Prevention of Maternal Mortality in Resource Poor Settings

The United Nations' fifth Millennium Development Goal (MDG) challenged countries to cut the maternal mortality ratio (MMR) by three quarters between 1990 and 2015. There is no dispute that persistently high MMR is linked to the fact that approximately half of all births worldwide are attended by a traditional birth attendant (TBA), a relative, or no one. Despite impressive declines in a few countries, MDG # 5 is unlikely to be achieved in the countries with the highest MMR unless new technologies are harnessed to prevent maternal deaths on a large scale. The purpose of this presentation is to examine the debate in the last decade over whether training TBAs has the potential to reduce the MMR in many developing countries.

We have conducted a literature search to review the recent poicies on skilled and unskilled delivery care in developing countries. Next we examined the 5 primary causes of maternal mortality to point out the current strategies and difficulties inherent in successfully managing these complications in a village without medical back-up. Next we use recent published and soon-to-be published data to highlight the untapped potential of misoprostol, a tablet form medication used to prevent and treat postpartum hemorrhage. This medication can be administered by outreach health care workers trained in its use. With a new understanding of the benefits and limitations of TBAs, along with new improvements in medical technology, the international community can begin move toward an integrated approach to reducing MMR in the developing world, incorporating the important role that TBAs play in their communities.