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Investing in Maternal Health : Learning from Malaysia and Sri Lanka

Author

Listed:
  • Indra Pathmanathan
  • Jerker Liljestrand
  • Jo. M. Martins
  • Lalini C. Rajapaksa
  • Craig Lissner
  • Amala de Silva
  • Swarna Selvaraju
  • Prabha Joginder Singh

Abstract

This study provides the most comprehensive and detailed analysis available on factors behind the decline in maternal mortality in Malaysia and Sri Lanka in the past 50 to 60 years and the magnitude of health system expenditures on maternal health. The main findings are that a modest investment in maternal health services, combined with other poverty reduction measures leads to a fairly rapid decline in the maternal mortality ratio (MMR), defined as the number of maternal deaths per 100,000 live births. The strategies of Malaysia and Sri Lanka changed over time, from an initial emphasis on expanding the provision of services, especially in underserved areas, to increasing utilization and, finally, to emphasizing the improvement of quality. Removing financial barriers to maternal care for clients was an important step in both countries. Professional midwives constitute the backbone of maternal care in Malaysia and Sri Lanka. The MMR reduction in developing countries is feasible with modest public expenditures when appropriate policies are adopted, focused wisely, and adapted incrementally in response to environmental conditions and systems capacity.

Suggested Citation

  • Indra Pathmanathan & Jerker Liljestrand & Jo. M. Martins & Lalini C. Rajapaksa & Craig Lissner & Amala de Silva & Swarna Selvaraju & Prabha Joginder Singh, 2003. "Investing in Maternal Health : Learning from Malaysia and Sri Lanka," World Bank Publications - Books, The World Bank Group, number 14754, December.
    • Handle: RePEc:wbk:wbpubs:14754
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    File URL: https://openknowledge.worldbank.org/bitstream/handle/10986/14754/259010REPLACEM10082135362401PUBLIC1.pdf?sequence=1
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    References listed on IDEAS

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    1. Matthew Jowett, 2000. "Cost-effective safe motherhood interventions in low-income countries: a review," Working Papers 181chedp, Centre for Health Economics, University of York.
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    Citations

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    Cited by:

    1. World Bank, 2007. "Sri Lanka - Poverty Assessment : Engendering Growth with Equity, Opportunities and Challenges," World Bank Publications - Reports 8050, The World Bank Group.
    2. William Joe & B Subha Sri & Jyotsna Sharma & Y Manasa Shanta & Suresh Sharma, 2015. "Strategies for Safe Motherhood in Tamil Nadu: A Note," IEG Working Papers 357, Institute of Economic Growth.
    3. Meera Chatterjee & Ruth Levine & Nirmala Murthy & Shreelata Rao-Seshadri, 2008. "Sparing Lives : Better Reproductive Health for Poor Women in South Asia, Summary for Policymakers," World Bank Publications - Reports 7848, The World Bank Group.
    4. World Bank, 2005. "Sri Lanka : Attaining the Millennium Development Goals in Sri Lanka, How Likely and What Will it Take to Reduce Poverty, Child Mortality and Malnutrition, and to Increase School Enrollment and Complet," World Bank Publications - Reports 8635, The World Bank Group.
    5. Kumar, Ramya & Birn, Anne-Emanuelle & Bhuyan, Rupaleem & Wong, Josephine Pui-Hing, 2022. "Universal health coverage and public-private arrangements within Sri Lanka's mixed health system: Perspectives from women seeking healthcare," Social Science & Medicine, Elsevier, vol. 296(C).
    6. Parkhurst, Justin Oliver & Penn-Kekana, Loveday & Blaauw, Duane & Balabanova, Dina & Danishevski, Kirill & Rahman, Syed Azizur & Onama, Virgil & Ssengooba, Freddie, 2005. "Health systems factors influencing maternal health services: a four-country comparison," Health Policy, Elsevier, vol. 73(2), pages 127-138, August.
    7. Arlette Campbell White & Thomas W. Merrick & Abdo S. Yazbeck, 2006. "Reproductive Health—The Missing Millennium Development Goal : Poverty, Health, and Development in a Changing World," World Bank Publications - Books, The World Bank Group, number 7116, December.
    8. Jerome K Kabakyenga & Per-Olof Östergren & Eleanor Turyakira & Karen Odberg Pettersson, 2012. "Influence of Birth Preparedness, Decision-Making on Location of Birth and Assistance by Skilled Birth Attendants among Women in South-Western Uganda," PLOS ONE, Public Library of Science, vol. 7(4), pages 1-8, April.
    9. Bharat Randive & Vishal Diwan & Ayesha De Costa, 2013. "India’s Conditional Cash Transfer Programme (the JSY) to Promote Institutional Birth: Is There an Association between Institutional Birth Proportion and Maternal Mortality?," PLOS ONE, Public Library of Science, vol. 8(6), pages 1-8, June.

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