Pathmanathan, IndraLiljestrand, JerkerMartins, Jo. M.Rajapaksa, Lalini C.Lissner, Craigde Silva, AmalaSelvaraju, SwarnaSingh, Prabha Joginder2013-08-012013-08-0120030-8213-5362-4https://hdl.handle.net/10986/14754This 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.en-USCC BY 3.0 IGOMATERNAL MORTALITYMATERNAL HEALTH SERVICESPOVERTY REDUCTIONMIDWIVESPUBLIC EXPENDITURESSYSTEMS ANALYSISDEVELOPING COUNTRIESHEALTH PROGRAMSINCOME LEVELSPOOR WOMEN IN DEVELOPING COUNTRIESCHILDBIRTHCHILD HEALTH SERVICES MATERNAL MORTALITYMATERNAL HEALTH SERVICESPOVERTY REDUCTIONMIDWIVESPUBLIC EXPENDITURESSYSTEMS ANALYSISDEVELOPING COUNTRIESHEALTH PROGRAMSINCOME LEVELSPOOR WOMEN IN DEVELOPING COUNTRIESCHILDBIRTHCHILD HEALTH SERVICESACCESS TO HEALTH CAREACCESS TO TREATMENTANTENATAL CAREBASIC HEALTH CAREBIRTHSCHILD HEALTHCHILD HEALTH SERVICESCHILDBIRTHCLINICSCOMMUNITY MOBILIZATIONCOMPLICATIONS OF PREGNANCYCONTRACEPTIVE PREVALENCECONTRACEPTIVE PREVALENCE RATECULTURAL BARRIERSDOCTORSDRUGSECONOMIC DEVELOPMENTETHNIC GROUPSEXPENDITURESFAMILIESFAMILY HEALTHFAMILY INCOMEFAMILY PLANNINGFAMILY PLANNING SERVICESFERTILITYFERTILITY DECLINEFERTILITY RATESHEALTHHEALTH EXPENDITUREHEALTH EXPENDITURESHEALTH FACILITIESHEALTH MESSAGESHEALTH POLICIESHEALTH PROFESSIONALSHEALTH SERVICESHEALTH SYSTEMHEALTH SYSTEMSHEMORRHAGEHOSPITAL CAREHOSPITAL SERVICESHOSPITALSHYPERTENSIVE DISEASEILLITERACYINFECTIONINSTITUTIONALIZATIONLIFE EXPECTANCYLIVE BIRTHSMALNUTRITIONMANAGERSMATERNAL AND CHILD HEALTHMATERNAL COMPLICATIONSMATERNAL DEATHMATERNAL DEATHSMATERNAL HEALTHMATERNAL HEALTH CAREMATERNAL HEALTH SERVICESMATERNAL MORTALITYMATERNAL MORTALITY RATESMATERNAL MORTALITY RATIOMATERNITY CAREMCHMIDWIFERYMIDWIFERY PRACTICEMORTALITY RATESNEONATAL MORTALITYNURSE-MIDWIVESNURSINGNURSING HOMESNUTRITIONOBSTETRIC CAREOBSTETRIC EMERGENCIESOLDER WOMENPEER REVIEWPREGNANCIESPREGNANCY COMPLICATIONSPRIVATE SECTORPUBLIC HEALTHPUBLIC HOSPITALSPUBLIC SECTORQUALITY CONTROLREPRODUCTIVE AGERURAL HOSPITALSSAFE MOTHERHOODSANITATIONSEPSISSOCIAL SERVICESTEEN PREGNANCIESTOTAL FERTILITY RATETRADITIONAL BIRTH ATTENDANTSTRAINED MIDWIVESUNSAFE ABORTIONWORKERSWorld Bank10.1596/0-8213-5362-4