Could a simple antenatal package combining micronutritional supplementation with presumptive treatment of infection prevent maternal deaths in sub-Saharan Africa?

Table 2 Estimated crude reduction in maternal mortality due to micronutritional supplementation and presumptive treatment of infection, by cause of maternal death.

Cause of maternal death	Proportion of all maternal deaths (range)¹	Intervention	Effectiveness of intervention – reduction in deaths by cause (95% CI)²	Crude reduction in all-cause maternal mortality³	Maternal deaths prevented per year⁴
Severe hypertensive disorders	9.1% (3.9–21.9)	calcium supplementation	20% (3–35)	0.1–7.7%	300–19,200
Puerperal sepsis	9.7% (6.3–12.6)	anti-microbial prophylaxis	51% (0–77)	0.0–9.7%	0–24,300
Anemia	3.7% (0.0–13.2)	anti-malarial prophylaxis	38% (22–50)	0.0–1.2%⁵	0–3,000
		iron supplementation	67% (31–84)	0.0–6.4%⁶	0–15,900

¹ Source: WHO systematic review of causes of maternal deaths [9].
² Source: Cochrane Reviews [19,22,24,26].
³ Calculated using Equation 1.
⁴ Assuming 250,000 deaths per year in sub-Saharan Africa [8].
⁵ Assuming 18% of maternal deaths caused by anemia are attributable to P falciparum infection [12].
⁶ Assuming 30–70% of non-malarial maternal deaths caused by anemia are attributable to iron deficiency [12-17].

ISSN: 1471-2393