A functioning health system is crucial ucial for maternal health programmes to achieve their goals of improving maternal and perinatal health. The six essential building blocks of a health system are service delivery, health workforce, information, equipment and supplies, financing and leadership and governance. Health systems are complex and interconnected social and political organizations. Although some of their core elements are tangible (infrastructure, equipment, supplies, vehicles and people), many are intangible or conceptual in nature, such as health sector reforms and governance. Maternity services are the means through which the health system provides care for mothers and their babies. Maternity services are usually organized in at least three levels - primary, secondary and tertiary. Acute problems exist in the recruitment, retention, deployment and distribution of people working in the health system. The problems are not restricted to doctors, nurses and midwives, but extend to paramedical and ancillary staff (such as laboratory technicians, radiographers) and professional managers. Health sector reforms are changes in policy and institutional arrangements of the health system and are required for a health system to be responsive to a range of external factors and ultimately to provide equitable and efficient health services. Some major reforms pertinent to maternity care in India are discussed in this chapter, including examples of public-private partnerships, financing health care and aid harmonization.
To estimate levels and determinants of perinatal mortality, we conducted a hospital-based surveillance and case-control study, linked with a population survey, in Ahmedabad, India. The perinatal mortality rate was 79.0 per 1000, and was highest for preterm low-birth-weight babies. The case-control study of 451 stillbirths, 160 early neonatal deaths and 1465 controls showed that poor maternal nutritional status, absence of antenatal care, and complications during labour were independently associated with substantially increased risks of perinatal death. Multivariate analyses indicate that socioeconomic factors largely operate through these proximate factors and do not have an independent effect. Estimates of attributable risk derived from the prevalence of exposures in the population survey suggest that improvements in matemal nutrition and antenatal and intrapartum care could result in marked reductions of perinatal mortality.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.