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APHA Scientific Session and Event Listing

Recorded presentation

Ndola Prata, MD, MSc, Farnaz Vahidnia, MD, MPH, Martha Campbell, PhD, and Malcolm Potts, MB, PhD, FRCOG. University of California, Berkeley, 513 Warren Hall, Berkeley, CA 94720, 510-643-7627, fvahid@berkeley.edu

Availability and delivery of quality maternal health services in rural settings remains for the most part a disappointment for safe motherhood programs in developing countries. The provision of quality services in rural settings has proven to be very difficult, extremely costly and therefore not feasible with current health budgets. Faced with human and financial resource contraints, it is time now for maternal health program planners to reassess and reprioritize interventions, selecting those that are realistically feasible and sustainable, if we are to achieve the Millennium Development Goal of reducing maternal mortality. This paper examines a set of maternal health interventions, service delivery and financing mechanisms that can be implemented in rural settings using the human capacity available in those areas. We assess the evidence and theory of using private sector providers, including the non-professional sector to improve maternal health indicators. Having explored the epidemiologic profile and the complexity of delivering maternal health services for the poor, we conclude that provision of family planning methods and misoprostol for postpatum hemorrhage are two interventions that address most of the maternal health burden, and could be scaled-up rapidly. Using a combnation of social marketing and community –based approaches, family planning methods can be delivered to all women in need. Misoprostol administered by minimally trained traditional birth attendants is an effective uterotonic agent for prevention and treatment of PPH in household settings, where most of the deliveries occur in rural areas, and the use of other uterotonic agents is not an available option.

Learning Objectives:

• 1. Describe factors resulting in high maternal mortality in resource poor settings.
• 2. Recognize misoprostol as an effective and safe uterotogenic agent to control postpartum hemorrhage in rural settings.
• 3. Identify family planning as a cost effective measure to tackle down maternal mortality in resource poor areas.

Keywords: Maternal Health, Rural Health Care Delivery System

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation