Access to health care services during pregnancy and maternal health outcomes in developing countries

Background:

The gap between developed and developing countries in terms of maternal mortality is huge. Almost 80% of deaths occur due to sepsis, hemorrhage, hypertensive disorder, induced abortion, and obstructed labor. Globally, around 536,000 maternal deaths were recorded in the year 2005 and the maternal mortality ratio was as high as 400 per 100,000 live births. Maternal deaths and maternal mortality ratio were highest in Southeast Asia, Sub-Saharan Africa, East Asia and Latin America.

Barriers to prenatal care access:

There are five important factors associated with access to health care viz. affordability, availability, accessibility, accommodation and acceptability. Underutilization of these services is most prevalent in low income countries of Africa and Asia due to factors such as age, lack of medical insurance, low education levels, socioeconomic and demographic factors, increased clinical risk factors and decreased supply of health care services in the form of clinics’ availability and distance of travel. Overcoming the burden: Countries like Malaysia and Sri Lanka among other developing countries have successfully reduced their maternal mortality rates to levels much comparable to developed countries. They shifted their strategies from focusing on expanding their services in underserved areas to increasing utilization and improving quality of services provided. Examples of successful interventions conducted in India, Brazil and Rural Ethiopia are discussed in detail.

Conclusion:

Maternal mortality is a huge burden in many countries especially in the developing world and the biggest challenge is the availability of adequate healthcare services. The best way to overcome this burden is to integrate health care services and public health interventions.