Future Global Challenge of Primary Maternal and Neonatal Health

Abstract

2 questions were repeatedly raised during the First International Congress on Maternal and Neonatal Health: what are the projects which are most promising and which should be given high priority in the programs sponsored by IAMANEH and its national sections as well as those of other government and nongovernment organizations working in the field of maternal and neonatal health; and what are the strategies for the implementation of these projects to improve maternal and neonatal health. Projects should be elaborated and implemented first of all in the following 4 areas: spacing of pregnancies as a means for improving maternal and neonatal health; treatment and prevention of obstetrical and pediatric infections; training and equipping of auxiliary health personnel working in a comprehensive maternal and child health program; and investigation of the health condition and reproductive behavior of the target population groups and evaluation of the impact selected projects have had on maternal and neonatal mortality and morbidity. Statistical data show clearly that child spacing is an important means of improving the health of mothers and children. Programs need to be developed for delivery of family planning services in rural villages. To achieve this goal, physicians and paramedical personnel must obtain adequate training in fertility control methods and be provided with contraceptive materials. In developing countries, teaching of adequate hygiene to birth attendants and expectant mothers, improvement of the habitat and of nutrition, are adequate preventive measures against infection, but it will take much time to realize these goals in rural areas and suburban slums. 1 way to improve the situation in the immediate future is to provide rudimentary training and basic equipment to traditional birth attendants (TBAs) who, in many countries, attend childbirth of the vast majority of women. To improve maternal and child health care at the primary level, it seems mandatory to include the TBAs in the health program. They should receive initial training followed by regular refresher courses. In view of encouraging results already obtained, the use of the maternity record in all major hospitals of a country and the formation of centers for computer analysis should be encouraged at a national or regional level. Priority should be given to selected projects likely to meet the most urgent needs in a given region. Health for all and particularly for mothers and children can only be secured through an interdisciplinary approach involving various medical disciplines but also several governmental ministries.