Washington, DC, 9 May 2002 (PAHO)-- Some 23,000 women die every year in Latin America and the Caribbean from causes related to the pregnancy. As a part of its activities to promote safe motherhood in the Americas, the Pan American Health Organization (PAHO) is supporting essential obstetric care systems in the 11 Latin American countries with the highest maternal mortality rates.

According to PAHO, "Maternal mortality represents a serious public health problem. Its causes are avoidable and it is the maximum expression of social injustice, since it is in the countries with lower economic development that the highest number of maternal deaths occur and those which have greater risk of dying from pregnancy, childbirth, or puerperium are the poor women."

The Organization is working to ensure that decision-makers help women gain access to quality services and care by trained staff, and to avoid discrimination based on sex, age, economic condition, race or religion and to promote the legal framework that allows the exercise of reproductive rights and the participation of the whole community.

In addition to the more than 23,000 pregnancy-related deaths, many more women suffer from prolonged related illness. The chance of dying during a woman's reproductive lifetime. In the United States, a woman's chance of dying is 1 in 3,500.

The direct obstetric causes of these illnesses coincide with ones observed elsewhere in the world: hemorrhage, pregnancy-induced hypertension, sepsis, obstructed and prolonged labor, and complications related to abortion.

"The results of qualitative and quantitative studies in the region indicate that maternal and neonatal health services are underutilized," according to a PAHO document. Reasons include cultural or physical barriers; perceptions on the part of the community of the quality and appropriateness of services; lack of awareness and understanding of problems occurring during pregnancy that require prompt action by providers.

To address the serious situation of mortality and maternal morbidity in the region, USAID is supporting the regional initiative centered on essential obstetric care, using advocacy, improving service quality and increasing community participation.

In view of the fact that many women die of unforeseen complications that require immediate and emergency treatment, the principal objective of this initiative is to improve essential obstetric care at the first level of care and comprehensive essential obstetric care in referral hospitals. The project also includes elements that stimulate women to seek these services and to ensure that policies promote the quality of the services, facilitating access to those in need.

Three pilot sites were established for the community and quality components in Ecuador, Bolivia, and Honduras and a fourth pilot site in Paraguay is underway. USAID, in collaboration with the implementing agencies, PAHO, the Quality Assurance Project (QAP) and John Snow, Inc. works with local and national authorities to achieve sustainable changes.

PAHO, which also serves as the Regional Office for the Americas of the World Health Organization, was established officially in 1902 and is the oldest health organization of the world. It works with all the countries of the Americas to improve the health and raise the living standards of their peoples.