Safe Motherhood: A Review - Family Care International

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Lao People’s Democratic Republic
Conclusion
In Lao PDR, the maternal mortality ratio
is among the highest in Asia at 656
per 100,000 live births in 1995. The high
MMR is attributed to a range of factors,
including very low utilization of health
facilities, poor coverage of skilled attendance
during childbirth, very low antenatal care,
almost no postpartum care, inadequate
essential obstetrics care, lack of functioning
referral system, absence of birth and death
registration systems, and a poor functioning
health system. Compounding these are
a high total fertility rate at 5.6, and a low
contraceptive prevalence of 3%.
While maternal mortality has declined,
progress has been slow. A long history of
neglect of the health system, punctuated
by inadequate human resources and poor
infrastructure, has featured as a main
obstacle to continued improvements in
safe motherhood.
Most safe motherhood interventions have
been funded by international donors, with
the government contributing recurrent
expenditures including staff salaries, facilities’
maintenance, etc. While financial support
in general has been inadequate, the lack
of coordination among donors, the vertical
programming structure, and the lack of
efficient monitoring and data systems have
further contributed to funding inefficiencies.
The government is making efforts to
coordinate the multiple agencies to fasttrack
implementation, avoid duplication
of programs, promote better working
relationships, and identify unmet program
needs. Substantial efforts are still needed
to improve monitoring and evaluation
systems, establish registration and referral
systems, develop more effective partnerships
with NGOs, and provide an assessment of
program implementation. A reassessment of
maternal health needs is needed to determine
the quality of maternal and neonatal care
available, the level of service utilization, and
the sustainability of interventions in an effort
to build on the gains that have been achieved
thus far.