China: lowering maternal mortality in Miyun county Beijing.

This account provides a description for Miyun County (outside Beijing) China of the number of maternal deaths access to maternal health services and system improvements during 1985-88. Maternal health care in Miyun County is provided through local township hospitals county hospitals and maternity hospitals. Community education is provided locally by village doctors and birth attendants at health stations. Health procedures were changed to include the application of Ministry of Public Health rules on strengthening referrals between village health stations township hospitals and county hospitals. Case management procedures were established for caring for postpartum hemorrhage severe pregnancy-induced hypertension amniotic embolism shock and neonatal asphyxia. Maternal health records were standardized monitoring procedures for perinatal care were widely promoted and high-risk pregnancies were identified and referred according to specific procedures. Six pilot areas were identified for testing the success of program implementation. Findings of this evaluation were that 27.3% (33) of maternal deaths were not reported. Maternal mortality was adjusted to account for these deficiencies (114/100000). 60% of deaths were obstetrically-related. The leading causes were hemorrhage followed by postpartum infections and pregnancy-induced hypertension. 63% of deaths involved insufficient prenatal care. Almost 40% of deaths were unnecessary and about 66% were preventable. In the pilot townships hospitals showed improvements in hospital equipment and staff training. Only in the pilot areas did mortality rates improve. The maternal mortality rate in pilot areas declined by over 75%.