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Maternal, neonatal, and child health in southeast Asia: towards greater regional collaboration.
Open accessAbstract
Although maternal and child mortality are on the decline in southeast Asia, there are still major disparities, and greater equity is key to achieve the Millennium Development Goals. We used comparable cross-national data sources to document mortality trends from 1990 to 2008 and to assess major causes of maternal and child deaths. We present inequalities in intervention coverage by two common measures of wealth quintiles and rural or urban status. Case studies of reduction in mortality in Thailand and Indonesia indicate the varying extents of success and point to some factors that accelerate progress. We developed a Lives Saved Tool analysis for the region and for country subgroups to estimate deaths averted by cause and intervention. We identified three major patterns of maternal and child mortality reduction: early, rapid downward trends (Brunei, Singapore, Malaysia, and Thailand); initially high declines (sustained by Vietnam but faltering in the Philippines and Indonesia); and high initial rates with a downward trend (Laos, Cambodia, and Myanmar). Economic development seems to provide an important context that should be coupled with broader health-system interventions. Increasing coverage and consideration of the health-system context is needed, and regional support from the Association of Southeast Asian Nations can provide increased policy support to achieve maternal, neonatal, and child health goals.
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Metadata
- Authors
- Acuin, C. S., Khor, G. L., Liabsuetrakul, T., Achadi, E. L., Htay, T. T., Firestone, R., & Bhutta, Z. A.
- Affiliations
- University of the Philippines Manila (PH)
- IMU University (MY)
- Prince of Songkla University (TH)
- University of Indonesia (ID)
- Ministry of Health (MM)
- Harvard University (US)
- Aga Khan University (PK)
- Corresponding author
- Acuin, Cecilia S
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2011-02
- Volume
- 377
- Issue
- 9764
- Pages
- 516-525
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- PMC
- PMC7159081
- OpenAlex
- W2117371169
- Cited by
- 108
- References
- 50
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 8 · 2023: 6 · 2022: 5 · 2021: 7 · 2020: 4 · 2019: 9 · 2018: 6 · 2017: 5 · 2016: 8 · 2015: 6 · 2014: 3 · 2013: 12 · 2012: 10
- FWCI
- 9.74
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Lancet (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- China Medical Board
- Prince of Songkla University
- University of the Philippines
- Faculty of Medicine, Prince of Songkla University
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Keywords
- maternal mortality, neonatal mortality, child mortality, Southeast Asia, mortality trends, health equity, wealth inequality, urban-rural differences, Lives Saved Tool, mortality averted, economic development, health system interventions, regional cooperation, ASEAN, Millennium Development Goals
- MeSH terms
- Asia, Southeastern, Child, Child Health Services, Child Welfare, Female, Health Workforce, Health Personnel, Health Policy, Humans, Infant, Newborn, Maternal Health Services, Maternal Mortality, Maternal Welfare, Poverty, Vaccination, Rural Health Services, Urban Health Services, Universal Health Insurance, Child Mortality, Healthcare Disparities
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