Reaching the Mother: Eight Safe Motherhood Programs from Sri Lanka to India

Start in 1926, when Sri Lanka began training and posting public health midwives to give home based antenatal, delivery and postnatal care. The entity records the maternal mortality ratio falling from more than 1,500 per 100,000 live births in 1940 to 1945 to 95 per 100,000 by 1980.

Launched in 1987 at a Nairobi conference sponsored by the World Health Organization, UNICEF, the World Bank and the United Nations Population Fund, it made maternal mortality a distinct global priority. Its goal of halving maternal deaths by 2000 was missed, yet the attention it raised fed later global frameworks.

Nepal began this volunteer network in 1988 in 27 districts and reached all 75 districts by 1995. The recorded count is 51,416 volunteers, married women of reproductive age who promoted family planning and supported the maternal and child health focus of the time.

Indonesia launched Bidan di Desa in 1989 to place a resident midwife in every village. By 1997 midwives were posted in 54,000 of roughly 67,000 villages, though the entity notes that the benefit skewed toward wealthier households.

Established in 1994, this program gives each Lady Health Worker responsibility for about 1,000 people, with priority for couples of reproductive age and children under five. It has grown from about 30,000 workers to more than 125,000.

Nepal launched its Safe Motherhood Programme in 1997 and adopted a National Safe Motherhood Policy in 1998, later folding newborn health into the plan in 2006. The cited review puts the maternal mortality ratio at 239 per 100,000 live births, still short of national and global targets.

India launched this conditional cash transfer in 2005 under the National Rural Health Mission, paying women to deliver in a government or accredited facility and paying the community health workers who help arrange it. Researchers have debated whether more facility births brought matching drops in deaths.

Launched on 1 June 2011, this entitlement guarantees free and cashless delivery care, including cesarean sections, at public facilities, and was extended in 2014 to sick newborns and infants up to one year old. It covers drugs, diagnostics, blood, diet and transport, and sits within the National Health Mission beside other maternal entitlement schemes.