Preliminary report of an identification mission for safe motherhood, Senegal: putting the M back in M.C.H.

Abstract

The Government of Senegal, in keeping with the priority given to women and children in its health programs, requested the assistance of the United Nations Development Program (UNDP) in identifying and executing a program to diminish maternal mortality in that country. A UNDP "Mission of Identification" was carried out in response to this initiative. The preliminary results of this mission confirm that the issue of maternal safety is of primary concern not only to the government but also to women in the Republic of Senegal. The methodology employed during this mission allowed the team of national and international experts to confirm the level of this concern and to identify four major potential areas of intervention. Quantitative goals for the program have been set and estimates for the efficacy of each of the intervention areas indicate that intervention through the timely provision of access to emergency surgical services and appropriate prenatal care will yield the largest reduction. The feasibility of providing interventions in each of the four areas was also addressed during the mission. This methodology will be applicable to other settings as Third World countries begin to address the problem of excessive maternal mortality.

Maternal mortality audit in a Zimbabwean province

“…The global figure of 137 maternal deaths for 100,000 births is comparable with other informations from Third World Countries (Walker et al 1986, Adetoro 1987, Kimball et al 1988, Brown 1978 but is much higher than in developed societies. The main causes of maternal death in this part of the world remain uterine rupture, eclampsia, haemorrhage and infection, if one does not consider abortion-related mortality.…”

“…In March 1986, the United Nations Development Program conducted an "identification mission for safe motherhood" (Kimball et al 1988). Among their conclusions is the suggestion that "primary health care should include prenatal care addressing locally prevalent problems, access to basic surgical services when necessary, effective family planning and attendance at delivery by some-one capable of recognizing and acting appropriately in the face of complications".…”

Determinants of Maternal Mortality in the Developing World

“…Women do more than 'holding up half the sky' in certain parts of the world (40). They plant, harvest, and process food, fetch firewood and water, cook, and in addition to bearing, feeding, and looking after the children, they care for the old and the sick family members (22). In addition some may have to seek employment for remuneration either in the home or outside to help with the family finances.…”

The role of emergency obstetric care in preventing maternal deaths: an historical perspective on European figures since 1751

“…This discussion is fundamental for the design of the beststrategies to follow in the developing world where 150 million births occur each year, associated with the loss of half a million mothers. OUf involvement in programs devoted to reduce maternal deaths in Sub-Saharan Africa [1][2][3][4] was the incentive to define essential obstetric functions [5]. An under-standing of why they were successful in Europe could have important implications for safe motherhood elsewhere.…”