Promoting safer childbirth:

A Sri Lankan success story

Sri Lanka has emerged as a success story in promoting safer childbirth. The country's significant decline in maternal deaths will be presented today at the Royal College of Obstetricians and Gynaecologists (RCOG) South Asia Day. The conference gathers together a group of international experts to discuss maternal and child health in South Asia.

Presenters at the conference describe Sri Lanka as a model for cost-effective healthcare. Despite the country's meagre healthcare budget, its maternal and child health indicators are vastly more favourable than what would be expected.

The maternal mortality ratio of Sri Lanka has declined dramatically as a direct result of the availability of midwives and trained assistance at birth - from 340 per 100,000 live births in 1960 to 43 per 100,000 live births in 2005.

Dr. Hemantha Senanayake, from the University of Colombo, said: "The most important contribution to maternal and childcare has come from Sri Lankan midwives, who form the backbone of healthcare delivery. They are recruited from the areas they are meant to serve, which ensures minimal geographic and cultural barriers. The hallmark of our interventions is that they are low-cost and indigenous.

"Every household in Sri Lanka belongs to a designated Public Health Midwife (PHM) area and the norm is for the PHM to provide home-based care. During the past few decades the Government has made a policy decision to increase the number of midwives. The number of women having a minimum of four antenatal visits has reached 99 percent."

"In addition, there have been other policy decisions that have had significant effects on maternal deaths. Home births have been discouraged (1% in 2006) and the availability of comprehensive emergency obstetric care is being expanded. Presently, 85 percent of births take place in facilities that have the services of a specialist obstetrician."

"The provision of free education without gender discrimination over the past six decades has been a key non-health intervention that has had a major impact on maternal mortality."

"Our experience demonstrates the fundamental importance of ensuring trained assistance at birth. These simple interventions have made a tremendous difference for women in Sri Lanka."

The South Asia Day conference is taking place at the RCOG in London on July 03, 2009 (Friday). This event is being organized jointly by the RCOG, All India Coordinating Committee (AICC RCOG) and South Asian Federation of Obstetrics and Gynaecology (SAFOG).

- Royal College of Obstetricians and Gynaecologists