Current strategies for the reduction of maternal mortality.
The purpose of this article is to review current strategies for the reduction of maternal mortality and the evidence pertinent to these strategies. Historical, contextual and current literature were examined to identify the evidence base upon which recommendations on current strategies to reduce maternal mortality are made. Current safe motherhood strategies are designed based mostly on low grade evidence which is historical and observational, as well as on experience and a process of deductive reasoning. Safe motherhood strategies are complex public health approaches which are different from single clinical interventions. The approach to evidence used for clinical decision making needs to be reconsidered to fit with the practicalities of research on the effectiveness of strategies at the population level. It is unlikely that any single strategy will be optimal for different situations. Strengthening of the knowledge base on the effectiveness of public health strategies to reduce maternal mortality is urgently required but will need concerted action and international commitment.
Bullough
Colin
C
Dugald Baird Centre for Research on Women's Health, Aberdeen Maternity Hospital, University of Aberdeen, UK.
Meda
Nicolas
N
Makowiecka
Krystyna
K
Ronsmans
Carine
C
Achadi
Endang L
EL
Hussein
Julia
J
D000028:Abortion, Induced / Q000401:mortality; D003906:Developing Countries; D019587:Dietary Supplements; D004638:Emergency Treatment; D019317:Evidence-Based Medicine; D005193:Family Planning Services; D005260:Female; D006801:Humans; D008427:Maternal Health Services / Q000592:standards / Q000600:supply & distribution; D008428:Maternal Mortality; D039382:Maternal Nutritional Physiological Phenomena; D008880:Midwifery / Q000193:education; D011204:Poverty Areas; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality / Q000517:prevention & control*; D011295:Prenatal Care / Q000379:methods; D011787:Quality of Health Care