[Safe motherhood: is the initiative an orphan?]

Ten years after the Safe Motherhood Initiative has been set up, maternal morbidity and mortality remain a major public health issue in most developing countries. This presentation reviews the background of the initiative and the strategies adopted in Nairobi. Then, it undertakes an analysis of recent developments in maternal health policies. The authors discuss the comparative impact on maternal mortality of efforts aimed at a global improvement of the socio-economic and educative status of women, family planning activities, traditional birth attendants training programmes, and antenatal care. They stress the importance of the effective accessibility to life saving obstetric. Finally, they advocate a major involvement by gynecologist-obstetricians in the development and in the implementation of safe motherhood programmes.