Safe Motherhood: A Review - Family Care International

VII VII
National Programs, Policies, and
Budgetary Commitments for
Safe Motherhood
Political commitment and action in
support of safe motherhood have been
mixed at the country level: in some countries
(e.g., Malaysia, Sri Lanka, Egypt, Honduras)
concerted efforts on the policy, program, and
budgetary fronts resulted in improved access
and availability of maternal health services
and a reduction in maternal mortality levels;
in other countries, maternal mortality ratios
have stagnated, and in some settings, appear
to have increased. 32
What needs to be in place at the national
level in order for pregnancy and childbirth
to be safe for all women? Several published
reports 33 have examined the strategies and
interventions that have been conducive for
improving maternal health. Building upon
this body of work, this report seeks to analyze
the development of national (government)
policies, programs, and budgetary allocations
for safe motherhood in select countries in
Latin America, sub-Saharan Africa, and Asia,
in particular focusing on the time period from
1987 to the present. In consultation with a
range of partners, the following countries
were identified: Bolivia, Indonesia, Lao
People’s Democratic Republic, Malawi, Mali,
and Tanzania.
The profiles provide a brief overview of the
key policy, programmatic, and budgetary
efforts related to safe motherhood in
these countries, and as such are not a
comprehensive analysis of what has occurred
at the national level. They examine how
and why maternal health was identified as
a national priority, what main programmatic
strategies were put forward, and what have
been the associated budgetary allocations.
For those countries operating under SWAps, it
assesses to the extent possible how maternal
health has fared within this resource-allocation
mechanism. Through interviews and
document research, in-country consultants
traced the development of each government’s
commitment to safe motherhood; identified
the main programmatic priorities; and, to
the extent possible, analyzed the budgetary
allocations for safe motherhood. What follows
are the main findings from each of the
country reviews.
32 Make Every Mother and Child Count. Geneva: WHO, 2005.
33 Pathmanathan I., Liljestrand J., Martins J.M., Rajapaksa L.C., Lissner C., de Silva A., Selvaraju S., and Singh P.J. Investing in
Maternal Health: Learning from Malaysia and Sri Lanka. Washington DC: The World Bank, 2003.
Koblinsky M.A.. Reducing Maternal Mortality: Learning from Bolivia, China, Egypt, Honduras, Indonesia, Jamaica, and
Zimbabwe. Washington, DC: The World Bank. 2003.
Skilled Care During Childbirth: Country Profiles. New York: Family Care International, 2002.