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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.
The evaluation of reproductive, maternal, newborn, and child health (RMNCH) by the Disease Control Priorities, Third Edition (DCP3) focuses on maternal conditions, childhood illness, and malnutrition. Specifically, the chapters address acute illness and undernutrition in children, principally under age 5. It also covers maternal mortality, morbidity, stillbirth, and influences to pregnancy and pre-pregnancy. Volume 3 focuses on developments since the publication of DCP2 and will also include the transition to older childhood, in particular, the overlap and commonality with the child development volume. The DCP3 evaluation of these conditions produced three key findings: 1. There is significant difficulty in measuring the burden of key conditions such as unintended pregnancy, unsafe abortion, nonsexually transmitted infections, infertility, and violence against women. 2. Investments in the continuum of care can have significant returns for improved and equitable access, health, poverty, and health systems. 3. There is a large difference in how RMNCH conditions affect different income groups; investments in RMNCH can lessen the disparity in terms of both health and financial risk.
In this context, the overall purpose of this review is to bring attention to the opportunities that five countries in the region - Bangladesh, India, Nepal, Pakistan and Sri Lanka - have to strengthen and expand interventions to improve the reproductive health of poor women. The specific objectives are: i) to provide an accurate picture of the current status of women's reproductive health, describe the use of reproductive health services and barriers to use, and identify the improvements required to increase their effectiveness and improve health outcomes; ii) to elucidate individual and household characteristics that affect reproductive health status and use of services so that the most important of these can be used to identify women and households with the greatest need for care to achieve better health; iii) to describe a simple and effective approach - decentralized action planning - that can be used widely in all five countries to improve reproductive health service delivery and outcomes, and point to a body of best practices in reproductive health that provides models and lessons for improvements in South Asia; and iv) to strengthen the case for investing in poor women's reproductive health by demonstrating the links between poverty, inequality, reproductive health care and expenditure.
Mahbub ul Haq's Human Development Centre's 2004 Report on the challenge of health underlies the imperative of focusing on a human-centred economic growth policy in South Asia that is based on improved health and education.
Proceedings of the South Asian Dialogue on Reproductive Health, Rights & Well-Being, organized by SID-Nepal Chapter, on July 11, 2003.
The Center for Reproductive Rights report, Women of the World: Laws and Policies Affecting their Reproductive Lives - South Asia, is the first extensive examination of laws and policies that influence women s reproductive health in five countries of the region - Bangladesh, India, Nepal, Pakistan and Sri Lanka. The report, which is based on three years of research, is the result of a collaborative partnership between the Center and leading nongovernmental organizations in the region. It offers advocates and policymakers a broad view of the laws and policies that determine women s reproductive choices in these countries, to enable legal and policy reform and the implementation of norms needed to improve women s health and lives. The report is a resource for those interested in advancing and protecting women s reproductive health and rights through legal advocacy and establishing state accountability for violations of reproductive rights.
Women's disproportionate poverty, low social status, and reproductive role expose them to high health risks, resulting in needless suffering and many preventable diseases. This report describes the health problems of Pakistani women, whose health and general welfare are among the lowest in the world, and identifies steps to address these problems.