The Mother-Baby Package: an approach to implementing safe motherhood

The basic objectives of the Mother-Baby Package are neither new nor controversial - they are considered the 'four pillars' of Safe Motherhood: (1) family planning - to ensure that individuals and couples have the information and services to plan and space pregnancies; (2) antenatal care - to ensure that complications of pregnancy are detected as early as possible and treated appropriately; (3) clean/safe delivery - to ensure that all birth attendants have the knowledge, siwills and equipment to perform a clean and safe delivery; (4) essential obstetric care - to ensure that essential care is made available to all women who need it. Complications during pregnancy and childbirth affect not only the women but their newborns as well. The woman and the fetus, the mother and the neonate, should be seen as a dyad - two units treated as one. Poorly managed pregnancies and/or deliveries and/or inadequate care of neonates during the first critical hours of life account for significant numbers of perinatal and neonatal deaths. Each intervention of the Package can be appropriately applied at community, health center and hospital levels. Only by providing this continuum of care from the community through to the referral hospital will significant impact on mortality be achieved. The goals of the Package are, by the year 2000, to reduce maternal mortality by half and neonatal and perinatal mortality by 30-40% of 1990 levels.