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PUBLIC RELEASE DATE:
31-May-2012

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Contact: Lisa Hallgarten
lhallgarten@rhmjournal.org.uk
44-207-267-6567
Elsevier
@elseviernews

Reproductive Health Matters addresses gap policy and practice maternal health and mortality

Latest issue of Reproductive Health Matters addresses the gap between policy and practice in maternal health and maternal mortality

London, May 31, 2012 - As the UN Special Rapporteur on maternal mortality in India points out there is a 'yawning gulf between ... commendable maternal mortality policies and their urgent, focused, sustained, systematic and effective implementation', the May issue of Reproductive Health Matters explores the causes and impact of this gap, but also highlights hopeful signs of progress.

Two papers from India included in the issue capture both the good and bad news that characterise the gap between rhetoric and reality in maternal health and maternal mortality. In India a range of provisions to support better maternal nutrition and access to subsidised health care are required by law, but there is a wide gap between policy and practice. Preventable deaths are caused by several factors including a shortfall in antenatal care, delays in emergency obstetric care and inappropriate referral. Detailed case studies of women who died point to lack of accountability, discrimination on the grounds of poverty and caste, and according to Subha Sri Balakrishnan, author of one of the papers, "In some cases...quality of care (that) was so poor that it may be considered negligent."

Both papers follow subsequent action taken to seek government accountability and justice. In one paper, author Jameen Kaur, reports on the way in which a women's family sought redress in the courts, supported by human rights lawyers. The second paper details an investigation lead by Subha Sri Balakrishnan into maternal deaths in response to a public protest about local maternal deaths in Madhya Pradesh. The researchers presented their findings to district and state level health officials which led to some improvements in care.

Examples of using law to promote accountability and good practice are described in a paper from Latin America reporting on landmark decisions by the UN Committee on the Elimination of Discrimination Against Women (CEDAW) calling for appropriate maternal health care (Brazil) and decriminalisation of abortion to safeguard women's health (Peru). These are promising examples of the application of human rights to demand government responsibility for maternal deaths and to assert the rights of women not to die in pregnancy, childbirth and unsafe abortion.

Furthermore a new emphasis on evidence-based practice is described in several papers, providing grounds for optimism. It suggests there is a real desire to improve outcomes and the hope that new initiatives may have a greater chance of success in saving women's lives. Without the political commitment to addressing equity, however, important initiatives will continue to fail the poorest and most marginalised women. As one author notes, "The death of a woman due to pregnancy complications is not just a biological fact it is also a political choice."

Articles in the issue include focus on Brazil, China, Egypt, Bangladesh, Ethiopia, Haiti, India, Nigeria, Peru, Tanzania and Rwanda.

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Notes to editors

This issue of Reproductive Health Matters is volume 20, issue number 39; published by Elsevier. Journalists wishing to interview the authors may contact Lisa Hallgarten at +44 207 267 6567 or lhallgarten@rhmjournal.org.uk

About Reproductive Health Matters (RHM)

Reproductive Health Matters is a bi-annual peer-reviewed international journal aiming to: promote laws, policies, research and services that meet women's reproductive health needs; examine experiences, values, information and issues from the point of view of the women whose lives are affected; explore the multifaceted nature of problems and their solutions; inspire new thinking and action and new forms of consensus in the field. Each issue of Reproductive Health Matters concentrates on a specific theme and has papers on other timely topics and a round-up of information from the published literature.

About Elsevier

Elsevier is a world-leading provider of scientific, technical and medical information products and services. The company works in partnership with the global science and health communities to publish more than 2,000 journals, including The Lancet and Cell, and close to 20,000 book titles, including major reference works from Mosby and Saunders. Elsevier's online solutions include SciVerse ScienceDirect, SciVerse Scopus, Reaxys, MD Consult and Mosby's Nursing Suite, which enhance the productivity of science and health professionals, and the SciVal suite and MEDai's Pinpoint Review, which help research and health care institutions deliver better outcomes more cost-effectively.

A global business headquartered in Amsterdam, Elsevier employs 7,000 people worldwide. The company is part of Reed Elsevier Group PLC, a world-leading publisher and information provider, which is jointly owned by Reed Elsevier PLC and Reed Elsevier NV. The ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).

Media contact
Lisa Hallgarten
Editorial office Reproductive Health Matters
+44 207 267 6567
lhallgarten@rhmjournal.org.uk



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