Maternal Health Program (MHP)

7The birth of a baby is known to bring joy for the mother and her family. However, the complex physiological function of the female reproductive system might produce a number of possible outcomes including death and disability for the mother and her baby, particularly in low to middle income countries. A suspected maternal death is defined as death of any woman while pregnant or within 42 days of the termination of pregnancy. Worldwide, over 800 women die every day due complications associated with pregnancy and childbirth. Of the 800 women who die every day, 50% live in sub-Saharan Africa and 25% in Southern Asia. In developing countries, conditions related to pregnancy and childbirth constitutes the second leading causes (after HIV/AIDs) of death among women of reproductive age.

Studies indicate the four main killers are: severe bleeding, infections, unsafe abortion and hypertensive disorders (pre-eclampsia and eclampsia). Post-partum bleeding is a life threatening condition which can kill even a healthy woman. Most of these deaths are preventable if life-saving preventive and therapeutic interventions are provided in a timely manner. Chances of survival depend on what are known as “the three delays”: 1.) delay in recognizing and seeking care when complications occur, 2.) delay in reaching a health facility, 3.) delays in receiving appropriate care within the health facility.




Over 136 million women give birth each year of which approximately 20 million of them experience pregnancy related illness after childbirth. Common post-partum morbidities include: fever, anemia, fistula, incontinence and depression. It is unfortunate that due to a lack of knowledge, women who suffer from some of these conditions such as fistula are often stigmatized and ostracized by their husbands, families and communities.


Worldwide, approximately 16 million girls between the ages of 15 and 19 give birth each year. This accounts for more than 10% of all births. In developing countries complications from pregnancy and childbirth are the leading cause of death amongst this age group.


Considering the high maternal mortality rates in developing countries, it is undeniable that the state of maternal health mirrors the gap between the rich and the poor. Less than 1% of maternal deaths occur in developed countries. In developing countries, a woman’s lifetime risk of dying from complications in childbirth or pregnancy is an average of one in 150 compared to one in 3800 in developed countries. This confirms the fact that maternal mortality remains a major public health concern in developing countries especially in rural, low income, less educated and underserved communities. 


In sub-Saharan Africa where maternal deaths are the highest, less than 50% of women are attended by a trained midwife, nurse or doctor during childbirth. In developing countries the percentage of women who have at least four antenatal care visits during pregnancy ranges from 56% for rural women to 72% for urban women. Those who do not receive antenatal care remain at high risk for pregnancy and birth complications since they miss the opportunity to detect problems as well as receive proper treatment and care. Poor maternal nutrition also increases the risk of death of the mother at birth and may be associated with approximately 20% of maternal deaths.


More than 222 million women worldwide want to avoid pregnancy, but are not exposed to modern methods of contraception. Enabling couples to determine whether, when and how often to have children is vital to safe motherhood and healthy families. Voluntary family planning has profound health, economic and social benefits for individuals, families and communities. It is estimated that 21 million unsafe abortions are carried out in developing countries yearly resulting in 47,000 maternal deaths. Many of these deaths could be prevented if education and information on family planning and contraceptives were available and put into practice.


Our Goal for MHP: To eliminate preventable maternal mortality.


Considering the severity and complexity of this problem, CAGISC has developed a comprehensive and holistic approach that includes the following strategies:

  • Provide support to health care facilities that practice accurate data collection on all maternal deaths.
  • Encourage comprehensive reviews of maternal death records for problem identification and quality improvement.
  • Analyze data to make evidence based recommendations for actions to decrease maternal mortality.
  • Disseminate findings to health personnel, decision makers, policy makers, to increase awareness about the magnitude, social effects and preventability of maternal mortality.
  • Identification and prompt referral of women with signs of complications of unsafe abortion, domestic and sexual violence, postpartum blues/depression.
  • Identify specific needs and allocate resources effectively and efficiently.
  • Instituting maternal monitoring indicators.
  • Advocate for free medical services for pregnant women and infants.
  • Increase access to care and support for women living with HIV/AIDS.
  • Identify women at risk and implement a case management approach for close monitoring from gestation through birth.
  • Educate post partum women to report possible child birth complications such as post partum depression, infections and fistulas to facilitate early diagnosis and treatment.
  • Create maternal waiting homes close to district hospitals for high risk pregnant women who live in rural areas with limited access to care.
  • Provide supplemental nutrition for pregnant women and mothers at risk for under-nutrition. 
  • Enhance population based education and information dissemination regarding family planning and use of contraception to decrease occurrence of unsafe abortions.
  • Establish standards of practice to enhance accountability for maternal health and quality of care provided.
  • Provide healthcare personnel with the opportunity for continuous education to enhance their knowledge and skills about maternal health problems and acceptable standards of care.
  • Adopting district hospitals to strengthen the health system in partnership with the private sector.