| Description |
1 online resource |
| Contents |
Front Cover; Contents; Foreword; Acknowledgments; About the Authors; Executive Summary; Abbreviations; Chapter 1 Introduction; The Analytical Framework: Drivers and Enablers for Improving Maternal and Reproductive Health Outcomes; Research Methodology; Organization of the Report; Notes; Chapter 2 Regional Trends in Maternal and Reproductive Health; Key Messages; Regional Context; Maternal Mortality; Maternal Health; Reproductive Health; Note; Chapter 3 Household Drivers; Key Messages; Introduction; Household Gender Dynamics; Access to Information and Increased Use of Services |
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Women's Education and Household IncomeChapter 4 Program Drivers; Key Messages; Introduction; Skilled Birth Attendance; Institutional Delivery; Emergency Obstetric Care; Safe Abortion Services and Post-Abortion Care; Family Planning; Antenatal Care and Female Community Health Workers; Chapter 5 Health Sector Drivers; Key Messages; Introduction; Health Care Financing; Health Service Delivery; Human Resources for Health; Essential Drugs and Health Commodities; Health Information Systems; Leadership and Governance; Note; Chapter 6 Community Enablers; Key Messages; Introduction |
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Deploying Community-Based Female Health WorkersCommunity-Based Interventions; Engaging Community Leaders; Reaching Economically and Socially Marginalized Women; Chapter 7 Multisectoral Enablers; Key Messages; Introduction; Education; Transport and Communications; Water and Sanitation; Nutrition; Energy; Conditional Cash Transfers; Microcredit; Chapter 8 Contextual Enablers; Key Messages; Introduction; Political Enablers; Economic Enablers; Demographic Enablers; Sociocultural Enablers; Chapter 9 No Single Intervention Is Sufficient; What Worked; Where More Evidence Is Needed |
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What Made SAR Stand Out?The Way Forward; Notes; Appendix A The Different Conceptual Frameworks for Maternal Health Outcomes; Appendix B Structured Literature Review on Maternal Mortality; Appendix C Literature Review of Systematic Reviews on Maternal and Reproductive Health; Bibliography; Boxes; Box 3.1 Role of Men in Punjab, Pakistan; Box 5.1 Health Financing Schemes for Maternal Health; Box 7.1 Emergency Response System in Andhra Pradesh, India; Figures; Figure 1.1 Concentric Spheres of Constraints that Cause Maternal Mortality; Figure 1.2 Drivers and Enablers for Improving MRH Outcomes |
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Figure 2.1 MMR Reduction by Region, 1990-2013Figure 2.2 Regional Maternal Mortality Ratios, 1990-2013; Figure 2.3 MMR Trends among SAR Countries; Figure 2.4 Proportion Reduction in MMR among SAR Countries, 1990-2013; Figure 2.5 Causes of Maternal Deaths in SAR, 2013; Figure 2.6 Performance of SAR Countries in Achieving MMR with Level of Health Expenditure; Figure 2.7 Skilled Birth Attendance by Region; Figure 2.8 Skilled Birth Attendance in SAR; Figure 2.9 Skilled Birth Attendance across Wealth Quintiles in Pakistan, 1990-2013 |
| Summary |
South Asia Region (SAR) has decreased maternal mortality ratio (MMR) by 65 percent between 1990 and 2013, which was the greatest progress among all world regions. Such achievement implores the question, What made SAR stand out against what is predicted by standard socioeconomic outcomes? Improving Maternal and Reproductive Health in South Asia: Drivers and Enablers identifies the interventions and factors that contributed to reducing MMR and improving maternal and reproductive health (MRH) outcomes in SAR. In this study, the analytical framework assumes that improving MRH outcomes is influenced by a multitude of forces from within and outside the health system and considers factors at the household and community levels, as well as interventions in other sectors and factors in the enabling environment. The analysis is based on a structured literature review of the interventions in SAR countries, relevant international experience, and review of the best available evidence from systematic reviews. The focus of the analysis is mainly on assessing the effectiveness of interventions. The findings from this study indicate that the most effective interventions that prevent maternal mortality are those that address the intra-partum stage - the point where most maternal deaths occur - and include improving skilled birth attendance coverage, increasing institutional delivery rates, and scaling up access to emergency obstetric care. There is also adequate evidence that investing in family planning to increase contraceptive use also played a key role during the inter-partum phase by preventing unwanted pregnancies and thus averting the risk of maternal mortality in SAR countries. Outside the programmatic interventions, the levels of household income, women's education, and completion of secondary education of girls were also strongly correlated with improved MRH outcomes. Also, there is strong evidence that health financing schemes - both demand and supply side - and conditional cash transfer programs were effective in increasing the uptake of MRH services. The study points out to many other interventions with different degrees of effectiveness. The study also identified four major reasons for why SAR achieved this progress in MMR reduction. The best practices and evidence of what works synthesized in this study provide an important way forward for low- and middle-income countries toward achieving the health-related Sustainable Development Goals |
| Subject |
Reproductive health.
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Reproductive health -- South Asia
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Reproductive Medicine
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HEALTH & FITNESS -- Healthy Living.
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HEALTH & FITNESS -- Holism.
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HEALTH & FITNESS -- Reference.
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MEDICAL -- Preventive Medicine.
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Reproductive health
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South Asia
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| Form |
Electronic book
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| ISBN |
9781464809644 |
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146480964X |
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