Is maternal mortality worsening in Sudan?

Historically, the magnitude of maternal mortality lessened globally, since the mid-forties, due to availability of antibiotics, blood transfusion services and improved antenatal care. In Sudan, the introduction of midwifery care in 1922, the obstetric and gynaecology specialty in 1955 and family planning in 1965 lead to major improvements. The adoption of primary health care [PHC] in 1978, mother child health/family planning [MCH/FP] being its major component, the safe motherhood initiative in 1987 and the International Cairo Conference on Population and Development [ICPD] in 1994 were crucial factors. Its assessment became more reliable by household surveys. Unfortunately, inspite of concerted efforts, its levels worsened, particularly where armed conflicts prevailed, recently partially settled by peace agreements. Major health reforms, in addition to specific reproductive health measures, are necessary to meet the millennium development goals [MDG] of reducing the maternal mortality ratio by 3/4[th] by the year 2015

Maternal morbidity care in Sudan is substandard

With the decline of maternal mortality levels and the increasing life expectancy at birth associated with increased family planning [FP] care, maternal morbidity assumed greater importance. The aim of the article is therefore to review the significance and magnitude of specific maternal morbidities in Sudan, such as female genital- mutilation [FGM], vesico-vaginal-fistulae [VVF], STI/HIV/AIDS, infertility, cervical cancer and violence against women. Quality of reproductive health [RH] care is emphasized. The implications of rising health care costs are realized. The negative influences of implementing the peace agreements are stressed. The use of maternal morbidities as indicators of maternity care services are highlighted, while realizing the problems of maternal mortality assessment

Augmenting hospital support of maternal and child health care, Saudi Arabia

This paper describes the Saudi maternal and child health training programme [1988-1997] to augment hospital support of health centres. Maternal and child health trainer/trainee manuals were prepared, then implemented through 4-day trainers workshops and 2week trainee courses. Mid-term evaluation and follow-up demonstrated reasonable coverage and quality of training. Improved integration of care was reflected by a trainers attitude questionnaire and a trainees interview/observation questionnaire. To date, 589 trainers have been trained, three-quarters of them from hospitals. They in turn have trained about 7658 trainees, 93% of target. The programme is ongoing with continuous updating of content