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Development, coinfection, and the syndemics of pregnancy in Sub-Saharan Africa

Merrill Singer

Author Affiliations

Department of Anthropology and Department of Community Medicine, University of Connecticut, Storrs, CT 06269, USA

Infectious Diseases of Poverty 2013, 2:26  doi:10.1186/2049-9957-2-26

Published: 15 November 2013


Notable among gaps in the achievement of the global health Millennium Development Goals (MDG) are shortcomings in addressing maternal health, an issue addressed in the fifth MDG. This shortfall is particularly acute in Sub-Saharan Africa (SSA), where over half of all maternal deaths occur each year. While there is not as yet a comprehensive understanding of the biological and social causes of maternal death in SSA, it is evident that poverty, gendered economic marginalization, social disruptions, hindered access to care, unevenness in the quality of care, illegal and clandestine abortions, and infections are all critical factors. Beyond these factors, this paper presents a review of the existing literature on maternal health in SSA to argue that syndemics constitute a significant additional source of maternal morbidity and mortality in the region. Increasing focus on the nature, prevention, and treatment of syndemics, as a result, should be part and parcel of improving maternal health in SSA.

Syndemics; Coinfection; Maternal health; Sub-Saharan Africa; Millennium development goals