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Maternal Health
To reduce maternal deaths and ill-health, UNFPA supports
a range of activities in developing countries,(74)
taking into consideration poverty reduction, governance,
economic and social development and health
system reform.
NEEDS ASSESSMENTS. Working with the Averting
Maternal Death and Disability (AMDD) programme
managed by Columbia University’s Mailman School
of Public Health and supported by the Bill & Melinda
Gates Foundation, UNFPA has conducted needs assessments
in Cameroon, Côte d’Ivoire, India, Mauritania,
Morocco, Mozambique, Nicaragua, the Niger and
Senegal, among others.
In Nicaragua, the assessment of 125 facilities led
to a range of improvements in three health regions:
physical upgrades, publication of standards and protocols
for care, staff training and efforts to improve
service quality. Between 2000 and 2003, the proportion
of women with complications receiving
emergency care in these regions rose by one third.(75)
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REBUILDING EMERGENCY OBSTETRIC CARE IN MOZAMBIQUE |
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Following civil war and natural disaster, the health care system in Mozambique’s Sofala Province was in shambles, with little
capacity to provide emergency care to pregnant women. The UNFPA/AMDD initiative supported training of medical staff and provided the provincial hospital and peripheral health
facilities with medications, supplies and equipment. As a result, the number of women with complications who received appropriate care nearly doubled. Thanks to collaborative funding
from other donors, the project will be extended to nine other provinces and will soon cover the entire country.
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TRAINING. Training of doctors, nurses, midwives and
anaesthetists in emergency obstetric care and postabortion
care is ongoing in all regions, along with
training of service providers in record keeping and
data collection. Health personnel have been trained
to evaluate maternal deaths and complications. The
Fund has also developed technical materials, a distance
learning course and an Emergency Obstetric
Care Checklist for planners.
INFRASTRUCTURE DEVELOPMENT. UNFPA has upgraded
facilities and built new ones, provided equipment
and supplies, and procured ambulances and radio
communications.
In Rajasthan, India, with support from the
UNFPA/AMDD initiative, 83 emergency obstetric care
facilities were upgraded, covering a population of
approximately 13 million people. Fifty-nine teams of
health professionals were trained to provide emergency
obstetric care; 12 were trained in infection
prevention. Management information systems were
introduced to improve monitoring and evaluation
of services. In 2003, local television stations and
newspapers started airing programmes related to safe
motherhood. As a result of these efforts, the number of
women treated for obstetric complications has
increased 50 per cent in four years, and India has
introduced similar interventions in other states.(76)
POLICY AND ADVOCACY. UNFPA, along with UNICEF
and WHO, organized Vision 2010 to spotlight maternal
and neonatal mortality in Central and West Africa,
and initiated the Forum for Maternal Mortality reduction
in Latin America with the Pan-American Health
Organization. The Fund has worked with health ministries
to develop emergency obstetric care guidelines
and protocols, national safe motherhood policies and
routine monitoring of referral systems.
COMMUNITY MOBILIZATION. The Fund trains volunteers
and health promoters to educate communities
about safe motherhood services and family planning
and encourages community-sponsored transportation
schemes.
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