Maternal and Child Health, HIDN, USAID, Washington, DC, USA.
Department of Learning Health Sciences and Department of Obstetrics and Gynecology, Global REACH, University of Michigan Medical School, Ann Arbor, MI.
Lancet. 2016 Nov 5;388(10057):2307-2320. doi: 10.1016/S0140-6736(16)31333-2. Epub 2016 Sep 16.
To improve maternal health requires action to ensure quality maternal health care for all women and girls, and to guarantee access to care for those outside the system. In this paper, we highlight some of the most pressing issues in maternal health and ask: what steps can be taken in the next 5 years to catalyse action toward achieving the Sustainable Development Goal target of less than 70 maternal deaths per 100 000 livebirths by 2030, with no single country exceeding 140? What steps can be taken to ensure that high-quality maternal health care is prioritised for every woman and girl everywhere? We call on all stakeholders to work together in securing a healthy, prosperous future for all women. National and local governments must be supported by development partners, civil society, and the private sector in leading efforts to improve maternal-perinatal health. This effort means dedicating needed policies and resources, and sustaining implementation to address the many factors influencing maternal health-care provision and use. Five priority actions emerge for all partners: prioritise quality maternal health services that respond to the local specificities of need, and meet emerging challenges; promote equity through universal coverage of quality maternal health services, including for the most vulnerable women; increase the resilience and strength of health systems by optimising the health workforce, and improve facility capability; guarantee sustainable finances for maternal-perinatal health; and accelerate progress through evidence, advocacy, and accountability.
要改善孕产妇健康状况,需要采取行动确保所有妇女和女童都能获得优质的孕产妇保健服务,并保证为体制外的妇女提供获得保健服务的机会。本文重点介绍了孕产妇健康方面的一些最紧迫的问题,并提出以下问题:在未来 5 年内,可采取哪些措施来推动行动,实现到 2030 年将每 10 万例活产的孕产妇死亡数减少到 70 人以下的可持续发展目标,且任何一个国家的孕产妇死亡数都不超过 140 人?可采取哪些措施确保优先为世界各地的每一位妇女和女童提供高质量的孕产妇保健服务?我们呼吁所有利益攸关方共同努力,确保所有妇女都拥有健康、繁荣的未来。各国政府和地方政府必须在发展伙伴、民间社会和私营部门的支持下,带头努力改善孕产妇围产期健康状况。这意味着需要投入必要的政策和资源,并持续实施,以解决影响孕产妇保健服务提供和使用的诸多因素。所有合作伙伴都应优先采取以下五项行动:优先提供针对当地具体需求并应对新出现挑战的优质孕产妇保健服务;通过普及优质孕产妇保健服务,包括为最脆弱的妇女提供服务,促进公平;通过优化卫生人力和提高设施能力,增强卫生系统的弹性和实力;为孕产妇围产保健提供可持续的资金;并通过证据、宣传和问责制来加速进展。