1. 21-11-2001UNFPA - Delhi MATERNAL DEATH CAN AND SHOULD BE PREVENTED By Francois M. Farah UNFPA REDEFINING PREGNANCY AND CHILDBIRTH FROM A RISK MANAGEMENT PERSPECTIVE

2. 21-11-2001UNFPA - Delhi OBSTACLES TO SAFE MOTHERHOOD- I A - LACK OF ACCESS TO HEALTH CARE NON AVAILABILITY OF HEALTH FACILITIES AND SERVICES GEOGRAPHICAL DISTANCE HOME/HEALTH FACILITY NON-AVAILABILITY OF TRANSPORTATION TRANSPORT COST

3. 21-11-2001UNFPA - Delhi OBSTACLES TO SAFE MOTHERHOOD - II B - POOR QUALITY OF CARE AT HEALTH FACILITY FEW, UNSKILLED, NON-MOTIVATED HEALTH PERSONNEL LACK OF EQUIPMENT LACK OF SUPPLY (BLOOD) NON AVAILABILITY OF EOC: REFERRAL SYSTEM, COMMUNICATION, RECORD KEEPING, ETC.

4. 21-11-2001UNFPA - Delhi OBSTACLES TO SAFE MOTHERHOOD - III C - HIGH RISK PREGNANCIES PREDISPPOSING FACTORS SUCH AS MATERNAL AGE, PREGNANCY ORDER, NARROW BASIN, ETC.. MATERNITY HISTORY BIRTH INTERVAL FATALIST HEALTH SEEKING BEHAVIOUR SOCIAL CULTURAL BARRIERS AND GENDER BIASED HARMFUL SOCIAL AND HEALTH PRACTICES

5. 21-11-2001UNFPA - Delhi PREVIOUS ATTEMPTS AND LESSONS LEARNED - I TO REDUCE MATERNAL DEATH AND MORBIDITY: ACKNOWLEDGE SERIOUSNESS OF COMPLICATIONS TIMELY DETECTION OF COMPLICATIONS IMPROVING WOMEN’S ACCESS TO PROMPT, EFFECTIVE TREATMENT OF OBS. COMPLICATIONS SUCH SYSTEM SHOULD BUILD UPON EXISTING CADRES OF HEALTH SERVICE PROVIDERS IMPROVE QUALITY AND RESPONSIVENESS OF RH CARE

6. 21-11-2001UNFPA - Delhi PREVIOUS ATTEMPTS AND LESSONS LEARNED - II TO REDUCE MATERNAL DEATH AND MORBIDITY: SYSTEM MUST BE COST EFFECTIVE AND SUSTAINABLE TO WORK FOR POOR COMMUNITIES WITH POOR HUMAN AND FINANCIAL RESOURCES IN REMOTE AREAS PROGRAMME MUST WORK WITH COMMUNITY, CONVINCE FAMILIES, HUSBANDS, LOCAL AUTHORITIES, RELIGIOUS AND CULTURAL LEADERS THAT MATERNAL DEATH CAN AND SHOULD BE PREVENTED

7. 21-11-2001UNFPA - Delhi CONCRETE PROGRAMME RESPONSE TO MATERNAL DEATH FUNCTIONAL, SUSTAINABLE, COMMUNITY FRIENDLY REFERRAL SYSTEM: R E S C U E R (RURAL EXTENDED SERVICES AND CARE FOR ULTIMATE EMERGENCY RELIEF) A THREE-PRONGED DESIGN: IDENTIFYING REFERRAL POINTS AND EQUIPPING THEM FOR CATCHMENT AREAS COMMUNICATION SYSTEM BETWEEN RP AND VILLAGES EFFICIENT, FUNCTIONAL AND SUSTAINABLE MEANS OF TRANSPORTATION

8. 21-11-2001UNFPA - Delhi 1 - IDENTIFYING REFERRAL POINTS MAPPING OF HEALTH FACILITIES COMPREHENSIVE NEEDS ASSESSMENT ENSURE MINIMUM REFERRAL CARE AND SERVICES THROUGH TRAINING OF DAIs ON REFERRAL, PERSONNEL AT 1 st REFERRAL, AND IN HOSPITAL LOGISTICS, EQUIPMENT (BASED ON NEEDS ASSESSMENT) RENOVATION (BASIC) TO MAKE THE FACILITY FUNCTIONAL

9. 21-11-2001UNFPA - Delhi 2 - COMMUNICATION SYSTEM VHF RADIO COMMUNICATION SYSTEM TWO WAY COMMUNICATION: REFERRAL POINT- VILLAGE; 1 ST REFERRAL REFERRAL POINT- HOSPITAL 2 ND REFERRAL IDENTIFY REFERRAL HOSPITAL A TWO PRONGED TRAINING: EARLY DETECTION OF COMPLICAITONS SIGNS OF EMERGENCIES AND USE OF RADIO

10. 21-11-2001UNFPA - Delhi 3 - TRANSPORTAION SIMPLE, ECONOMICAL, EASY TO MAINTAIN AND REPAIR, TRANSPORT DEVICE THREE WHEELER WITH A SIMPLE STRUCTURE TO ACCOMMODATE EXPECTING WOMEN SIDE SEAT FOR ACCOMPANYING PERSON (DAI OR RELATIVE) EMERGENCY DELIVERY KIT RESCUER BOATS FOR THE TWO ISLANDS

11. 21-11-2001UNFPA - Delhi SIMULATION PRELIMINARY FINDINGS IN PILOT AREA MARCH 8, 1996 – MARCH 1997 ANTENATAL: 22885 ---- 26078 NORMAL DELIVERIES 5410 ---- 6094 CS 468 ---- 640 REFERRED CASES342 ---- 1028 MATERNAL DEATHS 48 ---- 33

12. 21-11-2001UNFPA - Delhi REPLICATION PRELIMINARY CONSULTATIONS FEASIBILITY STUDY SENSITIZATION AND MOBILIZATION OF COMMUNITY, ADMINISTRATION AND HEALTH SYSTEM SELECTION OF HEALTH UNITS/ CATCHMENT AREAS NEEDS ASSESSEMENT HUMAN RESOURCE DEVELOPMENT/TRAINING HEALTH UNIT RENOVATION/PROCUREMENT IMLEMENTATION MONITORING, EVALUATION AND INTRODUCTION OF NECESSARY ADJUSTMENTS

13. 21-11-2001UNFPA - Delhi EXAMPLES FROM OTHER CONTEXTS AMDD: AVERTING MATERNAL DEATH AND DISABILITY Multiple Country Project Preliminary Findings

14. 21-11-2001UNFPA - Delhi MATERNAL MORBIDITY AND MORTALITY CAN AND SHOULD BE PREVENTED

15. 21-11-2001UNFPA - Delhi ONE UNNECESSARY AND PREVENTABLE MATERNAL DEATH IS ONE TOO MANY