Articles: mortality.
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The author analyzes excess female mortality in nineteenth-century England. She concludes that such mortality was affected by the economic environment and that "much literary evidence points to unequal access to food and a resulting susceptibility to epidemic and respiratory diseases as the transmission mechanism converting dependence and discrimination into relatively high death rates." Women were also adversely affected by harsh labor conditions, in addition to the heavy duties involved in motherhood and housework.
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Clinical Trial Controlled Clinical Trial
Effect on mortality of community-based maternity-care programme in rural Bangladesh.
Various community-based interventions have been proposed to improve maternity care, but hardly any studies have reported the effect of these measures on maternal mortality. In this study, the efficacy of a maternity-care programme to reduce maternal mortality has been evaluated in the context of a primary health-care project in rural Bangladesh. Trained midwives were posted in villages, and asked to attend as many home-deliveries as possible, detect and manage obstetric complications at onset, and accompany patients requiring referral for higher-level care to the project central maternity clinic. ⋯ By contrast, during the following 3 years, the ratio was significantly lower in the programme than in the control area (1.4 vs 3.8 per 1000 live births, p = 0.02). The findings suggest that maternal survival can be improved by the posting of midwives at village level, if they are given proper training, means, supervision, and back-up. The inputs for such a programme to succeed and the constraints of its replication on a large scale should not be underestimated.