comprehensive approach to improving maternal health and achieving mdg 5 report from the mountains of lesotho全面的方法来改善孕产妇健康和实现目标5报告从山上的莱索托.pdfVIP

Comprehensive Approach to Improving Maternal Health and Achieving MDG 5: Report from the Mountains of Lesotho 1,2 1 1 1 3,4 Hind Satti *, Sophie Motsamai , Palesa Chetane , Leshoboro Marumo , Donna J. Barry , Jennifer Riley3, Megan M. McLaughlin3,4, Kwonjune J. Seung3,4, Joia S. Mukherjee2,3,4 1 Partners In Health Lesotho, Maseru, Lesotho, 2 Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America, 3 Partners In Health, Boston, Massachusetts, United States of America, 4 Division of Global Health Equity, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America Abstract Background: Although it is now widely recognized that reductions in maternal mortality and improvements in women’s health cannot be achieved through simple, vertical strategies, few programs have provided successful models for how to integrate services into a comprehensive program for maternal health. We report our experience in rural Lesotho, where Partners In Health (PIH) in partnership with the Ministry of Health and Social Welfare implemented a program that provides comprehensive care of pregnant women from the community to the clinic level. Methods: Between May and July 2009, PIH trained 100 women, many of whom were former traditional birth attendants, to serve as clinic-affiliated maternal health workers. They received performance-based incentives for accompanying pregnant women during antenatal care (ANC) visits and facility-based delivery. A nurse-midwife provided ANC and delivery care and supervised the maternal health workers. To overcome geographic barriers to delivering at the clinic, women who lived far from the clinic stayed a