The State of Maternal and Infant Health and Mortality in Chad

Brice Wilfried Obiang-Obounou, Manka Eunice Fuh

Abstract

The level of Chad’s government expenditure on health is a predictor of the general health of the population and, consequently, life expectancy. We used data from the World Bank’s World Development Indicators and publications from the World Health Organization to assess the state of maternal and infant health and mortality. The primary objective of this research was to investigate whether Chad had reduced the risk of maternal and infant mortality after signing the Abuja Declaration in 2001. We hypothesised that increased general government health expenditure was associated with improved health mediated by increased numbers of skill health workers and minimum out-of-pocket health expenditure. Our secondary objective was to assess effective implementations of health policies in line with the Millennium Development Goals that Chad has agreed to achieve by 2015. We observed that, as of 2015, the government health expenditure was only 6.28% and the population out-of-pocket spending was over 56%. Furthermore, only 20% of women give birth in a hospital. These results led to three major policies recommendations in order to improve maternal and infant health in Chad: skilled birth attendants training, enhanced social status of nurses, and the development of a supplemental nutrition care program for women. (Afr J Reprod Health 2020; 24[1]:26-34).

Full Text:

PDF

References

WorldBank. Poverty headcount ratio at $1.90 a day (2011 PPP) (% of population). 2013 [cited 2018; Available from:https://data.worldbank.org/topi/poverty?locations=TD-1W.

Northrop W. Poverty in Chad. 2016.

UNDP, Human Development Index. 2016.

UNDP, Chad Human Development Indicators. 2016.

Bilas V, Franc S and Bosnjak M. Determinant factors of life expectancy at birth in the European Union countries. Coll Antropol, 2014. 38(1): p. 1-9.

Bae J, Kim YY and Lee J-S. Factors Associated With Subjective Life Expectancy: Comparison With Actuarial Life Expectancy. J Prev Med Public Health, 2017. 50(4): p. 240-250.

Bae JH and Obiang-Obounou BW. Presence of Dental Caries Is Associated with Food Insecurity and Frequency of Breakfast Consumption in Korean Children and Adolescents. Preventive Nutrition and Food Science, 2018. 23(2): p. 94-101.

Piabuo SM and Tieguhong J Chupezi. Health expenditure

and economic growth - a review of the literature and an analysis between the economic community for central African states (CEMAC) and selected African countries. Health Econ Rev, 2017. 7(1): p. 23.

Bhutta Z, Das J, Rizvi A, Gaffey M, Walker N and Horton S. Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? Lancet, 2013. 382(9890): p. 452-477.

Goonewardene M, Shehata M and Hamad A. Anaemia in

pregnancy. Best Pract Res Clin Obstet Gynaecol, 2012. 26(1): p. 3-24.

Gangopadhyay R, Karoshi M and Keith L. Anemia and

pregnancy: a link to maternal chronic diseases. Int J Gynaecol Obstet, 2011. 115 Suppl 1: p. S11-5.

Nandlal V, Moodley D, Grobler A, Bagratee J, Maharaj

NR and Richardson P. Anaemia in pregnancy is associated with advanced HIV disease. PLoS One, 2014. 9(9): p. e106103.

WHO. Exclusive breastfeeding for six months best for

babies everywhere 2011.

Steenkamp L, Lategan R and Raubenheimer J. Moderate

malnutrition in children aged five years and younger in South Africa: are wasting or stunting being treated? South African Journal of Clinical Nutrition, 2016. 29(1): p. 27-31.

UNICEF. State of the World's Children, Childinfo, and

Demographic and Health Surveys. 2015.

WHO. Trends in Maternal Mortality: 1990 to 2015.

, World Health Organization.

UNFPA. Delivering Hope and Saving Lives: Investing in

Midwifery. 2012 [cited 2018 July30]; Available from: https://www.unfpa.org/sites/default/files/resource-pdf/EN-SRH%20fact%20sheet-Midwifery.pdf.

Children St. Ending Newborn Deaths: Ensuring Ever y

Baby Survives. 2014 [cited 2018 July 30]; Available from: http://www.herdignity.net/2014/08/14/ending-newborn-deaths-save-the-children-2014/.

IRIN. Chad’s health system struggles to combat

malnutrition. 2013; Available from: http://www.irinnews.org/report/97327/chad%E2%80%99s-health-system-struggles-combat-malnutrition.

WHO/workforcealliance. Chad Human Resources for

Health. 2018 [cited 2018 august 4]; Available from: http://www.who.int/workforcealliance/countries/tcd/en/.

Noubaramadje M. Système de Santé au Tchad et l'appui

du projet santé 8e FED: Bilans et perspectives, in Administration-Gestion des Services de Santé. 2006, Ecole Nationale d'Administration et de magistrature Djamena

Jaeger F, Bechir M, Harouna M , Moto D and Utzinger J.

Challenges and opportunities for healthcare workers in a rural district of Chad. BMC Health Serv Res, 2018. 18(1): p. 7.

Delobelle P, Rawlinson J, Ntuli S, Malatsi I, Decock R

and Depoorter AM. Job satisfaction and turnover intent of primary healthcare nurses in rural South Africa: a questionnaire survey. J Adv Nurs, 2011. 67(2): p. 371-83.

Kekana HP, du Rand EA, and van Wyk N. Job satisfaction of registered nurses in a community hospital in the Limpopo Province in South Africa. Curationis, 2007. 30(2): p. 24-35.

Nabirye R, Brown K, Pryor E and Maples E. Occupational stress, job satisfaction and job performance among hospital nurses in Kampala, Uganda. J Nurs Manag, 2011. 19(6): p. 760-8.

Refbacks

  • There are currently no refbacks.