Healthy motherhood: an urgent call to action

Abstract

While the past 3 years have ushered in a new phase of commitment to child survival, 1 Bryce J Terreri N Victora CG et al. Countdown to 2015: tracking intervention coverage for child survival. Lancet. 2006; 368: 1067-1076 Summary Full Text Full Text PDF PubMed Scopus (171) Google Scholar issues surrounding maternal survival have remained largely neglected. The fifth Millennium Development Goal (MDG-5) is to reduce maternal mortality by three-quarters between 1990 and 2015. Yet, sub-Saharan Africa seems to have stalled in its efforts to improve maternal survival. Only two out of five births benefit from skilled attendants at delivery—and that share has remained unchanged between 1990 and 2003. South Asia has seen improvements: from 27% to 38% coverage with skilled attendants. But coverage rates still remain far too low. Safe motherhood initiative: 20 years and countingThe global campaign to reduce maternal mortality was launched in February, 1987, when three UN agencies—UNFPA, the World Bank, and WHO—sponsored the international Safe Motherhood Conference in Nairobi, Kenya. The event aimed to raise awareness about the numbers of women dying each year from complications of pregnancy and childbirth, and to challenge the world to do something. Full-Text PDF Meeting MDG-5: an impossible dream?Reduction of the maternal mortality ratio by three-quarters by 2015 is the target for one of the eight Millennium Development Goals (MDGs) set by 189 countries in 2000. That this goal (MDG-5) is the one towards which the least progress has been made,1 despite the launch nearly 20 years ago of the Safe Motherhood Initiative,2 is widely acknowledged. Nonetheless, we believe that substantial progress can be achieved. Indeed, a 2003 World Bank report3 on the success of several developing countries in (including China, Sri Lanka, and Malaysia) reducing maternal mortality rates concluded that “maternal mortality can be halved in developing countries every 7–10 years…regardless of income level and growth rate”. Full-Text PDF Women's wisdom—a source of knowledge for medicineMaternal mortality is a major public-health problem in rural Africa and all over the developing world. Policymakers and governmental agencies urgently need to set priorities and develop strategies to improve reproductive health. In today's Lancet, Mikey Rosato and colleagues present a comprehensive and systematic community-mobilisation strategy in Mchinji district in rural Malawi.1 171 participatory women's groups, including over 2800 women, identified maternal health problems and prioritised the problems they considered most important. Full-Text PDF Maternal mortality: who, when, where, and whyThe risk of a woman dying as a result of pregnancy or childbirth during her lifetime is about one in six in the poorest parts of the world compared with about one in 30 000 in Northern Europe. Such a discrepancy poses a huge challenge to meeting the fifth Millennium Development Goal to reduce maternal mortality by 75% between 1990 and 2015. Some developed and transitional countries have managed to reduce their maternal mortality during the past 25 years. Few of these, however, began with the very high rates that are now estimated for the poorest countries—in which further progress is jeopardised by weak health systems, continuing high fertility, and poor availability of data. Full-Text PDF