The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #62762

Shana Yansen, MHS, Bloomberg School of Public Health Center for Communication Programs, Johns Hopkins University, 111 Market Place, Baltimore, MD 21231, 410 659 6150, syansen@jhuccp.org and Sereen Thaddeus, MA, MPH, The Maternal and Neonatal Health Program, 1615 Thames Street, Baltimore, MD 21231.

Skilled care and targeted policies are recognized as major pillars of successful maternal mortality reduction efforts. The contribution of each is well documented and described in the literature. The “dynamic tension” between the clinical supply side and the behavioral demand side of maternal health is, however, rarely broached in discussions of maternal mortality reduction. It is paradoxical that researchers focus on women’s behavior, belief systems, and social contexts when they are harmful practices leading to maternal death or when they act as barriers to receiving care, yet they overlook them in accounts of successful strategies to reduce maternal mortality. The behavioral and social changes that underlie increased use of care are neither documented, nor told in the safe motherhood literature. In fact, the question is never posed. This paper begins to fill that gap. It focuses on Honduras, a country that has successfully reduced its MMR in a relatively short period, and highlights the “demand” side of this success story. The paper identifies and describes approaches to increasing use, such as communication, community outreach, community participation, and word of mouth and it analyzes their role in changing perceptions and behaviors that surround birth. The paper discusses how these approaches were used to increase access to the clinical interventions, thereby increasing their effectiveness. A discussion follows, with conclusions offered, about the role of demand strategies in efforts to reduce maternal deaths.

Learning Objectives:

• Learning Objectives
• At the conclusion of the presentation, participants will be able to
• ·Describe the dynamic tension between the supply of and demand for services that reduce maternal deaths
• ·Recognize that behavioral and social factors are not only barriers to use of care
• ·Describe the experiences of three countries, what they share and what they did differently in the effort to reduce their maternal mortality
• ·Discuss the ways through which behavioral and social factors facilitate use of services and contribute to maternal mortality declines

Keywords: Access to Care, Safe Mother Program

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.