equipped with a halogen-sealed beam headlight to provide warmth, a dashboard fan for convective heating, a signal light reused as an alarm, and a motorcycle battery for energy storage. Materials found in the incubator include silicon, lithium, cobalt, aluminium, and nickel.
A thermometer is a vital technology for diagnosing hypothermia. Traditionally, thermometers used to consist simply of a vacuum-sealed glass with engraved scale marks indicating temperature range, and mercury, which would expand or contract according to ambient temperature. Since mercury is highly poisonous, it has been replaced by non-toxic alcohol, which not only is safer but also has larger coefficient expansion. Digital (or electronic) thermometers are often used in medicine, featuring an LCD display that allows higher level of precision in readings. The resistance temperature detector (RTD), found in digital thermometers, measures temperature based on electrical resistance of metals. A typical material used in the wire windings is platinum, due to its fast response and accuracy – but they can also be made of copper or nickel.