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The safe motherhood initiative: Why has it stalled?

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  • Maine, D.
  • Rosenfield, A.

Abstract

Complications of pregnancy and childbirth are still the leading cause of death and disability among women of reproductive age in developing countries. After decades of neglect, the founding of the Safe Motherhood Initiative in 1987 promised action on this problem. A dozen years later, there is no evidence that maternal mortality has declined and there are still few sizeable programs. A major reason for this disappointing record is that the initiative lacks a clear, concise, feasible strategy. This article reviews the available options and proposes a strategy based on improving the availability and quality of medical treatment of obstetric complications. Once district hospitals and health centers provide such needed care, community mobilization to improve utilization may be beneficial. Substantial reductions in maternal deaths would be possible in a relatively short period of time if this strategy were embraced.

Suggested Citation

  • Maine, D. & Rosenfield, A., 1999. "The safe motherhood initiative: Why has it stalled?," American Journal of Public Health, American Public Health Association, vol. 89(4), pages 480-482.
    • Handle: RePEc:aph:ajpbhl:1999:89:4:480-482_8
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    Cited by:

    1. Gyimah, Stephen Obeng & Takyi, Baffour K. & Addai, Isaac, 2006. "Challenges to the reproductive-health needs of African women: On religion and maternal health utilization in Ghana," Social Science & Medicine, Elsevier, vol. 62(12), pages 2930-2944, June.
    2. Sammy Zahran & David Mushinski & Hsueh‐Hsiang Li & Ian Breunig & Sophie Mckee, 2019. "Clinical Capital and the Risk of Maternal Labor and Delivery Complications: Hospital Scheduling, Timing, and Cohort Turnover Effects," Risk Analysis, John Wiley & Sons, vol. 39(7), pages 1476-1490, July.
    3. Chen, Chin-Shyan & Liu, Tsai-Ching & Chen, Li-Mei, 2003. "National Health Insurance and the antenatal care use: a case in Taiwan," Health Policy, Elsevier, vol. 64(1), pages 99-112, April.
    4. Vitzthum, Virginia J. & Spielvogel, Hilde, 2003. "Epidemiological transitions, reproductive health, and the Flexible Response Model," Economics & Human Biology, Elsevier, vol. 1(2), pages 223-242, June.
    5. World Bank, 2002. "Brazil : Maternal and Child Health," World Bank Publications - Reports 15434, The World Bank Group.
    6. Brunson, Jan, 2010. "Confronting maternal mortality, controlling birth in Nepal: The gendered politics of receiving biomedical care at birth," Social Science & Medicine, Elsevier, vol. 71(10), pages 1719-1727, November.
    7. Chen, Chin-Shyan & Liu, Tsai-Ching & Lin, Herng-Ching & Tian, Wei-Hua, 2007. "The effect of Taiwan's National Health Insurance on infants' preventive care use and inpatient care use," Health Policy, Elsevier, vol. 80(3), pages 432-443, March.
    8. Berry, Nicole S., 2006. "Kaqchikel midwives, home births, and emergency obstetric referrals in Guatemala: Contextualizing the choice to stay at home," Social Science & Medicine, Elsevier, vol. 62(8), pages 1958-1969, April.
    9. Social Policy and Population Section, Social Development Division, ESCAP., 2006. "Asia-Pacific Population Journal Volume 21, No. SP," Asia-Pacific Population Journal, United Nations Economic and Social Commission for Asia and the Pacific (ESCAP), vol. 21(SP), pages 1-116, November.
    10. Summer, Anna & Guendelman, Sylvia & Kestler, Edgar & Walker, Dilys, 2017. "Professional midwifery in Guatemala: A qualitative exploration of perceptions, attitudes and expectations among stakeholders," Social Science & Medicine, Elsevier, vol. 184(C), pages 99-107.
    11. Cynthia K. Stanton, 2004. "Methodological Issues in the Measurement of Birth Preparedness in Support of Safe Motherhood," Evaluation Review, , vol. 28(3), pages 179-200, June.
    12. Emmanuel Olorunleke Adewuyi & Asa Auta & Vishnu Khanal & Olasunkanmi David Bamidele & Cynthia Pomaa Akuoko & Kazeem Adefemi & Samson Joseph Tapshak & Yun Zhao, 2018. "Prevalence and factors associated with underutilization of antenatal care services in Nigeria: A comparative study of rural and urban residences based on the 2013 Nigeria demographic and health survey," PLOS ONE, Public Library of Science, vol. 13(5), pages 1-21, May.
    13. Okiwelu, Tamunosa & Hussein, Julia & Adjei, Sam & Arhinful, Daniel & Armar-Klemesu, Margaret, 2007. "Safe motherhood in Ghana: Still on the agenda?," Health Policy, Elsevier, vol. 84(2-3), pages 359-367, December.
    14. Prata, Ndola & Greig, Fiona & Walsh, Julia & West, Anna, 2004. "Ability to pay for maternal health services: what will it take to meet who standards?," Health Policy, Elsevier, vol. 70(2), pages 163-174, November.

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