Human resources for maternal health: multi-purpose or specialists?

Area of Science:

• Public Health
• Global Health
• Health Systems Strengthening

Background:

• Maternal mortality reduction remains a global challenge, with limited progress despite initiatives like the safe motherhood initiative.
• A key debate exists on whether scaling up community-based multipurpose health workers or facility-based skilled birth attendants is more effective for achieving the Millennium Development Goal 5 (MDG5).
• Evidence on effective strategies for maternal mortality reduction, especially interim solutions for home deliveries, is scarce.

Purpose of the Study:

• To review the current human resources for maternal health landscape and associated challenges.
• To propose key areas for scaling up human resources to meet MDG5 targets.
• To identify lessons learned from country experiences in maternal health program implementation.

Main Methods:

• Literature review of the current situation of human resources for maternal health.
• Analysis of challenges faced by health workers in maternal health.
• Case study review of selected countries' experiences and advances in scaling up human resources for maternal health.

Main Results:

• Stagnation in maternal health programs may stem from confusion between scaling up skilled birth attendants and multipurpose workers.
• Empowering midwives and strengthening health systems are critical for significant maternal mortality reduction.
• Focusing on quality of care, rather than solely on the number of workers, is essential for effective maternal health services.

Conclusions:

• No significant progress in reducing maternal mortality can be achieved without strong political will to empower midwives.
• Substantial strengthening of health systems is necessary to provide adequate means for maternal health care.
• Addressing seven key areas, including empowering skilled birth attendants and improving health systems, is essential for MDG5 success.