Where Is the “E” in MCH? The Need for an Evidence-Based Approach in Safe Motherhood

Authors

  • Suellen Miller CNM, PhD,

    Corresponding author
      Women's Global Health Initiative, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, 74 New Montgomery Street, Suite 600, UCSF Box 0886, San Francisco CA 94105-344.
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    • currently Deputy Director of the Women's Global Health Imperative and Adjunct Assistant Professor, School of Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco. She teaches international MCH at the University of California, Berkeley. At the time this article was written, she was Senior Program Associate, International Programs Division, Population Council, New York.

  • Nancy L. Sloan DrPH,

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    • perinatal and nutritional epidemiologist. She is a Senior Program Associate in Reproductive Health, International Programs Division of the Population Council.

  • Beverly Winikoff MD, MPH,

    Corresponding author
      Women's Global Health Initiative, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, 74 New Montgomery Street, Suite 600, UCSF Box 0886, San Francisco CA 94105-344.
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  • Ana Langer MD,

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    • Population Council's Regional Director for Latin America and the Caribbean.

  • Fariyal F. Fikree MD

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    • Program Associate in the Population Council's International Programs Division. She directs research and activities on postpartum health care, breastfeeding, refugee reproductive health, and other related topics.


  • Program Director for Reproductive Health in the Population Council's International Programs Division and a Senior Medical Associate.

  • Support for this study was provided by the Population Council; when this article was written, all the authors were on the staff of the Population Council.

Women's Global Health Initiative, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, 74 New Montgomery Street, Suite 600, UCSF Box 0886, San Francisco CA 94105-344.

Abstract

Measuring the impact of obstetric interventions on maternal mortality and/or morbidity is especially difficult in developing countries, where most maternal deaths occur. Therefore, program planning has been based on theory rather than proved effectiveness. After reviewing both the strategies that have been promoted to reduce maternal mortality and the adequacy of existing evidence used to justify their selection, the investigators highlight reasons why rigorous criteria for the selection and evaluation of interventions should be adopted. Adequate evaluation of intervention effectiveness under real-life conditions in developing countries is an efficient way to identify interventions for large-scale program replication and could speed progress in reducing maternal deaths.

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