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Safe Motherhood

HP+ More recent Safe Motherhood publications are available.

  • The target of opportunity (TOO) in Bangladesh sought to strengthen women’s reproductive health using an innovative approach—repositioning family planning as a key component of safe motherhood programs. Family planning in the postpartum period not only allows couples to prevent unintended pregnancies, it enables women to plan and space births, which helps the mothers’ bodies recover before having another child. This limits the total number of pregnancies per woman and reduces the potential for higher-risk pregnancies. Promoting family planning in the postpartum is a critical strategy for Bangladesh because it has an estimated maternal mortality rate of 380—and, given the country’s population size, this places Bangladesh among the 10 countries with the highest number of maternal deaths in the world. Other priority action areas included promotion of safe motherhood practices for young couples, especially given early marriages in Bangladesh, and implementation of the Ministry of Health (MOH) draft National Maternal Health Strategy.
    English
    BangladeshTOO 12-19-06 FINAL.pdf
  • Over the past decade, Cambodia has made good progress in re-establishing a nationwide health system that had been devastated by decades of civil conflict. The efforts of the Ministry of Health and nongovernmental organizations to expand family planning services have had an impact on individual lives and most health indicators. Between 1995 and 2000, the contraceptive prevalence rate for married couples practicing modern family planning methods increased from 7 to 18.5 percent. The risk that women will die due to pregnancy-related causes, while still quite high, has also been greatly reduced due to lower fertility and improved access to service provision. Despite these achievements, Cambodia faces great challenges. This booklet reviews Cambodia's current reproductive health situation and focuses on the challenges ahead for family planning and safe motherhood programs. (Hard copy available in English and Khmer)
    English
    CAM_SavingLives.pdf
  • English
    Moz_Manual.pdf
  • Each year, nearly 530,000 women and girls die due to pregnancy- and childbirth-related causes and another 8 to 20 million suffer serious injuries and disabilities (WHO, 2003; UNFPA, 2005). The majority of maternal deaths occur immediately after or within one day of delivery, often due to severe hemorrhaging, obstructed labor, infection/sepsis, and eclampsia/hypertension. While proper care and nutrition throughout pregnancy (including regular antenatal checkups) are essential for reducing and identifying risks, researchers, health professionals, and policymakers are increasingly recognizing that skilled delivery assistance, access to emergency obstetric care, and prevention and treatment of postpartum hemorrhage are the most important strategies for preventing maternal and neonatal deaths and disabilities. It is skilled assistance at the critical time of delivery that can make the difference between life and death for thousands of women and their babies around the world.
    English
    Safe Motherhood Brief 1 HQP.pdf
  • The term “safe motherhood” refers to efforts to prevent maternal and infant death and disability through improved access to healthcare and other supportive services (White Ribbon Alliance, 2005). Sadly, women in the developing world experience a 1 in 61 lifetime risk of dying from pregnancy- or childbirth-related complications (World Health Organization, 2003). This is compared to a 1 in 2,800 lifetime risk for their counterparts in developed countries. Common causes of maternal and neonatal mortality and morbidity are excessive bleeding, obstructed labor, infections, and hypertensive disorders. They can occur suddenly, often with little warning. However, negative outcomes can be greatly reduced with proper nutrition throughout the pregnancy, skilled assistance at delivery, and access to regular antenatal checkups, emergency obstetric care, and postpartum care. Effective operational policies are essential for ensuring access to maternal health services, especially for underserved and hard-to-reach populations. Operational policies are the rules, regulations, codes, guidelines, and administrative norms that governments and organizations use to translate laws, policies, and resources into programs and services on the ground (Cross et al., 2001). These policies and guidelines affect all aspects of service quality and accessibility. Examples of operational barriers include unreliable supplies of medicines, unnecessary restrictions on the types of services that can be performed by various healthcare providers, high user fees for services, and inconsistent resource allocation and staffing plans that neglect rural health facilities.
    English
    Safe Motherhood Brief 2 HQP.pdf
  • In countries with high fertility rates and poor access to maternal healthcare services, each pregnancy can put a woman’s life at risk. Women in the developing world experience a 1 in 61 lifetime risk of dying from pregnancy- or childbirth-related complications. This is compared to a 1 in 2,800 lifetime risk for their counterparts in developed countries. Lifetime risk of maternal death considers the “probability of becoming pregnant and the probability of dying as a result of pregnancy cumulated across a woman’s reproductive years” (WHO, 2003, p. 1). Factors that increase the likelihood of complications during pregnancy and delivery include (1) too many pregnancies, (2) too short an interval between pregnancies, (3) having a pregnancy too early in life, or (4) having a pregnancy too late in life. These risk factors can negatively affect a woman’s long-term health by depleting her nutritional and overall health status— contributing to anemia, fatigue, increased blood pressure, and decreased immunity to diseases such as malaria and reproductive tract infections. These factors can also increase the risk of birth injury, miscarriage, or stillbirth. It stands to reason, then, that maternal and neonatal deaths can be prevented by (1) limiting the number of pregnancies each woman experiences during her lifetime and (2) improving access to reproductive and maternal healthcare—particularly antenatal care, skilled attendance at delivery, emergency obstetric care, postpartum care, and postabortion care. Family planning allows for healthy spacing and timing of pregnancies and limits the number of unintended pregnancies, both of which are essential components of comprehensive safe motherhood strategies (see Figure 1). Through integration of family planning and safe motherhood programs, women can limit their overall fertility and reduce the number of times they are at risk for maternal death; space births, thereby allowing their bodies to recover from previous pregnancies; and time their pregnancies. Improving access to and integrating family planning and safe motherhood programs provides additional societal benefits, including: healthier women who are better able to contribute economically to their families and communities; a reduction in neonatal deaths, deaths among children under 5, and children orphaned by maternal mortality; a reduced burden on public health and social welfare systems; and a reduction in abortions.
    English
    Safe Motherhood Brief 3 HQP.pdf
  • Russian
    MNPI_AltaiKra.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    English
    Bangladesh_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    French
    Benin_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    Spanish
    Bolivia_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    English
    Cambodia_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    Spanish
    Ecuador_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    English
    Egypt_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    English
    Ethiopia_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; identify program strengths and weaknesses; plan strategies to address deficiencies; encourage political and popular support for appropriate action; and track progress over time.
    English
    Ethiopia_MNPI_2002.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    English
    Ghana_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; identify program strengths and weaknesses; plan strategies to address deficiencies; encourage political and popular support for appropriate action; and track progress over time.
    English
    Ghana_MNPI_2002.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    English
    Guatemala_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    French
    Guinea_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    French
    Haiti_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; identify program strengths and weaknesses; plan strategies to address deficiencies; encourage political and popular support for appropriate action; and track progress over time.
    English
    Haiti_MNPI_2002.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    English
    Indonesia_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    English
    Jamaica_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    English
    Kenya_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    Russian
    MNPI_Khabarovsk.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    English
    Malawi_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    French
    Mali_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    Spanish
    Mexico_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    English
    Nepal_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    English
    Nigeria_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    Spanish
    Paraguay_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    Russian
    MNPI_Perm.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    English
    Peru_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    English
    Philippines_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    French
    Senegal_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; identify program strengths and weaknesses; plan strategies to address deficiencies; encourage political and popular support for appropriate action; and track progress over time.
    English
    Senegal_MNPI_2002.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    English
    South_Africa_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    English
    Tanzania_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    Russian
    MNPI_Tomsk.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    Russian
    MNPI_Tver.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    English
    Uganda_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; identify program strengths and weaknesses; plan strategies to address deficiencies; encourage political and popular support for appropriate action; and track progress over time.
    English
    Uganda_MNPI_2002.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; identify program strengths and weaknesses; plan strategies to address deficiencies; encourage political and popular support for appropriate action; and track progress over time.
    English
    Ukraine_MNPI_2002.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    Russian
    MNPI_Veronezh.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    English
    Vietnam_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    English
    Zambia_MNPI.pdf
  • Worldwide, over 500,000 women and girls die of complications related to pregnancy and childbirth each year. The tragedy - and opportunity - is that most of these deaths can be prevented with cost-effective health care services. POLICY's MNPI series provides country-specific data on maternal and neonatal health programs in more than 30 developing countries. Based on a study conducted by the Futures Group and funded through the MEASURE Evaluation Project, the MNPI is a tool that can be used to: Assess current health care services; Identify program strengths and weaknesses; Plan strategies to address deficiencies; Encourage political and popular support for appropriate action; and Track progress over time.
    English
    Zimbabwe_MNPI.pdf
  • This report focuses on the role of midwives in the prevention, detection, and treatment of HIV/AIDS and STIs and is based on a study in a rural community in Mexico. The document provides recommendations for improving the relationship between midwives and public health programs to better equip midwives to prevent, detect, and treat STIs and HIV/AIDS.
    English
    MEX_Midwives_STI.pdf
  • Brochure on maternal mortality and women's status in Haiti.
    French
    Mor.PDF
  • This document serves as a supplement to Networking for Policy Change: An Advocacy Training Manual, a resource for trainers of family planning and reproductive health advocacy issues worldwide. The training manual includes information on networking, communications, and policy environments; exercises on conceptualizing, implementing, monitoring, and evaluating advocacy campaigns; and relevant materials for advocates working in any area of reproductive health. Trainers can use the training techniques employed in the manual in various contexts, including when maternal health is the focus of advocacy. In creating this series of supplements and training modules, the POLICY Project recognizes that certain reproductive health topics require specific information that goes beyond the examples and materials included in the original manual. Maternal health is one of those issues. As with any area, there are special concerns that must be addressed when talking about advocacy for maternal health. The goal of maternal health is to ensure that every woman has access to a full range of high-quality, affordable sexual and reproductive health services especially maternal care and treatment of obstetric emergencies to reduce deaths and disabilities. Issues surrounding pregnancy, childbirth, and the postpartum period are integrally related to the status of women, and their ability to seek health care. Maternal health is a human right and must be underpinned by laws and policies that support effective action to increase women’s access to basic education, adequate nutrition, economic resources, as well as appropriate health services.
    English
    MH_FULL.pdf
  • The role of policy in improving program outcomes in the family planning/reproductive health (FP/RH), safe motherhood, and HIV/AIDS fields has been increasingly recognized. Despite this increased recognition, “policy” is often seen as a black box. Existing frameworks or models focus on some aspects of policy—the stages of policy development, decision makers and stakeholder institutions, the intent and content of a policy, or its implementation—yet none captures all policy components. This paper provides a practical framework to analyze components of family planning, reproductive health, maternal health, and HIV/AIDS policies. The Policy Circle framework is presented and the six “Ps” of policy are described: Problem, People/Places, Process, Price Tag, Paper, and Programs/Performance. Each component of the Policy Circle can be analyzed using a variety of tools. The Policy Circle is not intended to be linear or even circular, but places the problem or issue to be solved at the center. The six policy “Ps” of the Policy Circle operate under the broader contextual forces of politics, society, and economics. The Policy Circle has wide applicability. The proposed framework can be used to analyze different policy levels, including national and local policies and sectoral and operational policies. In the case of FP/RH, the Policy Circle can be viewed through different lenses specific to three overarching concerns: youth, gender, and human rights. Each of the six “Ps” points to important aspects of policy that need to be considered to ensure comprehensive policy analysis of the issue or area of concern to which the Policy Circle is applied. Visit the Policy Circle online - click here
    English
    wps-11.pdf
  • The research reported here concerns the Maternal and Neonatal Program Effort Index (MNPI), a standardized assessment instrument applied in both 1999 and 2002. Previous reports cover the detailed methodology and the results from the 1999 study, as well as the relation of the MNPI ratings to maternal mortality ratios (Ross, Campbell, and Bulatao, 2001; Bulatao and Ross, 2002; Bulatao and Ross, 2003a). The MNPI instrument is designed to measure the strength and character of government programs to improve maternal health. It contains items for the most proximate determinants of maternal survival, including those related to emergency obstetric and abortion cases, as well as the less proximate determinants of the policies and institutional arrangements necessary to build treatment capacities. Capturing these program features can document the low effort levels that now exist and create a baseline against which to trace future improvements. The overall purpose is to measure program inputs and strength of effort for the reduction of maternal mortality and morbidity and closely related neonatal items.
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    WPS15.pdf
  • User fees are gaining widespread use in government health programs as a means of alleviating pressure on constrained budgets as demand for services increases. Concerns that fees reduce access to services among the poor have led to the promotion of fee exemption mechanisms in order to protect those unable to pay for services. The exemptions, however, may not effectively ensure access among the poor because (1) informal fees and other costs associated with seeking and receiving services are not alleviated by most exemption mechanisms and (2) exemption mechanisms are poorly implemented. The low proportion of formal fees to total costs to the consumer and the unpredictable nature of informal fees and other costs of access may actually work against formal fee exemption mechanisms. Even though little is known about how well fee and waiver mechanisms function for maternal health services, it is important to understand whether exemption mechanisms alone hold promise for protecting access for the poor or whether the mechanisms need to be supplemented with other strategies. This study was conducted simultaneously in five countries: Egypt, India (Uttaranchal), Kenya, Peru, and Vietnam. The objectives were to survey actual costs to consumers for antenatal and delivery care; survey current fee and waiver mechanisms; assess the degree to which these mechanisms function; assess the degree to which informal costs to consumers constitute a barrier to service; and review current policies and practices regarding the setting of fees and the collection, retention, and use of revenue.
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    WPS16.pdf
  • Given the scarcity of resources available to implement the ICPD Programme of Action, this paper assesses effective interventions and their cost for three main components of reproductive health: family planning, safe motherhood, and STD/HIV/AIDS prevention and treatment. The paper also suggests some of the economic criteria governments can use to determine the role of the public sector in providing and/or financing reproductive health services. Family Planning Ensuring that individuals have access to a range of family planning methods and related information can help reduce unwanted pregnancy and thus maternal mortality. Promotion of condoms can help prevent the spread of sexually transmitted diseases (STDs). Family planning is most effectively provided through a range of channels, including clinics, community-based distribution, social marketing programs, and the private sector. Comparing the costs of service delivery approaches is problematic in that each channel tends to serve different clients. Contraceptive methods involve a range of costs; IUDs and sterilization tend to be the least expensive methods per couple-year of protection (CYP), although both have high "up-front" costs. The pill tends to be the least expensive supply method. Family planning, however, is most effective if a range of methods is available so that clients can select a method that matches their needs. One solution to the scarcity of resources may be for governments to subsidize all contraceptive methods for the poor and only lower cost methods for other groups and to require users to pay for the incremental cost of more expensive methods. Safe Motherhood An estimated 40 percent of pregnant women develop complications that require the assistance of a trained provider; 15 percent require medical care to avoid death or disability. Good prenatal care is important; given current screening tools, however, it is not prudent to spend resources on screening as the sole mechanism for predicting women's risk of developing complications. Instead, prenatal care should, among other activities, educate all women about danger signs, possible complications, and where to seek help. Micronutrient supplementation, including vitamin A, iron, folic acid, zinc, and calcium, show promising results in helping to improve pregnancy outcomes and reduce maternal mortality. The most crucial interventions for safe motherhood are to ensure that a health worker with midwifery skills is present at every birth, that transportation is available in case of emergency, and that quality and timely emergency care is available at the referral level. It is not only important that adequate access to emergency care be available but that women, families, and the community have confidence in the referral system and higher levels of care. Communities use emergency obstetric care services that they know to be functioning well. Nearly two-thirds of maternal deaths occur in the postpartum period; therefore, the World Health Organization (WHO) recommends that, if possible, community health workers visit women not attended at birth within 24 hours of delivery and again within three days. In many low-income countries, effective and safe postabortion care can significantly reduce maternal mortality rates by as much as one-fifth. Furthermore, such care can reduce overall health care costs as it is not uncommon for most beds in emergency gynecology wards to be occupied by women suffering from abortion complications, the treatment of which can cost five times the annual per capita health budget. The high cost of postabortion care can be reduced by switching from sharp curettage to manual vacuum aspiration (a safer and less expensive method), establishing referral systems and links with family planning and other reproductive health services, and preventing abortion through family planning. Substantial additional resources may not be required to improve emergency obstetric care. Most of the cost of providing such care is already paid through the maintenance of hospitals, health centers, and health care staff. Instead of creating new medical facilities and hiring new staff, emergency obstetric care can be improved by renovating existing facilities and training staff, including midwives and general practice physicians. STD/HIV/AIDS The best combination of STD/HIV/AIDS activities and services is general information and education, improved health-seeking behavior for STD treatment, wide access to condoms, and STD services with focused attention to core transmitters. WHO advocates the use of the syndromic management approach to managing STDs. This approach has limitations, however. It functions well for men with symptomatic urethral discharge and for women with genital ulcer disease, but not for women with vaginal discharge. The women who receive medical attention are often overtreated with drugs. More work is needed to develop cost-effective approaches to screening and treating reproductive tract infections. There are promising treatments to prevent mother-to-child transmission of HIV. Nevirapine has recently been shown to reduce transmission dramatically from mothers to infants at a fraction of the cost of treatment with Zidovudine (AZT) (US$4 compared with US$100), although universal HIV screening is not part of prenatal care in many developing countries and would raise the cost of prevention. Maternal syphilis diagnosis and treatment is also cost-effective. Blood screening for HIV/AIDS in high-prevalence areas has proven cost-effective. HAART (highly active antiretroviral therapy) for HIV/AIDS-infected individuals presently costs about US$8,000 to US$10,000 per person. Governments and donors will not be able to cover the cost of such treatment. In many developing countries, less than 1 percent of people living with AIDS will ever be treated, even if all reproductive health donor funds were allocated for that purpose. Information, Education, and Communication (IEC) and Behavior Change Communication (BCC) IEC and BCC have the potential to be highly effective in helping promote good reproductive health. Properly executed, IEC and BCC can encourage individuals to take preventive measures to protect their reproductive health as well as seek appropriate reproductive health services. IEC and BCC activities warrant government support if they convey appropriate messages to target audiences and are associated with services already in place. In the absence of these conditions, IEC and BCC activities are not only ineffective but also give rise to unsatisfied demand. Some Economic Criteria for Governments to Use in Deciding Whether They Will Provide and/or Fund Services From an economic standpoint, governments should intervene in reproductive health care if intervention increases efficiency and productivity in the health sector. Governments should redistribute resources to ensure equitable access to reproductive health services by all individuals. Governments should subsidize activities with large external or social benefits that go beyond the individual. Governments must regulate all sectors to ensure high-quality care and equitable access to reproductive health services. Government services are rarely more efficient than private sector services. Governments should encourage development of the private sector and provide subsidies to the poor so that they can afford needed services. To encourage development of the private sector, governments should provide similar subsidies to all providers (rather than only to government providers) either directly or through income transfers to individuals so that consumers can choose their own provider, thereby spurring competition and, it is hoped, better quality services for all. Governments should not provide subsidies to those able to pay for reproductive health services. Growing evidence suggests that some users, particularly in middle-income countries, can pay for family planning, maternal health, and postabortion care services. After reviewing implementation of the ICPD Programme of Action, the international community has reached consensus that certain basic services should be provided at the primary health care level and subsidized for those who cannot afford to pay for them. In low-income countries, where most individuals are too poor to pay for services, evidence suggests that it would be desirable for governments to subsidize family planning services, prenatal care that includes physical examinations, postpartum provision of family planning information and services, and postabortion services. In addition, skilled attendance at delivery and a functioning referral system and emergency care are essential to reduce maternal mortality. As for STD/HIV/AIDS, resources should be focused on prevention activities such as promotion and distribution of condoms to prevent STDs, STD treatment for high-risk groups, improved health-seeking behavior for STD treatment, and maternal syphilis treatment. Where HIV screening is part of prenatal care, provision of Nevirapine or AZT for infants of HIV-positive mothers may be feasible. While governments should strive to ensure that their citizens have access to reproductive health services as agreed at the ICPD and ICPD+5, policymakers will have to begin with a narrower set of interventions consistent with current resource and capacity levels and decide how to phase in additional services as resources become available. It is clear that a substantial amount of work on costing interventions and services and measuring their effectiveness is necessary before we can say, with greater assurance, what combination of services works at the most reasonable cost. Data collected in one country or service delivery setting may not apply in others, and further research is needed. Still, while the data are not comprehensive or perfect, policymakers and others can use the information at hand to help make difficult decisions, especially on what to provide to low-income clients through public sector facilities or financing.
    English
    op-05.pdf
  • The POLICY Project (POLICY) provided a focused technical assistance package between September 2002 and June 2004 in Peru to help identify and eliminate operational barriers that stand in the way of access to safe delivery care for low-income women, particularly in areas with high maternal mortality. Our research and analysis identified barriers to delivery care. Key stakeholders at both the regional and national levels assessed the most significant barriers as follows: the severe lack of financial resources and absence of appropriate personnel at health establishments; multifaceted problems with the implementation of the Integrated Health Insurance (SIS) resulting in poor quality services that clients must pay for; and lack of respect for local cultural practices and customs at health facilities that serve as a disincentive for women seeking institutional care for their deliveries.
    English
    Peru_CP_final.pdf
  • In the context of the HIV/AIDS pandemic, is there still a need for family planning? As government and donor resources in Africa shift increasingly to support AIDS programs, the answer to this question is crucial. The objective of this study was to document the status and trends in Zambia’s family planning (FP) program in the context of high prevalence of HIV/AIDS. A similar study was conducted in Kenya. This qualitative research study used focus group discussions (FGDs) to examine the views of 215 service providers, HIV-positive (HIV+) women, and FP/antenatal care (ANC) clients on the need for family planning within the context of the HIV epidemic. The study was conducted in Lusaka, Livingstone, Kitwe, and Kabwe in 2003.
    English
    Zam_FGD.pdf
  • USAID prepared pathways to achieve the strategic objective of reduced fertility and improved reproductive health in North India. Intermediate results to achieve the strategic objective have been prepared in December 1997 for the IFPS Project in Uttar Pradesh that covers 28 districts. Subsequently in January 1999, the SO2 Indicator survey was undertaken in five districts with a sample size of 5000 households to measure the progress made by the IFPS project during the calendar year 1998. In the following year, the study was undertaken in ten districts with a sample size of 10,000 households. Since the IFPS project was working in full gear in 15 priority districts and had started scaling-up its intervention in the 13 other PERFORM districts, it was desired to have separate estimates for priority and other PERFORM districts. Hence, the SO2 Indicator survey for year 1999 was undertaken with a sample size of 10,000 households covering 10 out of the 28 districts. The sample size was proportionally split between the priority and other PERFORM districts. As slightly over three-fifths of the population was in the priority districts, 6130 households from six districts were covered and the remaining 3870 households were from four other PERFORM districts. The selected priority districts were Etawah, Gorakhpur, Varanasi, Allahabad, Kanpur nagar and Meerut while the other PERFORM districts included Gonda, Azamgarh, Bareilly and Saharanpur.
    English
    India_SO2Report-2000.pdf
  • The Safe Motherhood Model (SMM) is a tool that can be used to improve the understanding of how changes in maternal health services can avoid maternal deaths. Some of the questions the model can ask are: • Where should effort be focused to yield the greatest reduction in maternal mortality? • How much would it cost to reach a certain level of maternal mortality? • How much of a reduction in maternal mortality is feasible in the next few years? • What can be learned from the performance of a similar country? The SMM estimates the impact of various scores from the Maternal and Neonatal Program Effort Index (MNPI) on the maternal mortality ratio (MMR). The MNPI is an index consisting of 81 different maternal and neonatal health services that have been evaluated by reproductive health experts around the world. The SMM uses the current scores for an individual country to represent the current situation of the delivery of these health services in a country.
    English
    SafeMoME.pdf
  • Los módulos contenidos aquí proporciona una lista de intervenciones en salud reproductiva e investigación de soporteque documentan la eficacia de las mismas. Esta guía será de utilidad para quienes desarrollen lineamientos para las mejores prácticas. Aquí se presenta una síntesis de las investigaciones publicadas en trabajos de revisión de pares con datos claros y transparentes sobre la efectividad de distintas intervenciones en salud reproductiva, iniciativas políticas y de programas que pueden ser implementados con el fin de mejorar la planificación familiar/salud reproductiva y reducir las ITS/VIH/SIDA en países en desarrollo, en vez de dosificar niveles de medicamentos específicos. La información biomédica ha sido incluida toda vez que ésta haya sido relevante para las consideraciones programáticas.
    Spanish
    WhatWorksSpan.pdf
  • This report presents information regarding practicing midwives’ skill sets, scopes and protocols of practice, and referral systems to identify gaps in access and service delivery, legal and operational barriers to practice, and geographical disparities in coverage. These data provide important direction for policymakers to increase the ability of Ghanaian women to access comprehensive services and strengthen midwives’ ability to provide those services. Midwives are important providers of reproductive healthcare in Ghana. There are more than 3,379 midwives in Ghana compared with fewer than 2,000 physicians. While midwives practice throughout the country, physicians tend to be clustered in large cities. As a result, midwives provide the majority of antenatal, delivery, and newborn and postpartum care, including emergency obstetric care, especially in rural areas. Further, midwives provide family planning services, postabortion care, treatment of sexually transmitted infections (STIs), nutrition and breastfeeding counseling, and child health services. The purpose of the Midwife Mapping Project was to assess the accessibility to comprehensive reproductive healthcare, including routine and emergency obstetric care, as provided by midwives, as well as to learn about midwives’ experiences in service provision throughout Ghana. The study included three complementary research methodologies: • Policy environment analysis • Survey of practicing midwives and geospatial mapping • Focus group discussions (FGDs) with practicing and non-practicing midwives
    English
    Ghana Midwife Mapping final.pdf
  • English
    JamPESRpt_rev_.PDF
  • Worldwide, about 500,000 women and girls die of complications related to pregnancy and childbirth each year; and over 99 percent of these deaths occur in developing countries. The tragedy – and opportunity – is that most maternal deaths could be prevented with cost-effective health care services. Facing a range of competing priorities and limited resources, policymakers and program planners are in need of concise information on programs that are both effective and feasible. The POLICY Project is pleased to have the opportunity to make a significant contribution to the maternal health field with the launch of a new resource that documents safe motherhood interventions that work. This publication – the first in a series entitled “What Works: A Policy and Program Guide to the Evidence on Family Planning, Safe Motherhood, and STI/HIV/AIDS Interventions” – presents a comprehensive review of the interventions (with supporting evidence) that have been shown to enhance maternal health in developing countries. Importantly, this document helps public health officials and decision makers answer the question “What should we do?” when trying to figure out how to improve maternal health. It is also a tool to help maternal health advocates demonstrate that safe motherhood programs save lives, benefit societies and communities, and are effective and feasible, even in resource-constrained settings. The Safe Motherhood Module brings together the best available evidence on a range of interventions and packages it in one convenient source, covering topics such as Labor and Delivery, Postnatal Care, Care During Pregnancy, Pre-pregnancy Care, and Policy and Program Issues. It also provides guidance on programs that have not been shown to work, programs that should be avoided, and programs for which more evidence is needed. Additional sections provide a summary of safe motherhood interventions and present resources for program designers. The Safe Motherhood Module has been reviewed by some of the world’s leading maternal health experts, including those from the United Nations Population Fund (UNFPA), World Health Organization (WHO), International Center for Research on Women (ICRW), JHPIEGO, Pan American Health Organization (PAHO), U.S. Agency for International Development (USAID), and others. Forthcoming modules in the series will focus on addressing STIs/HIV/AIDS and reducing unintended pregnancies.
    English
    SM_WhatWorksps2.pdf