A review of maternal mortality in Malaysia

There has been a significant decline inmaternal mortality from 540 per 100,000 live birthsin I957 to 28 per 100,000 in 2010. This decline is dueto several factors. Firstly the introduction of the ruralhealth infrastructure which is mainly constructing healthcentres and midwife clinics for the rural population.This provided the accessibility and availability ofprimary health care and specially, antenatal care forthe women. This also helped to increase the antenatalcoverage for the women to 98% in 2010 and it increasedthe average number of antenatal visits per women from6 in 1980 to 12 visits in 2010 for pregnant women.Along with the introduction of health centres,another main feature was the introduction of specificprogrammes to address the needs of the women andchildren. In the 1950s the introduction of Maternaland Child Health (MCH) programme was an importantstep. Later in the late 1970s there was the introductionof the High Risk Approach in MCH care and SafeMotherhood in the 1980s. In 1990, an important stepwas the introduction of the Confidential Enquiry intoMaternal Deaths (CEMD). Another significant factor inthe reduction is the identification of high risk mothersand this is being done by the introduction of the colourcoding system in the health centres. Other factorsinclude the increase in the number of safe deliveries byskilled personnel and the reduction in the number ofdeliveries by the Traditional Birth Attendants (TBAs).The reduction in fertility rate from 6.3 in 1960 to 3.3 in2010 has been another important factor. To achieve the2015 Millennium Development Goals (MDG) to furtherreduce maternal deaths by 50%, more needs to be doneespecially to identify maternal deaths that are missed byomission or misclassification and also to capture the latematernal deaths.