New push to reduce maternal mortality in poor countries.

Abstract

More than half a million women die each year in developing countries from complications of pregnancy and child birth. In order to address this problem some experts are advocating the addition of emergency obstetric care (EOC) to the available primary health care (PHC) services that focus on preventive Recent analysis suggests that EOC is affordable by all but the poorest countries and is one of the few truly cost-effective medical interventions. The barriers to the provision of this care have been political apathy and strategic misjudgment. While infant mortality has received world-wide attention the discrepancy in maternal mortality between developed and developing countries is as much as 10 times higher than the discrepancy in infant mortality. The greatest loss of life is associated with hemorrhage septic abortion eclampsia infection and obstructed labor. PHC strategies to improve the situation have included bolstering provision of prenatal care and training traditional birth attendants. While improved PHC led to increased child survival EOC is necessary to improve maternal survival. The World Health Organization has acknowledged its disillusionment with the Safe Motherhood Initiative by including emergency obstetric care as a component in and high priority of essential obstetric care. Major changes will involve upgrading hospitals and health centers training midwives and organizing means to transport women to hospitals. Efforts to convince developing countries that womens health is worth the expenditure may be enhanced by data showing the adverse impact of maternal mortality and morbidity on a countrys productivity and by the relatively low per capital cost of EOC and prenatal