Tropical obstetrics and gynaecology. 2. Maternal mortality

Estimates of maternal deaths per 100,000 births are 270 for Latin America, 420 for Asia and 640 for Africa, compared to only 30 in developed countries. In places with high maternal death rates, women who fail to receive antenatal care and who then report to hospital only when their lives are threatened by major obstetric complications constitute the crux of the problem. In reducing maternal deaths in such places, especially in Africa, the need is to provide vigorous treatment for the unbooked emergencies and, at the same time, work towards the removal of the cultural, health and socio-economic conditions which create the unbooked emergencies. The first objective can be achieved through developing a network of first referral hospitals so that life saving measures are accessible to all who need them before it is too late. The second objective can be realized only through the universal provision and utilization of basic but professional antenatal care and also through modernization of the society as a whole. For all of these goals, universal formal education is fundamental.