Safe Motherhood Program and

Strategies
• Every day, approximately 830 women die from preventable causes
related to pregnancy and childbirth.

• 99% of all maternal deaths occur in developing countries.

• Maternal mortality is higher in women living in rural areas and among

poorer communities.

• Skilled care before, during and after childbirth can save the lives of
women and newborn babies.

• Between 1990 and 2015, maternal mortality worldwide dropped by

about 44%.

(WHO Fact sheet, 2016)

 Introduction

Safe motherhood encompasses a series of

initiatives, practices, protocols and service
delivery guidelines designed to ensure that
women receive high-quality gynecological,
family planning, prenatal, delivery and
postpartum care, in order to achieve optimal
health for the mother, fetus and infant during
pregnancy, childbirth and postpartum.
• SDG 3: Good Health and well being
– By 2030, reduce the global maternal mortality
ratio to less than 70 per 100 000 live births.

– By 2030, end preventable deaths of newborns and

children under 5 years of age, with all countries
aiming to reduce neonatal mortality to at least as
low as 12 per 1000 live births and under-5
mortality to at least as low as 25 per 1000 live
births.
• SLTHP(1997-2017) recognized neonatal health
as an integral part of safe motherhood
programs.
– It has also included the importance of policy in
Skilled Birth Attendants
– Legalization of abortion
– Transmission of HIV from mother to child in HIV
– Importance of Equity
 Safe Motherhood Initiative

• First international Safe Motherhood

Conference in Nairobi jointly sponsored by
WHO, UNFPA and the World Bank in February
1987. 

• Action to reduce maternal mortality and

morbidity by one half by the year 2000.
The Pillars of Safe Motherhood
• ICPD in Cairo in 1994 (Safe motherhood as a
part of Reproductive health)

• 1995 UN Fourth World conference on Women

in Beijing (family planning and women’s
empowerment)
 Components of Safe Motherhood
• Family Planning
– Prevents Teenage pregnancy
– Birth Spacing methods

• Antenatal care
– Antenatal checkups
– Detection of high risk factors
– Behavior Change Communication
– Immunization, iron and folic acid supplementation
– Birth preparedness and complication readiness
• Obstetric Care
– Provision of SBAs
– Provision of Emergency Obstetric Care Kit(EOC Kit)
– Management of complications during delivery

• Postnatal care
– Postnatal visits
– Identification of complications
– Breast feeding
– Immunization
• Postnatal services for Newborn Care
– Cord care prevention
– Management of hypothermia

• Emergency obstetric Care and birthing centre

– Basic Emergency Obstetric Care: vaginal delivery
complications, administration of drugs,
– Comprehensive Emergency obstetric care:
caesarean section, anesthesia and blood
transfusion
• Safe Abortion services
– Access to legal and safe abortion services
– CAC(Comprehensive Abortion Care)
– Safe abortion services-service delivery, training of
manpower and monitoring

• HIV and other STD control

– Prevention of Mother to Child
Transmission(PMTCT)
 Current Activities of Safe Motherhood in
Nepal
• Birth Preparedness and community level
maternal and newborn health
• Rural Ultrasound programme
• Reproductive health morbidity prevention and
management programme
– Management of pelvic organ prolapse
– Cervical cancer screening and prevention training
– Obstetric Fistula management
• Human Resources
• Expansion and quality improvement of service
delivery sites
• Emergency referral funds
• Nyano Jhola Programme (2069-2070)
• Aama and Newborn programme( maternity
Incentive Scheme, user fees removal, Free
newborn care)
 Strategies for Management
• Promoting Intersectoral coordination at different
levels of health system with a focus on poor and
excluded groups.
• Strengthening and expanding delivery by SBAs.
• Strengthening other human resources
• Encourage community based awareness activities
that raise the status of women in community.
• Establish functional referral system
• Promote research on safe motherhood.
Resources
1. Annual Report of DoHS, 2075/76
2. WHO Fact sheet
3. 15th Five year plan