Improving maternity care in Africa

Improving health facilities and access to drugs could mean 60,000 fewer maternal deaths in Africa per year from post-partum bleeding and sepsis, according to a UCL study. The findings of the study by Christina Pagel (UCL Clinical Operational Research Unit), Professor Anthony Costello (UCL Institute of Child Health) and colleagues appear in The Lancet. Maternal mortality ratios have changed little since 1990 and progress towards Millennium Development Goal 5 ? to improve maternal health - is far off track in sub-Saharan Africa: the maternal mortality rate has fallen by only 16 deaths per 100,000 since 1990 (921 per 100,000 livebirths in 1990 to 905 per 100,000 in 2005). Pagel, Professor Costello and colleagues developed a mathematical model to assess the extent to which a combination of improving health facilities and community-based access to life-saving drugs could reduce maternal mortality due to post-partum haemorrhage or sepsis. Three possible 'packages' of improvements were studied: Package 1 ' ensuring that health facilities are supplied with oxytocin - a hormone that plays an important role in giving birth ' to prevent post-partum haemorrhage and antibiotics to treat sepsis. Package 2 - package 1 combined with improved drug provision via antenatal-care appointments and community health workers. Drug provision entailed distribution of misoprostol (and instructions on how to take it) to women attending outreach antenatal-care appointments, provided that the drug was in stock.