In spite of a number of interventions to prevent disability or death during pregnancy and childbirth, the level of maternal mortality in Madagascar is still high. In fact, if we take as a reference the fifth Millennium Development Goal’s target (“Reducing maternal mortality by 2015”), which set at 127 the number of maternity deaths every 100 thousand births, the current level of mortality is still high: in 2012, the maternity death rate has been of 478 women every 100 thousand births.
Moreover, the number of births that occurred in the presence of qualified staff has seen few positive developments in recent years: from 43.9% in 2008/2009, to 44.3% in 2012. It's a worrying figure if we consider the target (75%) set by government operational plan for the 2012-2015 period, a plan made according to the United Nations strategy framework for women and children health.
According to the last needs assessment report of obstetric and neonatal care made in 2010 by the Malagasy Ministry of Health in partnership with the United Nations Fund for Population, the main causes of maternal death are hemorrhage (almost 20% of deaths), complications during abortion (16%), eclampsia, infections (15%), and uterine dystocia.
Regarding the children mortality rate under five years of age, after a phase of a rapid decline between 1997 and 2004 due to the joint efforts of national and international public authorities, has gone from 159‰ to 72‰, this rate has stabilized between 2004 and 2009.
The situation for children mortality rate under one year is similar: after a sharp decline between 1997 and 2009 (from 93‰ to 48‰), the data are nearly the same today.
Infant mortality is caused mainly caused by diarrhea crises, malaria and respiratory infections that affects mostly malnourished children.
Another area of intervention to analyze when we talk about maternal and children health is family planning: this term includes births planning. Despite an increase ( from 18% in 2004 to 29% in 2009) in the use of modern contraception, unmet needs in terms of family planning are estimated at around 18 %.
Taking into account the scarcity of contraceptive products in the country, the risk is that with a loss of focus on this situation, caused by the state of crisis, this data could rapidly worsen.