Maternal mortality reports.

• Tenlastelegging: News from ICM, members and partners

A report published on the website of the Global Health Council analyses two successful cases of sustained reduction of maternal mortality over decades and confirms the validity of ICM's strategies of widening access to midwifery care.

With an average per capita income of just US$740, Sri Lanka has attained low levels of maternal mortality, rivalling those in developed countries with far greater incomes. Underpinning this success in Sri Lanka is widespread access to improved maternal health care through strong public investment in the overall health system, the professionalisation and broad use of midwives, the systematic use of health information to identify problems and guide decision making, and targeted quality improvements. Sri Lanka's successes also depended on higher levels of female education and improvements in basic living standards.

Honduras, like Sri Lanka, has achieved a stunning decline in maternal mortality despite its status as one of the poorest countries in the Western Hemisphere. The Honduras case study was undertaken during the period from 1990 to 1997, when the maternal mortality ratio declined by 38%.

This remarkable success is also attributable to increased access to skilled care, which the Honduran Ministry of Health achieved by instituting community health clinics and rural birthing...