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Improving maternal and reproductive health in South Asia - drivers and enablers (Paperback)
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Improving maternal and reproductive health in South Asia - drivers and enablers (Paperback)
Series: World Bank studies
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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
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