Maternal Mortality Reduction Through Best Practice Birthing Centers Is Limited by Economic and Cultural Barriers
Maternal mortality in El Salvador has been decreasing over the last two decades, however the rate of decrease is diminishing based on the current plan and the results are far short of El Salvador’s Millennium Development Goal (MDG) to reduce maternal deaths by three-quarters ((WHO)). The maternal mortality rate has dropped from 150 deaths per 100,000 live births in 1990 to approximately 81 deaths per 100,000 births. The progress is to be applauded, though it is important to understand the limitations of the current program and the circumstances leading to higher rates.
One of the key reasons maternal health has improved over the last several years has been due to increase access to health care through maternity waiting homes. Two decades ago maternal health care only reach about 60% of the population. Now nearly 95% of all mothers have access to at least some maternal care. Maternal waiting homes provide space where women with limited access to service where they live can come and have a place to stay while they receive appropriate care. As part of the program, transportation is provided to help the mother get to and from remote locations, and the “voluntary” contribution was removed entirely to reduce any stigma against recieving care ((El Salvador Ministry of Health Video)).
This program should be lauded. The Ministry of Health in conjunction with practitioners and international aid organizations have made a significant impact in the live of women and children through this program.
So why is the rate of maternal death decreasing far short of the MDG?
It should first be noted that this program appear to be less than 5 years old. It is very possible that when maternal mortality is measured in a few years more substantial improvements may have been achieved ((Cantero et al 2007)).
Additional reasons for maternal mortality may include limited access to nutritional programs in rural or underdeveloped regions ((El Salvador: Covenant on Economic, Social and Cultural Rights (CESCR), 2005) 35-36, 63-65, 72, 106-107, 110)). Domestic violence is widespread ((United States Department of State, Country Reports on Human Rights Practices: El Salvador, 2011, 12 December, 2013)). There is also a fairly high rate of teen pregnancy which when combined with poverty may also contribute to the higher maternal mortality rates ((UN, El Salvador: Convention on the Rights of the Child (CRC) Concluding Observations, 2004, 11)). At the time of the last CEDAW report there were no family planning or education programs aimed at reducing teen pregnancies ((ibid)).
- WHO ↩
- El Salvador Ministry of Health Video ↩
- Cantero et al 2007 ↩
- El Salvador: Covenant on Economic, Social and Cultural Rights (CESCR), 2005) 35-36, 63-65, 72, 106-107, 110 ↩
- United States Department of State, Country Reports on Human Rights Practices: El Salvador, 2011, 12 December, 2013 ↩
- UN, El Salvador: Convention on the Rights of the Child (CRC) Concluding Observations, 2004, 11 ↩
- ibid ↩