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maternal mortalityIs pregnancy getting safer for women? The answer is yes and no. There have been important gains in reducing maternal deaths in some countries but only modest progress – and sometimes no improvement at all – in others. Maternal deaths are the result of a perennial lack of commitment and finance to make pregnancy and delivery safe, to make abortion safe, and to ensure that timely emergency obstetric care and post-abortion care are available when complications occur. The papers on maternal mortality in this collection celebrate effective obstetric interventions and discuss the persistence of ineffective, harmful and unnecessary ones. They reveal shortages of drugs and equipment as well as the failure to fully educate and employ midwives and obstetric nurses – let alone obstetrician/gynaecologists – to care for pregnant women. Changing what happens in health systems is a social as well as a technical intervention, in which context is crucial. Monitoring and evaluation must foster and ensure learning by those who are expected to carry out and manage change – in order for change to take place. |
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