NURS FPX 8024 Assessment 2 Global Issue Investigation

NURS FPX 8024 Assessment 2

Global Issue Investigation

Student name

Capella University

NURS-FPX 8024

Professor Name

Submission Date

Global Issue Investigation

Maternal mortality is still one of the most prominent global health challenges that needs immediate attention. An estimated 260,000 women died during pregnancy and childbirth in 2023, a 40% decrease in the global maternal mortality ratio between 2000 and 2023 (from 328 to 197 deaths per 100,000 live births; World Health Organization, 2025; UNICEF, 2025). Sub-Saharan Africa carries the highest burden (approximately 70% of the global burden of maternal mortality), followed by southern Asia (17% of the global burden of maternal mortality, World Health Organization, 2025). There is a huge gap economically between low income countries and high income countries, for example, low income countries have 346 deaths per 100,000 live births while high income countries have 10 per 100,000 live births (World Health Organization, 2025). The preventable deaths are individual tragedies, as well as significant barriers to global development and health justice.

Description of the Problem

• Global Prevalence and Scope

Maternal mortality is still one of the biggest health problems in the world. An estimated 260,000 women lost their lives to complications of pregnancy and childbirth in 2023, every two minutes of the year (UNICEF, 2025; World Health Organization, 2025). Overall, the MMR declined by 40 percent from 328 to 197 deaths per 100,000 live births between 2000 and 2023 (United Nations Children’s Fund (UNICEF), 2025; The World Bank, 2025). According to the World Health Organization (2025), in 2023, more than 700 women died every day from preventable complications from pregnancy, with 92 per cent of the deaths occurring in low and lower-middle-income countries. The current global maternal mortality ratio (MMR) of 197 per 100,000 live births is almost three times the Sustainable Development Goals target of 70 per 100,000 (UNICEF 2025; World Bank 2025). The deaths represent catastrophic losses that require a coordinated international response now.

• Disproportionately Affected Nations

Cross-country geographical differences in maternal mortality reflect deep inequalities across regions. Sub-Saharan Africa alone is estimated to account for 70% of the global burden of maternal deaths (182,000), followed by southern Asia (17% or 43,000) of the global burden (World Health Organization, 2025). In 2023, there were 3 maternal deaths for every 100,000 births in Australia and New Zealand compared with 100 maternal deaths for every 100,000 births in the sub-Saharan African region (UNICEF 2025). The countries with the highest MMR are Chad and the Central African Republic (1 in 24 lifetime risk), Nigeria (1 in 25), Somalia (1 in 30), and Afghanistan (1 in 40) (World Health Organization, 2025). Thirty-seven countries that are in conflict or have institutional fragility were responsible for 61% of global maternal deaths and only for 25% of live births (WHO 2025). “The subregional differences highlight the important need for targeted interventions in the places most at risk.”

• Regional Inequities

Socioeconomic and emigration-related factors further aggravate maternal mortality. Despite this dramatic difference between the two classifications, there remain important economic differences, with maternal deaths per 100,000 live births standing at 346 in resource-poor countries versus 10 in high-income countries (World Health Organization, 2025). Globally, the risk of mortality in sub-Saharan Africa is 1 in 55 for women (nearly a quarter million times higher than 1 in 14,000 in Western Europe, according to the World Health Organization, 2025). In particular, the MMR in conflict-affected settings is significantly higher than in fragile (368) and tranquil (99) (World Health Organization, 2025) settings (504 deaths per 100,000 live births). Women in resource-poor countries are at greater risk of maternal death compared to women in high-income countries (1 in 66 lifetime risk vs. 1 in 8000, respectively; UNICEF 2025). Striking inequality sheds light on the connections between poverty, war, and maternal health across global populations.

Social Determinants That Impact the Problem

• Population Most Affected and Socioeconomic Determinants

Social determinants are complex obstacles that disproportionately affect sensitive populations. Mothers who are low socioeconomic, especially in rural areas with low education, have the highest risk of maternal mortality (Amjad et al., 2021). Cumulative disadvantage across the lifespan is caused by social factors such as poverty, level of education, racism, and gender inequality (Hossain & Zahid, 2025). Evidence shows that maternal education, husband’s education, caste/ethnicity, and economic status have a significant impact on maternal health service utilisation and outcomes (Omer et al. 2021). Structural racism impacts access to quality health care, education, income, employment, and safe housing, which leads to continued health disparities.

• Cultural Beliefs and Geographic Factors

Traditional practices and geographical factors are important determinants of maternal health experiences and outcomes. Rodriguez & Bae (2024) found that early age at first union, preference for a traditional birth attendant, and dietary restrictions in pregnancy are important determinants of maternal health outcomes. Superstition and herbal medicine are more likely to lead to a delay in medical treatment (Barnish et al., 2021). Geographic location and culture are barriers to professional birth care and emergency obstetric care (Rodriguez & Bae, 2024). Social norms related to masculine control over decision-making processes and restricted individual freedom for females have direct implications on health-seeking behaviors during pregnancy and delivery.

• Political Systems and Healthcare Access

The relationship between voice accountability mechanisms and governance generally is negative, indicating that good governance is associated with reduced maternal deaths. George (2024) concludes that left-of-center political traditions and the generosity of the welfare state have positive effects on maternal health via progressive social policies. Weak governance environments, political instability, and conflict settings are key barriers to maternal health progress and service delivery (Bogale et al, 2024). We find that countries with high ethnic fragmentation can lose the health benefits of democratization and economic growth due to elite capture and discriminatory policies.

Nongovernment Organization (NGO) Involvement

• Partners In Health (PIH): Rural Women in Post-Conflict Settings

NGO organisational interventions provide evidence that targeted programming can lead to major reductions in maternal mortality. Partners In Health works with rural women in Kono District of post-conflict Sierra Leone, where the lifetime risk for maternal death is 1 in 74 compared with 1 in 4,161 in the United States (Partners in Health, 2025a; Lassi et al., 2020). The PIH is implementing the maternal center of excellence intervention, which includes comprehensive emergency obstetric care, with 24-hour electricity, functional blood banks, surgical capacity, and maternal waiting homes (Partners in Health, 2025b). However, evidence from Partners in Health shows that the intervention was very effective in terms of facility delivery improving from 2020 to 2022 and maternal deaths decreasing over the same period (Partners in Health, 2025b). The importance of such large infrastructure investments cannot be overestimated if sustainable maternal health improvements are to be achieved in resource-constrained environments.

• Save the Children – Community-Level Maternal and Child Health

Community-based interventions are scalable approaches to maternal health in underserved populations. Save the Children is an international development organisation that works directly with vulnerable families and communities in developing countries, including communities with high maternal and neonatal mortality (Save the Children, 2025). The organization runs community-based intervention packages through trained community health workers who deliver evidence-based maternal and newborn care interventions for target populations. The interventions are highly effective, and there is evidence that scaling up to population coverage can help reduce maternal mortality, neonatal mortality, and stillbirths (Nove et al., 2020). Save the Children (2025) reaches an estimated 28.1 million children and women each year through health and nutrition programs. The community-based models illustrate the promise of population-level change through locally implemented interventions.

• Médecins Sans Frontières (MSF) – Emergency Obstetric Care in Crisis Settings

The MSF addresses the needs of pregnant women in conflict areas, in refugee camps, and in humanitarian emergency situations where health systems are collapsed or inadequate. The organization has referral systems for ambulance, emergency obstetric intervention 24 hours a day, management of caesarean section, blood transfusion, and complications (Médecins Sans Frontières, 2021). The intervention is very effective for the reduction of maternal mortality in the Kabezi area of Burundi and the Bo district in Sierra Leone (Médecins Sans Frontières, 2021). The emergency obstetric care interventions demonstrate that high-quality obstetric care in an emergency setting can significantly reduce maternal mortality even in the most difficult situations.

Culturally Sensitive Intervention

An Indigenous doula program is a culturally appropriate intervention that can provide Indigenous and marginalized women with traditional birthing knowledge and modern medical practices. The intervention would be delivered through community-based training programmes that recruit doulas from target communities and teach them about traditional birthing practices (Khaw et al., 2022) in culturally specific ways. There is evidence that the intervention is effective in improving maternal outcomes by reducing the rate of cesarean section and increasing the rate of successful breastfeeding, particularly in Black and Indigenous people who report experiencing systemic discrimination in health care (Martin et al., 2022). The intervention is culturally sensitive as it acknowledges Indigenous sovereignty over birthing practices, addresses historical trauma resulting from the colonization of childbirth, and reinforces cultural practices that enhance families and communities.

Conclusion

Maternal mortality remains a significant global health crisis that affects women in low- and middle-income countries in particular, in Sub-Saharan Africa and South Asia. Social factors (poverty, education, cultural norms, government instability, etc.) are the systemic barriers that reinforce the health inequities. Evidence suggests that targeted interventions by organizations, such as Partners in Health, Save the Children, and Médecins Sans Frontières, can achieve dramatic reductions in maternal mortality through emergency obstetric care, community health worker programs, and ambulance referral systems. However, responding to the emergency requires culturally appropriate strategies such as Indigenous doula programs that respect traditional birthing practices while integrating modern health care practices. In conclusion, the reduction of maternal mortality is a multifaceted issue that requires a holistic approach to address not only the immediate medical needs but also structural determinants that can ensure equitable access to high-quality and dignified care during pregnancy and childbirth.

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