Access to maternal and perinatal health services: lessons from successful and less successful examples of improving access to safe delivery and care of the newborn

V De Brouwere, F Richard, S Witter

    Research output: Contribution to journalA1: Web of Science-article

    Abstract

    Summary The huge majority of the annual 6.3 million perinatal deaths and half a million maternal deaths take place in developing countries and are avoidable. However, most of the interventions aiming at reducing perinatal and maternal deaths need a health care system offering appropriate antenatal care and quality delivery care, including basic and comprehensive emergency obstetric care facilities. To promote the uptake of quality care, there are two possible approaches: influencing the demand and/or the supply of care. Five lessons emerged from experiences. First, it is difficult to obtain robust evidence of the effects of a particular intervention in a context, where they are always associated with other interventions. Second, the interventions tend to have relatively modest short-term impacts, when they address only part of the health system. Third, the long-term effects of an intervention on the whole health system are uncertain. Fourth, because newborn health is intimately linked with maternal health, it is of paramount importance to organise the continuum of care between mother and newborn. Finally, the transfer of experiences is delicate, and an intervention package that has proved to have a positive effect in one setting may have very different effects in other settings
    Original languageEnglish
    JournalTropical Medicine and International Health
    Volume15
    Issue number8
    Pages (from-to)901-909
    Number of pages9
    ISSN1360-2276
    DOIs
    Publication statusPublished - 2010

    Keywords

    • B780-tropical-medicine
    • Maternal health services
    • Obstetric services
    • Perinatal health care
    • Antenatal care
    • Accessibility
    • Infants
    • Newborns
    • Mortality reduction
    • Stillbirth
    • Interventions
    • Refugees
    • Financing
    • Performance-based payment
    • Vouchers
    • Developing countries

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