Maternal health care

Abstract

This summary research report updates an earlier report on high-risk births and maternity care in developing countries and analyzes new data from the Demographic and Health Surveys II and III for 35 countries. The report focuses on data descriptions differences in maternal health care coverage differences over time within countries health risks in childbearing perinatal mortality and maternal health care. Maternal health is measured by prenatal care by a trained person tetanus toxoid immunization during pregnancy and delivery by a trained attendant. Findings indicate that nine countries had coverage of prenatal care of above 90% (Kenya Malawi Rwanda Tanzania Uganda Zambia Zimbabwe Kazakstan and Dominican Republic). Four countries (Niger Bangladesh Morocco and Pakistan) had levels under 35%. In 33% of the 35 countries over 25% of births were to women who received prenatal care but did not receive tetanus immunization. In most countries where women received tetanus toxoid they received two doses. Women were the least likely to have a child delivered by a trained attendant. There were greater differences in the access to delivery care than to prenatal care or immunization. In 15 countries urban women were 2.5-3 times more likely to have delivery care than rural women. Less than 33% of the 35 countries had the recommended levels (5-15%) of cesarean section deliveries. In seven countries tetanus toxoid coverage increased about 25%. In four countries prenatal care coverage increased by about 25%. In one country delivery care increased by about 25%. The improvements in coverage were associated with improved access to care for the underserved. Women who viewed themselves at risk of childbearing problems were somewhat more likely to deliver with a trained attendant. Mortality tended to be lower in countries with higher levels of service use.