Investing in Maternal Health : Learning from Malaysia and Sri Lanka

Pathmanathan, Indra; Liljestrand, Jerker; Martins, Jo. M.; Rajapaksa, Lalini C.; Lissner, Craig; de Silva, Amala; Selvaraju, Swarna; Singh, Prabha Joginder

Investing in Maternal Health : Learning from Malaysia and Sri Lanka

Autores

Singh, Prabha Joginder

Editor

Washington, DC: World Bank

Descripción

This study provides the most comprehensive and detailed analysis available on factors behind the decline in maternal mortality in Malaysia and Sri Lanka in the past 50 to 60 years and the magnitude of health system expenditures on maternal health. The main findings are that a modest investment in maternal health services, combined with other poverty reduction measures leads to a fairly rapid decline in the maternal mortality ratio (MMR), defined as the number of maternal deaths per 100,000 live births. The strategies of Malaysia and Sri Lanka changed over time, from an initial emphasis on expanding the provision of services, especially in underserved areas, to increasing utilization and, finally, to emphasizing the improvement of quality. Removing financial barriers to maternal care for clients was an important step in both countries. Professional midwives constitute the backbone of maternal care in Malaysia and Sri Lanka. The MMR reduction in developing countries is feasible with modest public expenditures when appropriate policies are adopted, focused wisely, and adapted incrementally in response to environmental conditions and systems capacity.

Palabras clave

MATERNAL MORTALITY, MATERNAL HEALTH SERVICES, POVERTY REDUCTION, MIDWIVES, PUBLIC EXPENDITURES, SYSTEMS ANALYSIS, DEVELOPING COUNTRIES, HEALTH PROGRAMS, INCOME LEVELS, POOR WOMEN IN DEVELOPING COUNTRIES, CHILDBIRTH, CHILD HEALTH SERVICES MATERNAL MORTALITY, MATERNAL HEALTH SERVICES, POVERTY REDUCTION, MIDWIVES, PUBLIC EXPENDITURES, SYSTEMS ANALYSIS, DEVELOPING COUNTRIES, HEALTH PROGRAMS, INCOME LEVELS, POOR WOMEN IN DEVELOPING COUNTRIES, CHILDBIRTH, CHILD HEALTH SERVICESACCESS TO HEALTH CARE, ACCESS TO TREATMENT, ANTENATAL CARE, BASIC HEALTH CARE, BIRTHS, CHILD HEALTH, CHILD HEALTH SERVICES, CHILDBIRTH, CLINICS, COMMUNITY MOBILIZATION, COMPLICATIONS OF PREGNANCY, CONTRACEPTIVE PREVALENCE, CONTRACEPTIVE PREVALENCE RATE, CULTURAL BARRIERS, DOCTORS, DRUGS, ECONOMIC DEVELOPMENT, ETHNIC GROUPS, EXPENDITURES, FAMILIES, FAMILY HEALTH, FAMILY INCOME, FAMILY PLANNING, FAMILY PLANNING SERVICES, FERTILITY, FERTILITY DECLINE, FERTILITY RATES, HEALTH, HEALTH EXPENDITURE, HEALTH EXPENDITURES, HEALTH FACILITIES, HEALTH MESSAGES, HEALTH POLICIES, HEALTH PROFESSIONALS, HEALTH SERVICES, HEALTH SYSTEM, HEALTH SYSTEMS, HEMORRHAGE, HOSPITAL CARE, HOSPITAL SERVICES, HOSPITALS, HYPERTENSIVE DISEASE, ILLITERACY, INFECTION, INSTITUTIONALIZATION, LIFE EXPECTANCY, LIVE BIRTHS, MALNUTRITION, MANAGERS, MATERNAL AND CHILD HEALTH, MATERNAL COMPLICATIONS, MATERNAL DEATH, MATERNAL DEATHS, MATERNAL HEALTH, MATERNAL HEALTH CARE, MATERNAL HEALTH SERVICES, MATERNAL MORTALITY, MATERNAL MORTALITY RATES, MATERNAL MORTALITY RATIO, MATERNITY CARE, MCH, MIDWIFERY, MIDWIFERY PRACTICE, MORTALITY RATES, NEONATAL MORTALITY, NURSE-MIDWIVES, NURSING, NURSING HOMES, NUTRITION, OBSTETRIC CARE, OBSTETRIC EMERGENCIES, OLDER WOMEN, PEER REVIEW, PREGNANCIES, PREGNANCY COMPLICATIONS, PRIVATE SECTOR, PUBLIC HEALTH, PUBLIC HOSPITALS, PUBLIC SECTOR, QUALITY CONTROL, REPRODUCTIVE AGE, RURAL HOSPITALS, SAFE MOTHERHOOD, SANITATION, SEPSIS, SOCIAL SERVICES, TEEN PREGNANCIES, TOTAL FERTILITY RATE, TRADITIONAL BIRTH ATTENDANTS, TRAINED MIDWIVES, UNSAFE ABORTION, WORKERS