Annals of Tropical Medicine and Public Health

: 2016  |  Volume : 9  |  Issue : 6  |  Page : 404--405

Responding to the public health challenge of rising maternal mortality in humanitarian crises

Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy 
 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamil Nadu, India

Correspondence Address:
Saurabh R Shrivastava
Department of Community Medicine, 3rd Floor, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur - Guduvanchery Main Road, Sembakkam Post, Kanchipuram - 603 108, Tamil Nadu

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Responding to the public health challenge of rising maternal mortality in humanitarian crises.Ann Trop Med Public Health 2016;9:404-405

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Responding to the public health challenge of rising maternal mortality in humanitarian crises. Ann Trop Med Public Health [serial online] 2016 [cited 2020 Feb 19 ];9:404-405
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Full Text

Dear Sir,

Globally, in the quest to achieve the Millennium Development Goals and to improve the health standards of adolescent girls and women, a remarkable improvement has been accomplished in heterogeneous settings.[1] However, the health sector has not been very successful in ensuring protection of the health and rights of women and girls in humanitarian crises.[2] In fact, owing to civil wars or natural disasters, lives of close to 26 million girls and women from the age group of 15–49 years is affected (viz., vulnerability to sexual violence, devoid of essential health services like maternal health care, contraception, etc.).[2]

Even though, the recent estimates suggest that an excess of 800 women worldwide die from preventable causes related to pregnancy and childbirth, nevertheless, almost 61% of these maternal deaths (more than 500 maternal deaths) have been reported from fragile and humanitarian settings.[1],[2] To be precise, close to 0.18 million maternal deaths have been estimated in the 35 nations that are encountering a humanitarian crisis in the year 2015, which is 1.9 times more than the global estimate of maternal deaths.[2] It is a clear indication that the areas that are facing humanitarian crises have a significant disparity with regard to access to the essential health care services.[3],[4]

Further, ten of the leading nations that account for the maximum share of maternal mortality, are all facing or emerging from the aftereffects of war.[2] In fact, it has been anticipated that by the end of 2015, about 67% of the maternal mortality will be from nations affected by a humanitarian crisis or fragile conditions.[2] This is predominantly because of the lack of assistance to the skilled health worker at times of birth and neglect toward the basic sexual and reproductive health services.[2],[3],[4] In addition, there is a remarkable shortage in the financial support, reproductive health equipment, medicines, and logistics required to address the challenge of improving maternal health at times of complex emergencies or conflicts.[3],[4],[5]

The need of the hour is to acknowledge that the range of humanitarian response goes way beyond the provision of logistics and health care services.[1] It is extremely important to enhance the capacity of communities to be resilient to crisis, especially with regard to ensuring improvement in poverty and health inequalities.[1],[2] It is high time that policymakers should invest the existing resources in an evidence-based manner in the maintenance of the reproductive health and human rights of the girls and women, as women do not stop giving birth at times of any conflict.[3],[4] Further, in order to deal with the issues pertaining to the health and rights of women and adolescents, strategies should be formulated well in advance, rather than planning for the same after the crisis occurs.[5],[6] Finally, all the stakeholders should establish linkages and work in a coordinated and streamlined manner to improve the health standards of women in general, including at times of humanitarian crises.[3],[4],[5]

To conclude, significant improvement in women and girls' health standards at times of humanitarian crises can only be achieved, provided they are empowered to play a crucial role in the family, society, and policy levels.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.


1World Health Organization. Maternal mortality-Fact sheet No 348; 2015. Available from: [Last accessed on 2016 Feb 14].
2UNFPA. 507 maternal deaths take place every day in emergencies, flagship report says; 2015. Available from: [Last accessed on 2016 Feb 14].
3Pillay N. Maternal mortality and morbidity: A human rights imperative. Lancet 2013;381:1159-60.
4Pyone T, Dickinson F, Kerr R, Boschi-Pinto C, Mathai M, van den Broek N. Data collection tools for maternal and child health in humanitarian emergencies: A systematic review. Bull World Health Organ 2015;93:648-58A-M.
5Nickerson JW, Hatcher-Roberts J, Adams O, Attaran A, Tugwell P. Assessments of health services availability in humanitarian emergencies: A review of assessments in Haiti and Sudan using a health systems approach. Confl Health 2015;9:20.
6Pottie K. Health equity in humanitarian emergencies: A role for evidence aid. J Evid Based Med 2015;8:36-8.