Trends in maternal health/healthcare in low-income countries and the implications on neonatal health.

Maternal health in low-income countries has received increasing attention over the last 15-20 years. Maternal mortality ratios in these countries are mainly still modelled estimates and one cannot discern trends. The introduction of registration systems-giving reliable causes of death-is essential both for monitoring maternal health and fuelling action. Countries with documented success in reducing maternal mortality have used systematic, incremental approaches, often tied to multi-sectoral efforts, including roads, communication links, education, water and sanitation. Improving maternal health requires a reasonably well-functioning health system and this typically requires the reduction of poverty and consistent investment in the health system. Increasingly, policies to improve maternal and newborn health are being implemented, but in the poorest countries the impact is still not discernible. New clinical interventions, such as effective treatment of (pre)eclampsia and post-partum haemorrhage, are often beyond reach of the majority in low-income countries. In summary, progress in maternal health, and the intimately linked perinatal and newborn health, is too slow and requires urgent efforts in poverty reduction and health system strengthening in low-income countries.