Sub-Saharan Africa's Mothers, Newborns, and Children: Where and Why Do They Die?

This paper is part of a PLoS Medicine series on maternal, newborn, and child health in Africa.Nearly 4.7 million mothers, newborns, and children die each year in sub-Saharan Africa: 265,000 mothers die due to complications of pregnancy and childbirth [1]; 1,208,000 babies die before they reach one month of age [2]; and 3,192,000 children, who survived their first month of life, die before their fifth birthday [1].This toll of more than 13,000 deaths per day accounts for half of the world's maternal and child deaths.In addition, an estimated 880,000 babies are stillborn in sub-Saharan Africa and remain invisible on the policy agenda [3].With only five years left to achieve the United Nation's Millennium Development Goals (MDGs) for maternal and child health, most African countries in the region are currently unlikely to meet their MDG targets [4].Since time is short for achieving success, a critical understanding of where and why these deaths occur, and of strategic, data-based prioritization of interventions, are essential to accelerate progress.The aim of this paper is to present the current situation in sub-Saharan Africa for mothers, newborns, and children under age 5 years-including the progress towards the MDGs for maternal and child health, why and where deaths occur, what known interventions can be employed to prevent these deaths, and current coverage of these interventions.All data used in this review are from the most recent UN databases, national household surveys, and peer-reviewed papers where appropriate, which are referenced accordingly.This paper is the first of two in a PLoS Medicine series on maternal, newborn, and child health (MNCH) in sub-Saharan Africa, along with three related essays providing critical commentary [5][6][7][8].The papers are based on a report entitled ''Science in Action: Saving the Lives of Africa's Mothers, Newborns, and Children,'' which was developed for the annual meeting of the African Science Academy Development Initiative in Accra, Ghana, in November 2009 [9].A team of over 60 scientists and researchers from nine countries outlined the current status of MNCH in sub-Saharan Africa, presented evidence-based solutions, and used national data to identify immediate high-impact opportunities for saving lives.With the MDG deadline of 2015 rapidly approaching, data on progress and on where, when, and why deaths occur are a critical basis for prioritizing actions.The Policy Forum allows health policy makers around the world to discuss challenges and opportunities for improving health care in their societies.