Safe Motherhood: A Review - Family Care International

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Lao People’s Democratic Republic care, and develop a new training curriculum to include emergency obstetric care, counseling, management of complications of abortion, management and treatment of STIs, and prevention of HIV/AIDS. It also reiterated the need for training TBAs, especially in remote areas and where ethnic groups have expressed a preference for them. In 1999, the Birth Spacing Policy was amended by the National Population and Development Policy (NPDP) of Lao PDR. One of the goals of the amended policy was to motivate and assist the population in improving the quality of their lives by ensuring safe motherhood, reducing maternal and child morbidity and mortality, and enabling couples to responsibly decide the number and spacing of their children. Specific targets are included in the table below. In response to recommendations to broaden the scope of family planning into an integrated approach to reproductive health, a National Reproductive Health Policy was developed in January 2005. The policy mandates that a core package of integrated reproductive health services consisting of safe motherhood and nutrition, family planning, and prevention and control of RTIs (including STIs and HIV/AIDS) will be made available in all primary health care facilities. A twoway referral system will ensure vertical and horizontal continuity of care from different health and information providers and service delivery points. Targets of the National Population and Development Policy Indicators Baseline data 2000 2010 2020 Maternal mortality ratio (per 100,000 live births) 656 in 1993 490 250 130 Total fertility rate 5.6 children in 1995 Contraceptive prevalence rate Infant mortality rate (per 1,000 live births) Under 5 mortality (per 1,000 live births) Girls’ enrollment rate in primary school Girls’ enrollment rate in secondary schools 4.5 3.5 3 3% in 1994 25–30% 50–55% 60–65% 104 in 1995 85 40 20 170 in 1995 127 60 30 Literacy rate of women 48% in 1995 60% 75% 85% 68% in 1995 75% 89% 95% 28% in 1995 35% 55% 74%
National Programs, Policies, and Budgetary Commitments for Safe Motherhood The policy’s specific objectives to reduce maternal, infant, and perinatal mortality and morbidity include: • achieve a significant and sustainable reduction in maternal, perinatal, and infant mortality and morbidity • ensure adequate child growth, nutrition, and development among children • protect the mothers and children from preventable infectious diseases • integrate safe motherhood and child growth and monitoring with reproductive health program activities The policy calls for the upgrading of facilities and skills of health care providers at the district/sub-district levels for improved detection and early referral of emergency obstetrical conditions as well as provision of transport and systematic referral. It also mandates the dissemination of clinical practice guidelines in all health centers and hospitals. The government has formulated other policy papers, poverty reduction strategies, and master plans up to the year 2020 which included maternal and child health as one of the priority concerns, especially among poor and marginalized minority groups. It has also targeted the improvement of the health sector and education of girls to correct gender imbalances. Programmatic Priorities Most activities have been carried out on a project basis and are funded by different international agencies. As outlined in the 1995 maternal needs assessment, projects have generally been implemented as vertical programs in specific areas of the country, and not on a national scale. Beginning in 1995, a government-led community health project to integrate maternal and child health services was instituted at the community and district levels, with the aim of building the capacity of the health system to improve the coverage and quality of maternal health care. Maternal and child health services serve as an entry point to link other primary health care interventions and facilitate the delivery of services to the community. The project has expanded to six provinces and is still ongoing. Donor-financed projects include the Survival, Growth and Development program implemented by unicef which targets women and children through an integrated project of maternal and child health management and promotion, child survival interventions, growth development, and safe motherhood. 56 The latter component included the development of an integrated package of safe motherhood outreach services in remote villages of six provinces; the development of training curricula/guidelines on emergency obstetric care; and training physicians and nurses in collaboration with WHO and UNFPA. A UNFPA project supports mobile clinics and provides equipment and supplies to health facilities in three southeastern provinces. The mobile clinics provide a range of reproductive health services and information—including family planning, prenatal care, treatment of sexually transmitted infections, and education on HIV/AIDS prevention. 56 unicef Country Program (2002–2006), Survival, Growth and Development Program, Mid-Term Review, 2004. 57
Page 1:
Safe Motherhood A Review The Safe M
Page 4 and 5:
Table of Contents Acknowledgments 3
Page 6 and 7:
II Introduction The year 2007 will
Page 8 and 9: whether a woman receives adequate c
Page 10 and 11: II II A Historical Review of Safe M
Page 12 and 13: The International Conference on Pop
Page 14 and 15: 12 For each of the Goals and target
Page 16 and 17: 1 The informants reported unanimous
Page 18 and 19: 1 The UN General Assembly Special S
Page 20 and 21: 1 Story Placement: • The greatest
Page 22 and 23: As the graph below illustrates, sim
Page 24 and 25: 22 Additionally, the Safe Motherhoo
Page 26 and 27: 2 • Family Care International: Fa
Page 28 and 29: 2 Development Agency Trends Sixteen
Page 30 and 31: 2 Representatives emphasized the im
Page 32 and 33: VI VI 0 Financial Trends for Safe M
Page 34 and 35: In addition to examining trends in
Page 36 and 37: • Central to increasing funds is
Page 38 and 39: Bolivia Bolivia In Bolivia, materna
Page 40 and 41: Bolivia 2002-2007. During this peri
Page 42 and 43: 0 Bolivia National Insurance Fund I
Page 44 and 45: 2 Bolivia Monitoring and Evaluation
Page 46 and 47: Bolivia Conclusion Maternal mortali
Page 48 and 49: Indonesia In 1994, the government r
Page 50 and 51: Indonesia While the national safe m
Page 52 and 53: Indonesia 4.0 3.5 3.0 2.5 2.0 1.5 1
Page 54 and 55: 2 Indonesia Conclusion Aggregated G
Page 56 and 57: Lao People’s Democratic Republic
Page 60 and 61: Lao People’s Democratic Republic
Page 62 and 63: 0 Lao People’s Democratic Republi
Page 64 and 65: Malawi There is a shortage of essen
Page 66 and 67: Malawi • Safe motherhood • Adol
Page 68 and 69: Malawi Numerous studies have shown
Page 70 and 71: Mali Safe Motherhood Policy Mali ha
Page 72 and 73: 0 Mali • Follow-through on the re
Page 74 and 75: 2 Mali About 80% of the health budg
Page 76 and 77: Tanzania Situated on the east coast
Page 78 and 79: Tanzania the delivery of primary he
Page 80 and 81: Tanzania Strategy for Reproductive
Page 82 and 83: Tanzania Sectors category, along wi
Page 84 and 85: 2 Tanzania MOH Budget Source: Plann
Page 86 and 87: care is provided. The 2005 report o
Page 88 and 89: List of Abbreviations AIDS Acquired
Page 90 and 91: Annex I: Development and donor agen
Page 92 and 93: 0 Major Activities/Publications Are
Page 94 and 95: 2 III. Information Clearinghouse (1
Page 96 and 97: Annex III: Ten Action Messages for
Page 98: 7. Improve Access to Quality Reprod
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