Where is the "E" in MCH? The need for an evidence-based approach in safe motherhood.
Measuring the impact of obstetric interventions on maternal mortality and/or morbidity is especially difficult in developing countries, where most maternal deaths occur. Therefore, program planning has been based on theory rather than proved effectiveness. After reviewing both the strategies that have been promoted to reduce maternal mortality and the adequacy of existing evidence used to justify their selection, the investigators highlight reasons why rigorous criteria for the selection and evaluation of interventions should be adopted. Adequate evaluation of intervention effectiveness under real-life conditions in developing countries is an efficient way to identify interventions for large-scale program replication and could speed progress in reducing maternal deaths.
Miller
Suellen
S
Sloan
Nancy L
NL
Winikoff
Beverly
B
Langer
Ana
A
Fikree
Fariyal F
FF
D003906:Developing Countries; D019317:Evidence-Based Medicine; D005260:Female; D014943:Global Health; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D008427:Maternal Health Services / Q000458:organization & administration*; D008428:Maternal Mortality; D008429:Maternal Welfare; D011203:Poverty; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D014944:World Health Organization