title: Eliminating preventable HIV-related maternal mortality in sub-Saharan Africa: what do we need to know?
abstract: BACKGROUND
  HIV makes a significant contribution to maternal mortality, and women living in sub-Saharan Africa are most affected. International commitments to eliminate preventable maternal mortality and reduce HIV-related deaths among pregnant and postpartum women by 50% will not be achieved without a better understanding of the links between HIV and poor maternal health outcomes and improved health services for the care of women living with HIV (WLWH) during pregnancy, childbirth, and postpartum.
  
  
  METHODS
  This article summarizes priorities for research and evaluation identified through consultation with 30 international researchers and policymakers with experience in maternal health and HIV in sub-Saharan Africa and a review of the published literature.
  
  
  RESULTS
  Priorities for improving the evidence about effective interventions to reduce maternal mortality and improve maternal health among WLWH include better quality data about causes of maternal death among WLWH, enhanced and harmonized program monitoring, and research and evaluation that contributes to improving: (1) clinical management of pregnant and postpartum WLWH, including assessment of the impact of expanded antiretroviral therapy on maternal mortality and morbidity, (2) integrated service delivery models, and (3) interventions to create an enabling social environment for women to begin and remain in care.
  
  
  CONCLUSIONS
  As the global community evaluates progress and prepares for new maternal mortality and HIV targets, addressing the needs of WLWH must be a priority now and after 2015. Research and evaluation on maternal health and HIV can increase collaboration on these 2 global priorities, strengthen political constituencies and communities of practice, and accelerate progress toward achievement of goals in both areas.
authors.affiliation: *Maternal Health Task Force, Women and Health Initiative, Department of Global Health and Population, Harvard School of Public Health, Boston, MA; †Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA; ‡School of Public Health and Family Medicine, Women's Health Research Unit, University of Cape Town, Cape Town, South Africa; §Independent Consultant, Harare, Zimbabwe; ‖Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada; ¶Office of HIV/AIDS, United States Agency for International Development, Washington, DC; #Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA; **Office of Health, Infectious Disease and Nutrition, United States Agency for International Development, Washington, DC; ††Department of Obstetrics and Gynecology, Nelson R. Mandela School of Medicine, University of KwaZulu Natal, Durban, South Africa; ‡‡Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL; and §§Office of the U.S. Global AIDS Coordinator, U.S. Department of State, Washington, DC.
authors.forename: Tamil
authors.initials: T
authors.lastname: Kendall
authors.forename: Isabella
authors.initials: I
authors.lastname: Danel
authors.forename: Diane
authors.initials: D
authors.lastname: Cooper
authors.forename: Sophie
authors.initials: S
authors.lastname: Dilmitis
authors.forename: Angela
authors.initials: A
authors.lastname: Kaida
authors.forename: Athena P
authors.initials: AP
authors.lastname: Kourtis
authors.forename: Ana
authors.initials: A
authors.lastname: Langer
authors.forename: Ilana
authors.initials: I
authors.lastname: Lapidos-Salaiz
authors.forename: Eva
authors.initials: E
authors.lastname: Lathrop
authors.forename: Allisyn C
authors.initials: AC
authors.lastname: Moran
authors.forename: Hannah
authors.initials: H
authors.lastname: Sebitloane
authors.forename: Janet M
authors.initials: JM
authors.lastname: Turan
authors.forename: D Heather
authors.initials: DH
authors.lastname: Watts
authors.forename: Mary Nell
authors.initials: MN
authors.lastname: Wegner
mesh_terms: D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D003906:Developing Countries; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000401:mortality*; D006291:Health Policy / Q000639:trends*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008427:Maternal Health Services / Q000458:organization & administration*; D008428:Maternal Mortality; D008875:Middle Aged; D049590:Postpartum Period; D011247:Pregnancy; D014481:United States; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents