Last updated on Sep 30th, 2016 at 09:53 am

Progress patchy

Progress has been patchy and authors warn against poor quality care with rising rates of over-medicalisation, too few trained staff or basic resources in many regions.

Phrases such as ‘skilled birth attendant’ and ‘emergency obstetric care’ can mask poor quality care, whilst many birth facilities lack basic resources such as water, sanitation and electricity. Furthermore, the authors point to new challenges including the increasing age of pregnancy and higher rates of obesity.

Widening gap

The gap between the groups of countries with the lowest and highest rates of maternal mortality doubled between 1990 and 2013.

“In all countries, the burden of maternal mortality falls disproportionately on the most vulnerable groups of women. This reality presents a challenge to the rapid catch-up required to achieve the underlying aim of the SDGs, which is ‘to leave no one behind’,” says Series author Professor Wendy Graham, London School of Hygiene & Tropical Medicine, London, UK.

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Too much medicalisation, too many C-sections

Two broad scenarios describe the landscape of poor maternal health care: the absence of timely access to quality care (defined as ‘too little, too late’) and the over-medicalisation of normal childbirth care (defined as ‘too much, too soon’). The problem of over-medicalisation has historically been associated with high-income countries, but it is rapidly becoming more common in low and middle income countries, increasing health costs and the risk of harm. For instance, 40,5% of all births are now by C-section in Latin America and the Caribbean.

Five key priorities

The authors of the Series identify five key priorities that require immediate attention in order to achieve the SDG global target of a maternal mortality ratio of less than 70 per 100 000 live births. These include: prioritising quality maternal health services that respond to local needs; promoting equity through universal coverage of quality maternal health services; improving the health workforce; improving facility capability; and, guaranteeing sustainable financing for maternal and perinatal health.

For the complete article see

http://www.thelancet.com/series/maternal-health-2016

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