Professor Zulfiqar A Bhutta, MB, BS, FRCP, FRCPCH, FAAP, PhD
Center of Excellence in Women & Child Health
The Aga Khan University, Karachi, Pakistan
Robert Harding Chair in Global Child Health & Policy
Ibn Sina Scholar in Global Child Health
University of Toronto, Toronto, Canada
Maternal and child health vastly improved over the Millennium Development Goals period (1990-2015) but progress varied across the globe. Regions that lagged behind were predominantly in South Asia, the Middle East and Africa. We assessed reproductive, maternal, newborn, child, and adolescent health (RMNCAH) and key determinants among Muslim majority countries (MMCs) globally and contrasted findings with non-MMCs. This ecological multi-national time series analysis from 1990 to 2015 and has now extended to 2019 to encompass the sustainable development goals (SDG) period. This is the first systematic and comprehensive analysis of reproductive, maternal, newborn, child and adolescent health among all 47 Muslim majority countries worldwide.
Our study underscores many key findings among Islamic nations. Muslim nations globally have higher mortality among vulnerable populations relative to non-Muslim countries, and coverage of essential interventions- especially those around reproductive health, prenatal, delivery and labour, and childhood vaccines- are significantly lower. Despite notable reductions from 1990 to 2015, MMCs on average continue to have higher mortality rates for all age groups relative to non-MMCs. The major causes of death among children remain infectious in nature and are largely preventable. Coverage of essential interventions across the continuum of care on average is lower among MMCs, especially for indicators around reproductive health, prenatal, delivery and labour, and childhood vaccines.
While widespread conflict, political instability and insecurity in MMCs could also be a contributing driver of adverse outcomes, there is evidence that relatively low empowerment of women and young girls, as evidenced by lower literacy rates, higher levels of fertility and younger ages at marriage are important contributors to observed differentials. We have however identified heterogeneity among MMCs, with some Islamic countries making great progress in RMNCH, such as Niger and Bangladesh, despite grinding poverty. The presentation will cover approaches to reducing inequities and key examples from the Islamic world itself.
Key findings from this study have several policy and programmatic implications that should be prioritized by national heads of state and policy-makers, development partners, funders, and the Organization of the Islamic Cooperation to improve RMNCAH and reduce inequities in the SDG period.
Professor Zulfiqar A. Bhutta
is the Robert Harding Inaugural Chair in Global Child Health at the Hospital for Sick Children, Toronto, Co-Director of the SickKids Centre for Global Child Health and the Founding Director of the Centre of Excellence in Women and Child Health, at the Aga Khan University, unique joint appointments. He also holds adjunct professorships at several leading Universities globally including the Schools of Public Health at Johns Hopkins (Baltimore), Tufts University (Boston), Boston University School of Public Health, University of Alberta as well as the London School of Hygiene & Tropical Medicine. Read more