Summary of Maternal Health
Worldwide, maternal mortality remains high and essentially unchanged over the past 15 years, with a maternal mortality rate (MMR) of 400/100,000 live births—or more than 500,000 deaths each year. Moreover, of all health indicators, maternal mortality ratios show the greatest gap between rich and poor countries. Ninety-nine percent of maternal deaths occur in developing countries, primarily in Africa and South Asia, and the lifetime risk of maternal death in sub-Saharan Africa is more than 200 times greater than in the United States. 

The major causes of maternal mortality are postpartum hemorrhage (PPH) and pre-eclampsia/eclampsia (PE/E)—which alone account for more than 40 % of maternal mortality—as well as obstructed labor, puerperal infection, and complications of abortion. Anemia and infections, such as malaria and HIV, also contribute to maternal mortality. Although poorly documented, maternal morbidity and disability are estimated to affect millions of women each year. 

Efforts to improve this situation over the past two decades have led to the development of a number of evidence-based high-impact interventions appropriate for use in low-resource settings at both the facility and community levels. MCHIP partners have implemented many of these interventions through initiatives at global and country levels, through policy and advocacy work, program implementation in facilities and communities, monitoring and evaluation (M&E) efforts at country and regional levels, and the sharing of results and knowledge.

MCHIP & Maternal Health
MCHIP’s approach to maternal health is well-aligned with USAID’s Maternal Health Results Pathways, and aims to act as a key contributor to USAID’s goal to reduce maternal mortality by 25% by 2013 in 20 priority countries with high mortality burden. The Program focuses on three main areas to contribute to this reduction in mortality—preventing PPH, preventing and treating pre-eclampsia/eclampsia (PE/E), and ensuring meaningful skilled attendance at birth—by:

• Providing catalytic inputs to develop effective, evidence-based maternal care interventions and scaling them up;
• Supporting activities that increase coverage and use of services/practices to prevent and treat conditions that cause high mortality, such as: active management of third stage of labor (AMTSL); community-based distribution of misoprostol; use of magnesium sulfate for pre-eclampsia/eclampsia; infection prevention; use of the partograph; and improved availability and quality of care given by skilled providers;
• Scaling up evidence-based approaches to improve maternal health by focusing on 20 priority MCH countries and applying core investments in selected scale-up efforts for the six focus countries selected jointly by MCHIP and USAID;
• Supporting the integration of FPand PMTCT with MNCH services where appropriate;
• Conducting program research and documenting evidence-based maternal care programs;
• Providing technical leadership in maternal health globally; and
• Strengthening and supporting strategic alliances that support implementation of maternal health programs at scale.

As appropriate, the focus of MCHIP’s interventions will be the household-to-hospital continuum of care, depending on the context. The Program will promote high-impact interventions at the community, facility and national levels, and will ensure accurate and global measurement of key indicators that provide evidence of use of interventions that can impact maternal mortality.