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close this book02. Of Blind Alleys and Things that Have Worked: History's Lessons on Reducing Maternal Mortality
View the document(introduction...)
View the documentSummary
View the documentIntroduction
View the documentPatterns of Reduction of Maternal Mortality in the West
View the documentSweden
View the documentUSA
View the documentEngland & Wales
View the documentAccessible Technology and Reliable Hospitals
View the documentSuccess or Failure: Combining the Right Ingredients
View the documentProfessionalisation of Delivery Care and Maternal Mortality in Developing Countries
View the documentInadequate Information
View the documentIll-Informed and Ineffective Strategies
View the documentMaking Professional Care Accessible
View the documentWinning the Hospital Battle
View the documentReferences

Accessible Technology and Reliable Hospitals

Between 1937 to 1970 maternal mortality dropped steeply throughout the industrialised world. By 1954 the USA and Sweden both reached 60 per 100,000. Further reductions after the 1970s brought maternal mortality ratios to the current low levels of less than 10. This new phase in the reduction of mortality ratios was a consequence of the improvement of techniques (antibiotics, caesareans, transfusions) in a context in which they were made available to the great majority of women, whether confined in hospital or at home. “Once the medical technology to treat obstetrical complications becomes widely accessible, it seems that the actual place of delivery is not of crucial importance.” (Maine et al. 1991). The improvement of financial access to professional care was a key factor, but health care systems also developed a culture of quality of care sustained by a system of control and professional accountability. This, in turn, was fed with information derived from generalised monitoring of mortality ratios and enquiries into maternal deaths.