|Reducing Maternal Mortality and Morbidity (UNFPA, 1998, 22 p.)|
At the International Conference on Population and Development (ICPD), held in Cairo, Egypt, in 1994, Governments and health advocates affirmed that sexual and reproductive health is essential for personal well-being and for national development. Furthermore, the ICPD recognized interventions to reduce maternal mortality and morbidity as key components of efforts to improve womens reproductive health and rights. It recommended defined objectives and actions to reduce maternal mortality and morbidity to levels where they no longer constitute a public health problem.
Specifically, the ICPD Programme of Action proposed the following objectives in relation to maternal mortality reduction:
· To promote womens health and safe motherhood;
· To achieve a rapid and substantial reduction in maternal morbidity and mortality and reduce the differences observed between developing and developed countries and within countries;
· To reduce greatly the number of deaths and morbidity from unsafe abortion; and
· To improve the health and nutritional status of women, especially of pregnant and nursing women.
"Countries should strive to effect significant reductions in maternal mortality by the year 2015: a reduction in maternal mortality by one half of the 1990 levels by the year 2000 and a further one half by 2015."
- ICPD Programme of Action, para. 8.21.
To realize these goals, countries, with the support of all sections of the international community, were urged to expand the provision of maternal health services in the context of primary health care. These services, based on the concept of informed choice, should include:
· Education on safe motherhood and programmes to engage men's support for maternal health;
· Measures to prevent, detect and manage high-risk pregnancies and births, particularly those to adolescents and late-parity women;
· Focused, effective prenatal and postnatal care (including maternal nutrition programmes and family planning services);
· Adequate delivery assistance (avoiding excessive recourse to caesarean sections and providing for obstetric emergencies and referral services) by trained persons, preferably nurses and midwives, but at least by trained birth attendants; and
· Management of the complications of unsafe abortion as a major public health concern and reduction in the recourse to abortion through expanded and improved family planning services.
The approach set out by the ICPD Programme of Action includes the identification of underlying causes of maternal morbidity and mortality as a basis for the development of strategies to overcome them and of adequate evaluation and monitoring mechanisms.