Definition and Determinants of Maternal Health Outcomes in Pregnancy

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The definition of reproductive health adopted at the International Conference on Population and Development in 1994 captures the essential characteristics that make reproductive and sexual health unique compared to other fields of health. Reproductive health extends before and beyond the years of reproduction, and is closely associated with socio-cultural factors, gender roles and the respect and protection of human rights, especially – but not only – in regard to sexuality and personal relationships.
The adoption of these comprehensive definitions at the International Conference on Population and Development marked the beginning of a new era, and the achievements of the past decade are many and profound. For example, the concept of reproductive and sexual health and rights has, with few exceptions, been widely accepted and has begun to be used by international health and development bodies, national governments, nongovernmental organizations and other parties. New reproductive health policies and programmes have been defined in almost all countries. Their adoption has produced significant changes in some countries in the conventional modes of delivering maternal and child health or family planning services.
Following this conceptualization of, and commitment to, reproductive and sexual health, new partnerships have been forged at national, regional and global levels. New evidence has also been collected in previously neglected areas such as the burden of disease due to reproductive and sexual ill-health and its relation to poverty, and gender-based violence. The number of evidence based best practices in reproductive and sexual health care has grown substantially, and the scope of clinical and behavioural research and of internationally recognized standards, norms and guidelines has broadened.


Experience has shown that, even in low-income settings, innovative country-specific approaches can considerably reduce maternal mortality and morbidity, for example. The challenge now is to formulate innovative national strategies for making health services accessible to the people in greatest need, such as adolescents and the poor, in order to attain international goals.

The strategy to accelerate progress
The overarching objective of the strategy is to accelerate progress towards meeting internationally agreed reproductive health targets and, ultimately, to attain the highest achievable standard of reproductive and sexual health for all.
Guiding principle: human rights
WHO’s strategy for accelerating progress rests on internationally agreed instruments and global consensus declarations on human rights, including the right of all persons to the highest attainable standard of health; the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so; the right of women to have control, and decide freely and responsibly on, matters related to their sexuality, including sexual and reproductive health-freely and responsibly on, matters related to their sexuality, including sexual and reproductive health – free of coercion, discrimination and violence; the right of men and women to choose a spouse and to enter into marriage only with their free and full consent; the right of access to relevant health information; and the right of everyone to enjoy the benefits of scientific progress and its applications. In order to ensure that these rights are respected, policies, programmes and interventions must


promote gender equality, give priority to poor and underserved populations and population groups, especially adolescents, and provide special support to those countries that bear the largest burden of reproductive and sexual ill-health.

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