1. Policy Brief: Maternal Mortality Case Of LESOTHO By M Ramathebane M Thoothe

2. Maternal mortality is high in the country at about 720 deaths per 100,000 live births, this is having a negative impact on the family life, health of the women, increase in number of orphaned children including economy of the country. The goal is to reduce maternal mortality and to improve access to health facilities. Encourage facility based deliveries. Mayor is requested to lead multi-sectoral approach for reduction of maternal mortality.

3. Issues of concern Medical causes: – HIV/AIDS – Pregnancy Induced Hypertension – Bleeding During pregnancy, labour And After Delivery – Multiple Pregnancies Socio-economic causes – Behaviour – Access to health services – Transport – Finance – Health systems Cultural causes: Beliefs Practices

4. Contributing Factors Some of the contributing factors are: Poverty Traditional and cultural practices Home deliveries at about 4 out of 10. Lack of infrastructure (roads, poor housing, lack of safe water and sanitation, electricity, etc.) Low opinion about unfriendly health services.

5. Policy We have good policies that address primarily the biomedical issues to be dealt with at health facilities, however they fail to adequately address socio-economic and cultural issues to pregnant women. there is poor implementation and enforcement of these existing policies/guidelines such as the Antenatal care guidelines.

6. Recommendations Some of these deaths could be prevented If delivery occurred in the health facilities under skilled health providers Proper information is passed on Building of proper road for ease of access to health facilities We therefore, request your leadership and intervention involving relevant sectors to tackle this challenge

7. Key Stakeholders Min. of Transportation Roads Agency Social development Infrastructure Emergency services Community Development Min. of education Traditional healers NGO’S and CBO’S Health Community structures

8. Health Argument Medical causes: Failure for a pregnant to attend antenatal clinics may have impact to the mother and child Socio-economic Failure to reach the health facilities on time may result in death of the mother and child Cultural women belief in attending clinic in the later stage to prevent from be-witched Taking traditional medicines to fasten labour process

9. Health to other-sector argument All sectors involved with clear action plan and task allocation to address and give solutions to the problem

10. Health to societal goal argument Health Education Empowerment Social relieve

11. ECONOMIC EVIDENCE Economic Burden: Orphans Decreased number of workforce

12. EVIDENCE DHS NSDP States that the death of pregnant women should be reduced to below currently the 480/100 000 country is standing at 720/100 000 Evidence is collected through manual data collection, Trend analysis

13. Policy Strengths brief Point form National Concern Require Multi-sectoral Collaboration Clear targets Weaknesses Inadequate time Too much literature Information /topic broad inadequate Skills Inadequate Leadership

14. Final Decision Since the country did not meet the target led to the National requested to identify the gaps: In terms of Existing policies – Inputs – Processes – outputs