REVIEW: Current strategies for the reduction of maternal mortality

Abstract

The purpose of this article is to review current strategies for the reduction of maternal mortality and the evidence pertinent to these strategies. Historical, contextual and current literature were examined to identify the evidence base upon which recommendations on current strategies to reduce maternal mortality are made. Current safe motherhood strategies are designed based mostly on low grade evidence which is historical and observational, as well as on experience and a process of deductive reasoning. Safe motherhood strategies are complex public health approaches which are different from single clinical interventions. The approach to evidence used for clinical decision making needs to be reconsidered to fit with the practicalities of research on the effectiveness of strategies at the population level. It is unlikely that any single strategy will be optimal for different situations. Strengthening of the knowledge base on the effectiveness of public health strategies to reduce maternal mortality is urgently required but will need concerted action and international commitment.

Effect of support supervision on maternal and newborn health services and practices in Rural Eastern Uganda

“…These services should be available at all levels where mothers give birth, since hemorrhage and preeclampsia are major causes of maternal deaths. Available evidence indicates that at least 60% of maternal and newborn deaths occur in the postpartum period [4,7], usually the first day after birth, and their management falls within the skilled attendance or emergency care strategies [7]. …”

“…Skilled delivery has long been indicated as the most effective intervention; but with the prevalent shortage of life-saving products and equipment, health workers cannot be expected to literally save lives with their bare hands [5]. The availability of Emergency Obstetric Care (EmOC) services is a major strategy to ensure that pregnant women and newborns have access to well-functioning facilities that include a wide range of maternal and newborn services [1,2,6,7]. The basic EmOC services that should always be at the facilities include administration of parenteral antibiotics, perinatal antibiotics, oxytocic drugs and anticonvulsants, manual removal of placenta, removal of retained products and assisted vaginal delivery [1].…”

“…The basic EmOC services that should always be at the facilities include administration of parenteral antibiotics, perinatal antibiotics, oxytocic drugs and anticonvulsants, manual removal of placenta, removal of retained products and assisted vaginal delivery [1]. Facilities that provide comprehensive services should perform all basic EmOC services, as well as cesarean section and provision of blood transfusion [2,7]. …”

Supporting Improved Maternity Care by Midwives: Design Opportunities and Lessons Learned

“…Each year worldwide 529000 maternal death occur [3]. The target set for MDG-5 is a 75% reduction of maternal mortality ratio between 1990 and 2015.…”

19: Measuring Access to Emergency Obstetric Care in Rural Zambia

“…While the UN process indicators have been used successfully in a variety of settings, some limitations have been identified [7][8][9][10][11]. To qualify as an EmOC facility, a health centre or hospital must have performed each of the six signal functions at least once within the past 3 months.…”