Maternal mortality can be reduced through the utilization of services such as prenatal services. According to WHO, every woman requires access to services such as skilled delivery, post, and prenatal care. 94% of maternal related deaths occur in low socioeconomic populations. The overall coverage of prenatal visits in these areas is only 49.5 percent. Therefore, socio-economic factors such as poverty, education and inadequate health care resources, among others, are the root causes of the problem. They prevent women from getting the required healthcare services throughout the gestation period and at childbirth. Different studies indicate that skilled health care can decrease the number of maternal deaths by preventing complications that arise in pregnancy and childbirth. Interventions of priority to reduce mortality rates are those that enhance access to maternal health care services.
Key Action Steps
According to Lavesque et al. (2013), access to care is characterized by the following five main aspects: being available, affordable, appropriate, approachable, and acceptable. The utilization of these services in developing areas, especially in rural parts, is unsatisfactory because of socio-economic factors. Actions that contribute to access to maternal healthcare services are essential for reducing maternal death rates hence a need to prioritize them. Among the most important actions is a collaboration between healthcare administrators and governance or political leaders in providing free maternal health services. For maternal health indicators to improve, increasing coverage among the poor and less fortunate populations in the society is critical (Miteniece et al., 2018). The relationship between socio-economic aspects and the prevalence of complications related to maternal health creates the need to strengthen policies that minimize health inequalities via actions such as free access to maternal health services. Policies and health care models that allow free access to services such as family planning and obstetric help during the prenatal period and delivery can significantly reduce maternal mortality. This can be of great benefit to developing areas where inequalities are persistent.
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Improving maternal health care services offered in healthcare settings through ensuring that the number of doctors, midwives, nurses, and other healthcare staff is adequate is important in addressing maternal mortality (Miteniece et al., 2018). Healthcare facilities in rural areas lack the adequate trained staff to meet the maternal needs of women. In addition, they are, in most cases, unable to retain qualified doctors hence the need for strategies that ensure their attraction and retention in such hospitals. Adequate trained and qualified staff would ensure that complications are handled and managed in an appropriate way when they arise. Other priorities and essential steps include training nurses on cultural sensitivity to increase prenatal visits and address the issue of family planning and maternal education on important health practices that can improve maternal outcomes and reduce mortality. Findings of a study conducted by Karlsen et al. (2011) propose that decreased levels of maternal knowledge is associated with a high maternal mortality even in women who can access or afford maternal and child health services. Therefore, if the ultimate goal, that is to reduce maternal mortality, is to be achieved, this action step is essential. This action can be complemented by marketing to reach a bigger number of women in the society who may not give pre- and postnatal care the seriousness it deserves.
Marketing can be used to distribute information on the need for maternal healthcare visits hence improve the number of women who seek the services. This is an important factor in reducing mortality rates related to pregnancy and child delivery. Obstructed labor is among the main cause of maternal deaths. Poor nutrition can increase the risk of death among women in multiple ways. In situations in which the mother is malnourished, stunted growth may occur, leading to a small pelvis. This may, in turn, lead to obstructed labor. Ensuring good nutrition throughout pregnancy is important not only for the wellbeing of the unborn child but that of the mother too. Therefore, patient education and marketing are very crucial steps in reducing maternal mortality. Execution of internal consulting is the last essential step in reducing mortality. Feedback on how maternal services are offered and suggestions on ways to improve them is important in reducing maternal mortality.
Actions that can be removed without a significant effect on the outcome are financial management and clinical support services. According to the United States Census Bureau (2018), one out of every ten women in the United States is uninsured. Women of color are the most uninsured because of economic reasons. Therefore, the provision of free maternal health services is more effective than subsidizing health insurance for maternity. Unemployment and poverty may prevent them from accessing insurance, even if it is subsidized. Therefore, the most effective strategy is free prenatal and postnatal services. In addition, clinical support services such as keeping the maternity area free from objects may not have a significant effect on the outcome, although such support services are essential. Most maternal related deaths are not related to clinical support services.
Conclusion
Maternal mortality is significantly high. Approximately 295,000 women lost their lives in 2017 as a consequence of complications related to pregnancy and delivery. Most of these deaths occur in areas considered low and/or middle-income where resources are limited and/or socio-economic status is low. The high number of maternal mortality shows inequalities in health care access. Some of the necessary actions that need to be taken is provision of free maternal health care and health education on diet and exercise during pregnancy among others. However, actions such as clinical support services may not have a significant effect on the number of maternal deaths.
References
Karlsen, S., Say, L., Souza, J., Hogue, C. J., Calles, D. L., Gülmezoglu, A. M., & Raine, R. (2011). The relationship between maternal education and mortality among women giving birth in health care institutions: Analysis of the cross sectional WHO global survey on maternal and perinatal health. BMC Public Health , 11 (1). https://doi.org/10.1186/1471-2458-11-606
Levesque J-F, Harris MF, Russell G. (2013). Patient-Centered access to health care: Conceptualizing access at the interface of health systems and populations. International Journal of Equity Health . 12(1):18.
Miteniece, E., Pavlova, M., Shengelia, L., Rechel, B., & Groot, W. (2018). Barriers to accessing adequate maternal care in Georgia: A qualitative study. BMC Health Services Research , 18 (1). https://doi.org/10.1186/s12913-018-3432-z
World Health Organization. (2019, September 19). Maternal mortality . https://www.who.int/news-room/fact-sheets/detail/maternal-mortality
