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The maternal mortality rate (MMR) is the annual number of female deaths per 100,000 live births from any cause related to or aggravated by pregnancy or its management.

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Calorie intake is the amount of food (measured in calories) a personconsumes.

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The pattern of maternal mortality rate is influenced by various factors:

Geographic: It's lower in developed countries and higher in developing ones, especially in sub-Saharan Africa. There are also urban-rural differences, with higher rates in rural areas due to limited healthcare access.

Socio-economic: Higher income and educated women generally have lower maternal mortality rates as they can afford better care and are more aware.

Temporal: Globally, it has been declining, but can increase in conflict or disaster areas. There may also be seasonal variations.

Demographic: Teenage and older mothers, as well as women with high parity, are at higher risk of maternal mortality

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the availability and use of facilities and services for the safe disposal of human waste (such as urine and feces), as well as the promotion of hygiene practices to prevent the spread of disease

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1. Collecting Data:

It's hard to get accurate data on maternal deaths because of things like lack of medical resources, bad transportation, and cultural or legal issues.

2. Limitations of the Indicator:

The maternal mortality rate only shows deaths related to pregnancy and not other health problems mothers might have.

3. Differences Between Regions and People:

The rate of maternal deaths is different in different places and among different groups of people. This is affected by things like how developed the area is, how healthcare is distributed, and cultural traditions.

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The probability per 1,000 births that a child will die before reaching the age of 5

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only measure deaths on one age group, ignore other age groups such as children under five

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Due to a combination of

population growth and slow progress, the number of people in sub

Saharan Africa without access to sanitation has increased since 1990. In

addition, there are rural and urban disparities: while over 80 per cent of

the urban population has access to improved sanitation facilities, only 51

per cent do in rural areas. The population without sanitation access lives

primarily in Asia, sub-Saharan Africa, Latin America and the Caribbean.

Figure F.19 shows the progress that has been made towards improved

sanitation by region, 2000–2015.

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The number of deaths in children

under the age of 1 per 1,000 live births.

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It is an age-specic mortality rate, that is, it is comparing the death rates among the same ages, and so is more useful than the crude death rate.

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definition: access to health service is measured in the number of per doctor or per hospital

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In some lack resources region, datas may be underreported because of poor health infrastructure, lack of record-keeping. It leads to inaccurate MMR data.

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- High-income countries, such as Austria and the USA, have a high daily calorie intake (around 3,800-3,750 kcal).

- Middle-income countries have an intake of around 3,400 kcal/day.

- Low-income countries typically have lower calorie intakes, such as 2,600 kcal/day.

e.g. Sub-Saharan Africa and Central Africa have even lower intakes, with some countries like Burundi and Eritrea showing very low levels (as low as 1,680 kcal/day).

* A correlation between calorie intake and the economic development of a country:

wealthier nations tend to consume more calories, possibly due to greater access to food and more resources.

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1. can shows the access to healthcare

2. can show the region's overall medical level

3. can use as a quantitative indicator for vertical comparison or horizontal comparison

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geographical: Extremely high rates of child mortality are found in Angola, Sierra Leone,

Chad and Somalia. Countries with a very low child mortality rate (that is, 0–1 per cent) are mainly in southern and eastern Europe

social: Countries with a high human development index (HDI) have a low IMR, and those

with a low HDI have a high IMR. The region with the highest IMRs is

Central Africa, with on average an IMR of 96 per thousand in 2015. In

contrast, the world average was 37 per thousand.

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Helps identify nutritional disparities: Understanding calorie intake helps to highlight health disparities between different countries or regions, especially between developed and developing nations.

Global health insights: The data on calorie intake can inform global health organizations and governments on where malnutrition or food insecurity may be a pressing issue. Countries with lower calorie intake, particularly in sub-Saharan Africa, could benefit from targeted food aid and programs aimed at improving nutrition.

Helps policy formulation: Knowing the daily intake across various nations can guide governments in creating food and health policies that ensure adequate nutrition for all segments of their population.

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1. Indicator of Public Health Infrastructure

Sanitation access reflects the overall state of a community's public health infrastructure. Areas with improved sanitation often have better healthcare systems and lower rates of disease.

2. Disease Prevention

Proper sanitation reduces exposure to pathogens that cause waterborne and fecal-oral diseases like diarrhea, cholera, and typhoid. Measuring sanitation helps predict and prevent potential outbreaks.

3. Child Health and Development

Access to sanitation is linked to lower child mortality and better nutrition. Poor sanitation contributes to stunting and malnutrition, so improvements indicate better child health outcomes.

4. Environmental Health

Effective sanitation prevents contamination of water sources and the environment, reducing ecological impacts and protecting natural resources.

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Does not account for quality of food: While calorie intake is an important metric, it does not account for the nutritional value of the food consumed. People may consume adequate calories but still lack essential nutrients like vitamins, proteins, and minerals, leading to malnutrition despite sufficient caloric intake.

Oversimplifies the complexities of food security: The passage focuses on calorie intake as a simple metric, but food insecurity and malnutrition are far more complex. Factors like food distribution, cultural eating habits, food waste, and political instability also influence food security and overall health.

Ignores individual variation: While generalizing average calorie intake by country can give broad insights, individual factors such as age, health conditions, and personal dietary preferences are not taken into account. This may skew the understanding of nutrition in specific populations.

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1. Limited Scope

Access to sanitation focuses primarily on waste management but doesn't directly measure other critical aspects of health, such as nutrition, disease prevalence, or access to medical care. It provides an incomplete picture of overall health.

2. Quality vs. Availability

Having access doesn't guarantee proper use or maintenance. Facilities may be available but unhygienic, unsafe, or non-functional, leading to inaccurate conclusions about health outcomes.

3. Behavioral Factors

Sanitation facilities are only effective if used correctly. Cultural practices, lack of awareness, or preferences for open defecation can reduce the effectiveness of sanitation infrastructure in improving health.

4. Neglects Broader Determinants of Health

Factors like clean water access, personal hygiene practices, and socioeconomic conditions also impact health. Focusing solely on sanitation may overlook these interconnected elements.

5. Data Collection Challenges

Gathering reliable data on sanitation access can be difficult, especially in rural or informal settlements. Self-reported data may be inaccurate, leading to misleading health assessments.

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low：Subsaharan Africa，Southeast Asia，West Asia，South Asia，Middle East （0-1 physician per 1000 people）

middle：North Africa, north of South America, East Asia, Central Asia, Central Europe, middle of North America (2-4 physicians per 1000 people)

high: Australia, south of South America, rest of Europe, Alaska，Greenland (5-7 physicans per 1000 people)

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* Cannot reflect the quality of medication

*physician are registered, some unregistered practitioners are not included in this data (barefoot doctors)

* Limited access to specialized care.

* Overburdened healthcare systems, which may affect quality and efficiency. Long waiting times for patients.

*variations between urban/rural; socio-economic groups: Access to services cannot be gurantened asthe poor people/rural people/female/remoted areas are not access to health care, even the ratio is high

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1. Maternal mortality rate can serve as a key indicator of the women‘s health, helping to assess the effectiveness of maternal health services.

2. Through maternal mortality rate across different regions and demographics, government can identify disparities in healthcare access and outcomes, then take some actions to decrease the rate.