| dc.description.abstract | Because most women prefer professionally provided maternity care when they have access to it, and since the needed
clinical interventions are well known, we discuss in their paper what is needed to move forward from apparent global
stagnation in provision and use of maternal health care where maternal mortality is high. The main obstacles to the
expansion of care are the dire scarcity of skilled providers and health-system infrastructure, substandard quality of
care, and women’s reluctance to use maternity care where there are high costs and poorly attuned services. To increase
the supply of professional skilled birthing care, strategic decisions must be made in three areas: training, deployment,
and retention of health workers. Based on results from simulations, teams of midwives and midwife assistants
working in facilities could increase coverage of maternity care by up to 40% by 2015. Teams of providers are the
effi cient option, creating the possibility of scaling up as much as 10 times more quickly than would be the case with
deployment of solo health workers in home deliveries with dedicated or multipurpose workers. | |
