Global progress and potentially effective policy responses to reduce maternal mortality

Abstract

a b s t r a c t a r t i c l e i n f o Keywords:Maternal health Maternal mortality Millennium Development Goals Policy response Success factors Reducing maternal mortality within significant margins is a global imperative that reflects attainment of development goals. Progress in reducing maternal mortality, in particular among countries with notably high maternal mortality ratios (MMRs), has been substantially slower than the Millennium Development Goal target of an annual rate of 5.5% decline. The latest UN maternal mortality estimates show a reduction in MMR in a number of countries between 1990 and 2008. Understanding the factors associated with progress in countries that have reduced maternal mortality provides other countries and development partners with opportunities to consider and implement policies and interventions that could help accelerate progress. This paper reviews 6 countries that have demonstrated marked progress. The policies that have been effective include innovative financing measures; investment in human resources both in terms of strengthening preservice education and emphasizing in-service training for healthcare providers; strengthening obstetric care by enhancing infrastructure and upgrading equipment, as well as improving quality of services; and investing in the broader determinants of maternal mortality, particularly family planning and women's education and socioeconomic empowerment. This range of actions, which includes a combination of facility and community-based approaches, provides a list of potentially effective strategies that could be considered when developing programs in other countries with slower progress. Strong political will and multistakeholder involvement and interventions are key in the development and implementation of these policies and actions.

Education and severe maternal outcomes in developing countries: a multicountry cross‐sectional survey

“…Health inequity is closely related to social determinants of health, where the burden of ill health is greatest in lower socio‐economic groups . A policy analysis highlighted that in six countries with marked progress in reducing maternal mortality, effective policies included investing in women's education . In our study, the women in the lowest education quartiles were significantly more likely to experience severe maternal outcomes, including maternal death.…”

“…As 2015 approaches, increasing efforts have been made to improve maternal health. Despite a 47% decline in maternal mortality since 1990, it is unlikely that the MDG5 global target will be met . An estimated 287 000 maternal deaths occurred in 2010, with nearly all (99%) occurring in low‐ and middle‐income countries (LMICs) .…”

How Education can help Solve Huge Perinatal Problems in Africa

“…Similarly, as school attendance is much higher in urban areas than in rural areas, the use of contraceptive methods is four times higher in cities (42.2%) than in rural areas (10.6%). [6][7][8] Unfortunately the youngest married women [15][16][17][18][19] are the ones that use contraception less (8.6%) whereas more women over 25 use it 16 (20%).…”

“…18 Early marriages usually lead women to give up school and social, economic and cultural prospects. [9][10][11][12] Delaying marriage has also a positive effect on education.…”

An Update on Maternal Mortality and Morbidity in the United States

“…The United Nations reveals a fall from 500,000 global maternal deaths per year to 358,000 estimated deaths per year related to pregnancy complications in 2008 (WHO, UNICEF, UNFPA, & The World Bank, ). (Remarkable reductions in maternal mortality are being reported in some countries where mortality rates had originally been recorded as the highest in the world [Chatterjee & Paily, ; Mbizvo & Say, ]. )…”