Rating maternal and neonatal health services in developing countries.
OBJECTIVE
To assess maternal and neonatal health services in 49 developing countries.


METHODS
The services were rated on a scale of 0 to 100 by 10 - 25 experts in each country. The ratings covered emergency and routine services, including family planning, at health centres and district hospitals, access to these services for both rural and urban women, the likelihood that women would receive particular forms of antenatal and delivery care, and supporting elements of programmes such as policy, resources, monitoring, health promotion and training.


RESULTS
The average rating was only 56, but countries varied widely, especially in access to services in rural areas. Comparatively good ratings were reported for immunization services, aspects of antenatal care and counselling on breast feeding. Ratings were particularly weak for emergency obstetric care in rural areas, safe abortion and HIV counselling.


CONCLUSIONS
Maternal health programme effort in developing countries is seriously deficient, particularly in rural areas. Rural women are disadvantaged in many respects, but especially regarding the treatment of emergency obstetric conditions. Both rural and urban women receive inadequate HIV counselling and testing and have quite limited access to safe abortion. Improving services requires moving beyond policy reform to strengthening implementation of services and to better staff training and health promotion. Increased financing is only part of the solution.
Bulatao
Rodolfo A
RA
Independent Consultant, Silver Spring, Maryland 20910, USA. Bulatoa@erols.com
Ross
John A
JA
D019985:Benchmarking; D002662:Child Health Services / Q000592:standards* / Q000706:statistics & numerical data; D003906:Developing Countries; D005193:Family Planning Services; D005260:Female; D006291:Health Policy; D006297:Health Services Accessibility; D006801:Humans; D007231:Infant, Newborn; D008427:Maternal Health Services / Q000592:standards* / Q000706:statistics & numerical data; D011247:Pregnancy; D019984:Quality Indicators, Health Care; D019035:Rural Health Services / Q000706:statistics & numerical data; D019037:Urban Health Services / Q000706:statistics & numerical data