[EQ] Strategies for reducing maternal mortality: getting on with what works

Strategies for reducing maternal mortality: getting on with what works

Oona MR Campbell, Department of Epidemiology and Population Health, London
School of Hygiene & Tropical Medicine, London

Wendy J Graham, Department of Obstetrics and Gynecology, University of
Aberdeen, Aberdeen, UK

The Lancet Maternal Survival Series steering group

The Lancet, Volume 368, Number 9543, 7 October 2006

Available online at:
http://www.thelancet.com/journals/lancet/article/PIIS0140673606693811/fullte
xt

Free subscription required

"...The concept of knowing what works in terms of reducing maternal
mortality is complicated by a huge diversity of country contexts and of
determinants of maternal health. Here we aim to show that, despite this
complexity, only a few strategic choices need to be made to reduce maternal
mortality. We begin by presenting the logic that informs our strategic
choices.

This logic suggests that implementation of an effective intrapartum-care
strategy is an overwhelming priority. We also discuss the alternative
configurations of such a strategy and, using the best available evidence,
prioritise one strategy based on delivery in primary-level institutions
(health centres), backed up by access to referral-level facilities. We then
go on to discuss strategies that complement intrapartum care.

We conclude by discussing the inexplicable hesitation in decision-making
after nearly 20 years of safe motherhood programming: if the fifth
Millennium Development Goal is to be achieved, then what needs to be
prioritised is obvious. Further delays in getting on with what works begs
questions about the commitment of decision-makers to this goal..."

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Received on Fri Oct 6 17:19:37 2006