Good progress has been made in reducing maternal deaths from 1990-2015 but accelerated progress is needed to achieve the Sustainable Development Goals (SDGs) in ending preventable maternal deaths through a renewed focus on accountability and actions. This paper looks at how Maternal Death Surveillance and Response (MDSR) systems are strengthening response and accountability for better health outcomes by analyzing key findings from the WHO and UNFPA Global MDSR Implementation Survey across 62 countries. It examines two concrete examples from Nigeria and Ethiopia to demonstrate how findings can influence systematic changes in policy and practice. We found that a majority of countries have policies in place for maternal death notification and review, yet a gap remains when examining the steps beyond this, including reviewing and reporting at an aggregate level, disseminating findings and recommendations, and involving civil society and communities. As more countries move toward MDSR systems, it is important to continue monitoring the opportunities and barriers to full implementation, through quantitative means such as the Global MDSR Implementation Survey to assess country progress, but also through more qualitative approaches, such as case studies, to understand how countries respond to MDSR findings.

Fertility in Cambodia is declining. The total fertility rate (TFR) for women aged 15-49 fell from 4.0 to 3.0 between 2000 and 2010 (NIS 2011). The median age at first marriage among Cambodian women, at 20 years, has not changed over the last two decades (ibid.: 88). Because almost all fertility in Cambodia occurs within marriage, the country's fertility decline is the result of a decline in marital fertility, rather than a reduction in the period of exposure to pregnancy that would have occurred had age at first marriage risen. This article explores patterns of childbearing in contemporary Cambodia with respect to the number of children and timing of childbearing, and analyzes the explanations and rationales of women and men for their fertility intentions and behavior. In particular, I examine how the fertility transition in post-conflict Cambodia is shaped by both the historical and contemporary social context.My findings are based on qualitative data collected during 21 months of ethnographic fieldwork in Cambodia and secondary data analysis of the country's Demographic and Health Survey. In Cambodia, societal changes related to education, employment conditions, agricultural systems, and living arrangements create new motivations that in turn affect fertility decisions. Many of the factors that affect reproductive decisions are not unique to Cambodia. My interpretation of the Cambodian findings takes a comparative perspective, examining the drivers of the fertility decline in Cambodia and comparing them with the influences present in Thailand at the time of its transition. This comparison allows for the identification of forces unique to Cambodia's fertility decline as well as those factors that are common to fertility transitions elsewhere.

No abstract

No abstract

No abstract