Rural-oriented maternity services

Abstract

The delivery of maternity and neonatal care in rural areas is extremely difficult for many reasons, the most critical being the serious shortages of doctors and other health personnel who are willing to work outside the cities. The problems are particularly serious in countries in Asia, Africa, and Latin America, the so-called “developing world”. In Thailand new regional maternal and child health (MCH) centers have been developed as a first step in attempting to bring about improvements in MCH care. Each of the 3 centers opened so far consists of a 60 to 80 bed maternity hospital and a school for auxiliary midwives. In spite of a history in which most rural women seem to prefer to be delivered at home, these centers have been heavily utilized by predominantly rural women. The improved maternity care has, in turn, led to a uniquely successful postpartum family planning program. Based on these successes, a plan is presented to begin to expand such services to the more than 80 per cent of rural women who presently do not receive maternity care. This, in turn, should result in reduced maternal and neonatal mortality and morbidity rates and in a significant increase in the percentage of eligible women accepting family planning services.