Another informative article from Dr. Donald Marsden of FRANZCOG– this one about maternal deaths in hospitals in Laos, largely due to hemmorage. http://www.ranzcog.edu.au/publications/oandg-magazine/doc_view/436-vol-11-no-3-spring-2009-complete-issue.html
I found this part of particular interest, as I research how Clean Birth Kits (CBKs) might aid in the effort to lower maternal and infant mortality after birth. It seems that a Australian nurse, Carol Perks of Save the Children, has produced dramatic falls in maternal mortality.
A report published in 2005 shows that the comprehensive district managed primary healthcare program introduced 12 years earlier resulted in a life expectancy increase of 12 years, a 48 per cent decrease in crude mortality rate, a 30 per cent decrease in crude birth rate, a 70 per cent decrease in infant mortality and a maternal mortality ratio of 110/100,000. The cost of the project was uS$4 million over 12 years, roughly uS$1 per person in the province per year. The reduced maternal mortality in the province was related to increasing use of contraception to space births. Modern contraceptive use rose from 12 per cent of women in 1997 to 67 per cent in 2003. The proportion of pregnant women attending three or more antenatal visits in Sayaboury province rose from 24 per cent to 58 per cent over the same period. Obviously, even very cheap interventions can have major benefits on health indicators in these poor societies.
Citation for the report:
Perks C, Toole MJ, Phoutonsy K. District health programmes and
health sector reform: case study in the Lao Peoples Democratic
Republic. Bulletin of the World Health Organisation, 2006. 84: 132-
138.
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