Safe Motherhood: A Review - Family Care International

National Programs, Policies,
and Budgetary Commitments for Safe Motherhood
Policies for Safe Motherhood
In 1995, the National Birth Spacing Policy
was formulated to ensure that the number
of children born to a woman would not
impair her health and well-being. Family
planning services were to be made available
as a means of child spacing for health
reasons and for the overall reduction of
maternal and infant morbidity and mortality.
The major goals were:
• Reduce maternal mortality and infant
mortality by 25% in the year 2000.
• Increase access and availability of birth
spacing methods and services as well as
accurate information needed by women and
couples who wish to plan and space the
births of their children.
The birth spacing program was to be
implemented in a phased manner and
integrated with safe motherhood activities.
It covered a variety of issues like program
management, contraceptive methods, service
delivery, IEC, clinic management, fertility, and
the import of contraceptives.
In 1997, the Safe Motherhood Policy was
promulgated as an addition to the existing
Birth Spacing Policy. This policy document
was prepared after the first safe motherhood
conference was held in Vientiane in March
1996. Ninety-seven delegates from the central
and provincial health departments, institutes,
and hospitals worked together to come up
with a draft document that was approved
in 1998. Only in 2000 was the action plan
developed. The 1997 policy defined the roles
of each health facility level; emphasized
the need to upgrade these facilities and the
competencies of health staff; and called
for improved quality of care through the
development of clinical protocols and the
promotion of good maternal health practices
such as antenatal and postnatal care, and
skilled attendance at delivery. The aim of the
policy was to reduce the MMR by 25% by
the year 2000 (from a MMR of 653 in 1993).
It mandated the provision of antenatal care
(at least once), and called for the prompt
recognition and treatment of the five most
common obstetric emergencies. At the
community level, TBAs, health volunteers,
and family members were to be provided
training on the recognition of high-risk
conditions during pregnancy, childbirth, and
after delivery to be able to assist in early
referrals to hospitals. For health promotion
purposes, they are also required to be trained
on early breastfeeding, maternal and child
nutrition, and immunization.
In 2002, the safe motherhood policy was
amended with the following revisions:
• Acknowledgment of the rights of women
regardless of age and class to reproductive
health information and services and as well
as the newborn’s rights to health care.
• Need for a continuum of care from
childhood to menopause.
• Reiteration of the four pillars of maternal
health care services (antenatal care, delivery,
postnatal care, and family planning) and
the relevant activities to be conducted at
the central, provincial, and district hospitals
as well as the health center and in the
community. The role of the community in
these four areas of safe motherhood
was emphasized.
Furthermore, the document called attention
to the need to upgrade the midwifery skills of
health care providers at the different levels of
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