6 Improve maternal health

Where we are?

While high level of access to perinatal health has been maintained over the last few years, inequalities are still apparent between rural and urban, insured and uninsured population, and marginalised groups (Roma women, persons with disabilities, migrants). Photo: UNDP/Julie Pudlowski

The high level of access to perinatal health has been maintained over the last few years. The same thing characterises access to medical services and this has contributed to maintaining a high rate of medically assisted deliveries. At the same time, inequalities are still apparent in terms of access to and quality of services –between rural and urban populations, insured and uninsured in the population, general population and marginalised groups (Roma women, persons with disabilities, migrants).

The maternal mortality rate has registered a sinuous development with a slight worsening trend, reflecting a number of structural factors in the health and social-economic sector. The low number of mortality cases is caused by significant and unpredictable variations, whenever reported per 100000 live births. Effective tools were implemented over the last years to identify the underlying causes and to develop cost-efficient measures to address the situation. In this context, concerns are raised related to focus on indirect factors (unrelated to pregnancy) of maternal mortality, inducing drawbacks in the antenatal surveillance and gaps in the quality of the provided health services. Although a regionalised and perinatal services’ referral system has been implemented, the professionalism and efficiency of many interventions, especially in emergencies, could benefit from considerable improvements.

The implementation of modern teaching methods based on simulation of emergency situations in the multidisciplinary teams of specialists in the maternity hospital is crucial. The level of knowledge among women and training about the needs and importance of early medical surveillance in case of pregnancy represents a very important factor, which can reduce the incidence of complications and deaths. The improvement of access for vulnerable groups and the increasing quality of family planning services provided to these groups are also essential in achieving the targets set in the MDG 5.

Targets for MDG 5
  1. Reduce by three quarters the maternal mortality ratio
    • Most maternal deaths could be avoided
    • Giving birth is especially risky in Southern Asia and sub-Saharan Africa, where most women deliver without skilled care
    • The rural-urban gap in skilled care during childbirth has narrowed
  2. Achieve universal access to reproductive health & inadequate funding for family planning is a major failure in fulfilling commitments to improving women’s reproductive health
    • More women are receiving antenatal care
    • Inequalities in care during pregnancy are striking
    • Only one in three rural women in developing regions receive the recommended care during pregnancy
    • Progress has stalled in reducing the number of teenage pregnancies, putting more young mothers at risk
    • Poverty and lack of education perpetuate high adolescent birth rates
    • Progress in expanding the use of contraceptives by women has slowed & use of contraception is lowest among the poorest women and those with no education