Guidance
Key Papers on Maternal Mortality - July 2006
This guide aims to give you an overview on the institutional literature on maternal mortality. It lists the key papers and gives a brief summary of each. The list is not exhaustive, but aims to be a starting point for your own reading on maternal health in developing countries.
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World Health Organization Publications
Strategic Approach to Improving Maternal and Newborn Survival and Health
World Health Organisation (WHO), 2006; available online at http://www.who.int/making_pregnancy_safer/publications/StrategicApproach2006.pdf
This publication emphasises the need for universal access to continual maternal healthcare and the importance of skilled attendants during childbirth. It presents the WHO's strategy consisting of twelve approaches which include the following: consideration of the local economic, political, social context and integrating different actors that are relevant to maternal health when policy and programme planning.
World Health Report 2005: Make every mother and child count
WHO, 2005; available online at http://www.who.int/whr/2005/whr2005_en.pdf or by writing to World Health Report, World Health Organization, 1211 Geneva 27, Switzerland.
This is the annual report by the World Health Organisation, this year focusing on maternal and child health. The report gives an overview of the global situation, and gives figures on maternal and infant mortality, highlighting the inequalities that exist between the North and the South. The report calls for action to increase access to a continuum of care, from pregnancy through to childbirth and into childhood.
Making Pregnancy Safer: The critical role of the skilled attendant
WHO/ICM/FIGO 2004; available online at http://www.who.int/reproductive-health/publications/2004/skilled_attendant.pdf
A statement made together by the World Health Organisation, the International Confederation of Midwives and the International Federation Gynaecology and Obstetrics, focusing on continual care of pregnant mothers and the crucial role of the skilled attendant during all phases of pregnancy and childbirth.
Beyond the numbers: Reviewing maternal deaths and complications to make pregnancy safer
WHO 2004; available online at http://www.who.int/reproductive-health/publications/btn/text.pdf
This guide provides information on the technical reasons for maternal death and complications. It also presents various approaches that healthcare practitioners can implement to improve the quality of maternal healthcare. The publication asks for a review of practices of those working in maternal health to ensure the safest and most effective approaches.
Global Action for skilled attendants for pregnant women
WHO, 2004; available online at http://www.who.int/reproductive-health/publications/global_action_for_skilled_attendants/mpr_global_action.pdf
A call for action to address the global shortage of skilled health care workers and skilled attendants for pregnancy, childbirth and postnatal care, in accordance with the Millennium Development Goals that aim for a severe reduction in maternal mortality. There is also discussion of the strategies needed to implement this action.
Unsafe Abortion: global and regional estimates of the incidence of unsafe abortion and associated mortality in 2000
WHO, 2004, available online at http://www.who.int/reproductive-health/publications/unsafe_abortion_estimates_04/estimates.pdf
This work highlights the preventable deaths of an estimated 68,000 women every year, who die following an unsafe abortion. It calls for the prevention of unplanned pregnancies by improving access to quality family planning services as the main priority to stop unsafe abortion.
Maternal Mortality in 2000: Estimates developed by WHO, UNICEF and UNFPA
WHO/UNICEF/UNFPA; available online at http://www.who.int/reproductive-health/publications/maternal_mortality_2000/mme.pdf
This is an attempt to fill the gap of reliable estimates on maternal mortality around the world. The report is based on new methods of calculating maternal mortality and draws attention to the existence and likely dimensions of maternal mortality.
Managing Complication in Pregnancy and Childbirth: A guide for midwives and doctors
WHO, 2003; available online at http://www.who.int/reproductive-health/impac/mcpc.pdf
This publication provides guidance for health workers who are responsible for the care of pregnant women and newborns. Outlines the clinical principles of managing complications, describes the symptoms, and the procedures that may be necessary in the management of the condition.
WHO Antenatal Care Randomized Trial: Manual for the Implementation of the New Model
WHO, 2001; available online at http://www.who.int/reproductive-health/publications/RHR_01_30/antenatal_care_randomized_trial.pdf
Along with the UNFPA, UNDP and the World Bank, the WHO has published this document to present its comparison of a new model of antenatal care with that of the standard model. The research was performed through randomized controlled trials. The publication expands on the necessary procedures to implement when carrying out the new model.
Mother-baby package: Implementing safe motherhood in countries
WHO, 1996; available online at http://www.who.int/reproductive-health/publications/MSM_94_11/mother_baby_package_safe_motherhood.pdf
This is a guide for practical usage in developing countries, presenting 18 interventions that are easy to implement in countries where resources are scarce.
Guidelines for Monitoring the Availability and Use of Obstetric Services
UNFPA/WHO/UNICEF 1997; available online at http://www.who.int/reproductive-health/publications/unicef/monitoring_obstetric_services.pdf
This document defines monitoring the delivery of essential obstetric care. It also outlines the processes of successful implementation of maternal health interventions.
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Department for International Development Publications
Reducing Maternal Deaths: Evidence and Action
DFID, 2004; available online at http://www.dfid.gov.uk/pubs/files/reducmaternaldeath.pdf
A discussion of strategies needed to fulfil Millennium Development Goal 5 in reducing maternal deaths by three-quarters by 2015. These include increasing awareness of maternal mortality, increasing investment in health systems, addressing the wider social, cultural and economic barriers to maternal health. None of these are possible, argues the report, without the international political will to act.
Evaluation of DFID Assistance: Gender Equality and Women's Empowerment; Phase II Thematic Evaluation - Maternal Mortality
DFID, 2005; available online at http://www.dfid.gov.uk/aboutdfid/performance/files/wp8.pdf
This document is an evaluation report describing the key issues in relation to maternal mortality and gender equality. It demonstrates that the high rate of maternal mortality is evidence of gross gender inequality and highlights the need to mainstream gender in all maternal health programmes.
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Other Publications
Who's got the power? Transforming health systems for women and children
UN Millennium Project-Task Force on Child Health and Maternal Health, 2005; available online at http://www.unmillenniumproject.org/documents/maternalchild-complete.pdf
This publication provides a thorough review of the status of maternal and child health in relation to the Millennium Development Goals 4 and 5. Its emphasis is placed on the improvement of health systems in order to achieve the global indicators set by the UN.
Maternal Mortality Update 2004
UNFPA and University of Aberdeen, 2004; available online at http://www.unfpa.org/upload/lib_pub_file/381_filename_mmupdate05_eng21.pdf
This report summarises recent trends in maternal mortality, examines the importance of medically trained attendants who have emergency backup, and offers approaches for improving the level of care women receive during childbirth.
State of the World's Mothers
Save The Children, 2004; available online at http://www.savethechildren.org/mothers/report_2004/images/pdf/SOWM_2004_final.pdf
This report highlights the problems of 'children who have children'. Around the world, tens of millions of girls marry and have children whilst they are still children, often with devastating consequences. It analyses countries where the problem is most severe, including Niger, Afghanistan, Burkina Faso and Ethiopia.
Promoting Quality Maternal and Newborn Care: A Reference Manual for Program Managers
CARE/The White Ribbon Alliance, 1998; available at http://www.whiteribbonalliance.com/pdf/wraqualitycareenglish.pdf
A discussion of the issues surrounding maternal mortality, including factors related to pregnancy and factors related to the wider socio-economic status of women. It is particularly useful for development practitioners.
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Links to reference documents on the WHO web site
For a comprehensive list of links to all on-line publications on maternal and neonatal health from the WHO-UNFPA Strategic Partnership Programme go to http://www.who.int/reproductive-health/publications/maternal_newborn.en.html
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