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= Maternal health in Malawi = The maternal health, characterized by the health of a woman during pregnancy, childbirth and the postpartum period, is one of the biggest challenges for Malawi, located in Sub-Saharan Africa. Malawi has one of the highest maternal mortality ratios of the world. Maternal morbidity and mortality remain the biggest public health problems of this time and poor quality of obstetric services is a continuing associated factor. Maternal health causes can be classified in direct obstetric causes (like obstructed labour, hypertensive disorders, haemorrhage, etc) and indirect non-obstetric causes (like anaemia, Malaria, HIV/AIDS, etc), [4]. Most maternal health causes are preventable, ending those preventable maternal health causes at the top of the global agenda of the World Health Organization. Furthermore, the Millennium Development Goal number 5: improve maternal health, is to accelerate progress to improve maternal health for all women over the world.

Maternal Health outcomes
The maternal health can be understood as the health of women during pregnancy, childbirth and the postnatal period. There are a lot of causes for maternal health problems. These causes can be classified in direct obstetric causes and indirect non-obstetric causes. The most common causes for maternal health problems are: There has been a significant process in reducing maternal mortality globally, between 1990 and 2015 it declined by 44%. Even though, every year more than 300 000 women die due to complications of pregnancy and childbirth, besides 2.5 million babies die during the first month of life. A common way to assess the standard health of pregnant women and the standard of care being provided to pregnant women is by using the maternal mortality ratio.

Maternal Mortality Ratio
The maternal mortality ratio (MMR) can be explained by “the number of maternal deaths during a given time period per 100 000 live births during the same time period”. The MMR describes the risk of maternal death relative to the number of live births and essentially comprehends the risk of death in one pregnancy or one live birth.

Maternal health in Malawi
Malawi has one of the highest maternal mortality ratios in the world. The current estimation is on 439 maternal deaths per 100 000 live births. The most common causes of maternal health problems in Malawi are sepsis, haemorrhage and obstructed labor/ruptured uterus. The current maternal mortality ratio of Malawi is 349.

Millennium Development Goal 5: Improve Maternal Health
Every year, about 140 million births take place. In the past two decades, the deaths from complications during pregnancy, childbirth and postnatal period have declined, with even 38%. Although, this is on average a decrease of just 3% each year. Worldwide, an estimated 300 000 women died during pregnancy and childbirth, in 2015. This is also a decrease of 44% since 1990. Most common deaths were caused by no access to skilled routine and emergency care. The number 5 Millennium Development Goal of the World Health Organization, offers an opportunity for the international community to work together and accelerate progress to improve maternal health for all women, globally, under all circumstances.

In Sub-Saharan Africa the risk of maternal death is very high, at 1 in 38. There is an increase in women seeking care during childbirth in health facilities and therefore it is important that provided care is of optimal quality. About 10% of all women worldwide do not have access to or are not using an effective method of contraception. The focus of the MDG 5 of WHO is on: strengthening health systems and promoting interventions focusing on policies and strategies that work, monitoring and evaluating the burden of maternal and newborn ill-health, building effective partnerships for better use of scarce resources and minimize duplication in efforts to improve maternal and newborn health, and advocating for investment in maternal and newborn health.