In 2010, there were 287 000 maternal deaths globally, 90% of which were preventable and occurred in low-resource settings. Maternal mortality not only reflects the health status of a woman and her family, but also is a representation of the accessibility and effectiveness of a country’s health system. The most common causes of maternal mortality are haemorrhage, eclampsia and pre-eclampsia, infection, unsafe abortion and obstructive labour.
Key facts and figures
- Approximately 99% of all maternal deaths occur in low-income countries.
- In 2008, approximately 13 000 women in the Western Pacific Region out of 358 000 globally died of pregnancy and childbirth-related causes.
- Skilled care before, during and after delivery significantly decreases the mother’s chance of complications and increases her and her newborn child’s chance for survival.
Situation in the Lao People’s Democratic Republic
- The Ministry of Health acknowledges that reducing maternal mortality and morbidity is a priority, and that deaths due to complications during pregnancy, delivery, and after delivery are preventable by providing proper and immediate care and assistance when complications arise.
- Based on a recent population survey conducted, the maternal mortality ratio in the Lao People’s Democratic Republic decreased from 656 per 100 000 live births in 1995 to 357 per 100 000 live births in 2012.
- The maternal mortality rate in the Lao People’s Democratic Republic remains among the highest in the Western Pacific Region.
- Home delivery without a skilled birth attendant is very common among ethnic communities in mountainous areas, contributing to a problem of underreported maternal deaths.
WHO, in collaboration with the Ministry of Health and key development partners, is supporting the implementation and assessment of free maternal and child health services in 83 districts in 13 provinces. WHO specifically focuses on the provision of free delivery services for all women through a voucher programme, which includes the provision of free antenatal and postnatal care.
WHO is also assisting the Ministry of Health with the Maternal Death Review System, aiming to identify the causes and determinants of maternal deaths, while recognizing areas of clinical weakness and substandard care. The findings of the maternal death review will be used to formulate remedial and intervention strategies. Strategy development and dissemination of the WHO “Clinical practice handbook for safe abortion ” is in the pipeline.
According to the “Report on Lao PDR Maternal Death Review 2011–2013”, which reviewed 118 maternal death cases from 8 provinces and Vientiane Capital, 54% of the maternal deaths were caused by postpartum haemorrhage. Of all the cases reviewed, 53% of the women delivered at home, and 46% delivered with no skilled birth attendant or village health volunteer present. Furthermore, 44% did not receive any antenatal care, preventing knowledge of danger signs during and after pregnancy.
According to the same report, 75% of the reviewed cases worked as farmers, and approximately 46% were illiterate. Women who live far from a health facility that can provide emergency obstetric care are most vulnerable. This includes women who live in mountainous areas with poor access to roads and transportation. Over 45% of the women from the 118 reviewed cases resided 2 hours away from any health facility, and 43% lived in a village that had no roads or could not be accessed by a car.
- Strategy and Planning Framework for the Integrated Package of Maternal and Neonatal and Child Health Services (2009–2015)
- Improve Maternal Health: Key Determinants Affecting Maternal Mortality in Lao PDR (2014)
- Lao People’s Democratic Republic Health System Review (2014)
- Success Factors for Women’s and Children’s Health: Lao PDR
- Report on Lao PDR Maternal Death Review 2011–2013
Ministry of Health
Lao Association of Obstetrics and Gynecology