PHA-Exchange> Strategies for reducing maternal mortality: getting on with what works

Claudio claudio at hcmc.netnam.vn
Sat Oct 7 01:59:30 PDT 2006


From: Ruggiero, Mrs. Ana Lucia (WDC) 
 EQUIDAD at LISTSERV.PAHO.ORG 

Do I read another silver-bullet approach in the below?? Some more selective PHC? 
 Claudio


Strategies for reducing maternal mortality: getting on with what works

 

Oona MR Campbell, Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London

Wendy J Graham, Department of Obstetrics and Gynecology, University of Aberdeen, Aberdeen, UK

The Lancet Maternal Survival Series steering group

The Lancet,  Volume 368, Number 9543, 7 October 2006

 

Available online at: http://www.thelancet.com/journals/lancet/article/PIIS0140673606693811/fulltext 

Free subscription required

"...The concept of knowing what works in terms of reducing maternal mortality is complicated by a huge diversity of country contexts and of determinants of maternal health. Here we aim to show that, despite this complexity, only a few strategic choices need to be made to reduce maternal mortality. We begin by presenting the logic that informs our strategic choices. 

This logic suggests that implementation of an effective intrapartum-care strategy is an overwhelming priority. We also discuss the alternative configurations of such a strategy and, using the best available evidence, prioritise one strategy based on delivery in primary-level institutions (health centres), backed up by access to referral-level facilities. We then go on to discuss strategies that complement intrapartum care. 

We conclude by discussing the inexplicable hesitation in decision-making after nearly 20 years of safe motherhood programming: if the fifth Millennium Development Goal is to be achieved, then what needs to be prioritised is obvious. Further delays in getting on with what works begs questions about the commitment of decision-makers to this goal..."

 
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