Safe mother wood in reproductive health

2.  WHO in 1987 conceived the idea of safe motherhood initiative,at
a conference in Nairobi, at Kenya.
 It is global effort to reduce the maternal death by at least half by
year 2000, then it is extended to 2015.
 Objective of safe motherhood –
 To enhance the quality & safety of girls and woman’s lives
through adoption of acombination of health and non health
stratigies.

3.  Safe motherhood operate through-
a) Government agencies
b)Non government agencies
c)Other groups and individual.

4.  The White Ribbon Alliance for safe
motherhood of India ,an alliance
committed towards increasing public
awareness on preventing maternal death.

5.  Nearly 600,000 between the age 15 to 49 die every year due to
complications arising from pregnancy.
 99% of which occur in developing countries.
 In developed countries maternal mortality ratio is arround 8-17 ,
per 10,0000 live birth but in the developing countries ratio lies
between 240-730 .

6.  According to national & international treaties safe motherhood is
considerd a human right issues.
 So maternal death is the social disadvantage not merely a health
disadvantage.

7.  In an attempt to improve maternal mortality situation in
India, all the states of India have been categorised into
groups-
A. Empowered action group-
Bihar,Orissa,Jharkhand,MP,Chhattisgarh, UP, Rajasthan,
Uttarakhand & Assam.
B. Southern states -
Karnataka,AP,Kerla,Tamil Nadu.
C. Other states - the remaining states & union territories.

9.  Ensuring safe motherhood -
1. Education on safe motherhood
2. Prenatal care
3. Promotion of maternal nutrition
4. Assisted delivery in all cases
5. Provisions for obstetrics emergencies inclueding referral
servicesfor pregnancy,child birth.
6. Postnal care.

10.  Maternal death - death of a woman while
pregnant or within 42 days of the termination of
pregnancy irrespective of the duration and site of
pregnancy ,from any cause related to or aggravated by
the pregnancy or its management but not from
accidental or incidental causes.

13.  Maternal mortality ratio –
 The MMR is expressed in terms of such maternal
deaths per 100,000 live births.
 In most of the developed countries, the MMR
varies from 4-40 per 100,000 live births.
 In developing countries,it varies from 100-700
with India having about 254 per 100,000 live
births.

14.  Maternal mortality rate-
 It indicates the no. Of maternal deaths divided by the no. Of
women of reproductive age(15-49).
 It is expressed per 100,000 women of reproductive age per year.
 In India, it is about 120 as compared to 0.5 of united states.

15.  Currently maternal mortality rate in India has decline from
212 ( 2007 -2009)
178 (2010 – 2012)

16.  Millennium development goals(MDG) 4 and 5 for
maternal, newborn and child health care(MNCH)-
 Reduction of MMR by 75% b/w 1990-2015.
 Expected annual decline in MMR from 1990 is 5.5%
 Reduction of infant mortality below 30 per 1000 live birth by the year
2015.
 90% of alll births should be assisted by skilled attendants by 2015.
 Access for all who need reproductive health services by 2015.
 Other goals: gender equity,reduction of poverty, education of girls and
women.

17.  Magnitude of the problem-
 worldwide, every year approximately eight million women
suffer from pregnancy related complications.
 Over half a million of them, die as a result.
 The problems of maternal mortality and morbidity are
greatest(99%)for the poor women in the developing countries.

18.  One woman in 11 may die of pregnancy related complications in
developing countries, compared to one in 5000 in developed
countries.
 It is further estimated that for one maternal death at least 16
more suffer from severe morbidities.

19.  CLASSIFICATION-
 Direct
 Indirect
 Non-obstetric

20.  Direct obstetric deaths(75%)-resulting from
complications of pregnancy ,delivery or their
management.
 Such conditions are abortion ,ectopic pregnancy,
preeclampsia- eclampsia, antepartum and postpartum
haemorrhage and puerperal sepsis.

21.  Indirect deaths(25%)-
 Includes conditions present before or developed during
pregnancy but aggravated by the physiological effects of
pregnancy and strain of labor.
 These are anemia, cardiac disease, diabetes, thyroid
disease etc.
 In all of them, anemia is the most important single cause
in the developing countries.

22.  Viral hepatitis when endemic, contributes significantly to
maternal deaths.
 Non-obstetric or fortuitous deaths-
 Accidents, typhoid and other infectious diseases.

23. THANK YOU