Abstract
Notable among gaps in the achievement of the global health Millennium Development Goals (MDG) are shortcomings in addressing maternal health, an issue addressed in the fifth MDG. This shortfall is particularly acute in Sub-Saharan Africa (SSA), where over half of all maternal deaths occur each year. While there is not as yet a comprehensive understanding of the biological and social causes of maternal death in SSA, it is evident that poverty, gendered economic marginalization, social disruptions, hindered access to care, unevenness in the quality of care, illegal and clandestine abortions, and infections are all critical factors. Beyond these factors, this paper presents a review of the existing literature on maternal health in SSA to argue that syndemics constitute a significant additional source of maternal morbidity and mortality in the region. Increasing focus on the nature, prevention, and treatment of syndemics, as a result, should be part and parcel of improving maternal health in SSA.
Highlights
Introduction to SyndemicsSan Francisco: Jossey-Bass; 2009. 16
This study demonstrates the importance of assessing multidisease syndemics among pregnant women
I have reviewed available literature suggesting the critical importance of adverse disease interactions of infectious and noninfectious diseases to draw attention to the role of syndemics in maternal health in the region
Summary
In SSA, are an understudied group, but they are more vulnerable to infections because of suppression of the immune system during pregnancy and are at heightened risk for various noninfectious diseases as well. Capacity-strengthening efforts designed to improve the number and quality of syndemic “burden-ofdisease” studies could provide critical knowledge for the implementation of programs capable of improving the quality of care and maternal health in SSA Such studies would explore the constellation of diseases of pregnant patients; would investigate locally-identified syndemics and their health effects during pregnancy including the patterns of presentation of specific interacting diseases, the social conditions that foster disease clustering and interaction among pregnant women; and involve trials of integrated treatment regimens designed to treat multiple co-occurring diseases in this population. Ray and co-authors [114] argue that “failure to reduce preventable maternal deaths represents a violation of women’s right to life, health, non-discrimination and equality.” They advocate an activist approach, involving collaboration of health professionals and non-government civil organizations for improving material health in the African context. Competing interests The author declares that he has no competing interests
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