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PRIORITYMEASURE43
“Ensure that all women have effective access to comprehensive health care during the reproductive process and specifically to skilled, institutional, compassionate
obstetric care and to the best possiblematernal health services during pregnancy, childbirthand the puerperium, aswell as to services that include the
terminationof pregnancy in those caseswhere the lawprovides for such services, and guarantee universal access to assisted fertility treatments.”
Possible lines of action
1. Implement a system of Essential Obstetric and Newborn Care (EONC) that includes: (i) clinical training in essential obstetric and
newborn care; (ii) continuous improvement in the quality of care in health centres; (iii) care services that are compassionate and
culturally appropriate to users’ needs; (iv) community-based measures to boost demand for and access to health services; 2. Promote
participatory processes for achieving skilled childbirth care that responds to the cultural diversity of the population; 3. Ensure that
essential obstetric and newborn care is an integral component of primary health care; 4. Ensure that national legislation on sexual and
reproductive health care includesmeasures for universal access tomedically assisted procedures and techniques for becoming pregnant.
Targets
1. All primary healthcare centres have updated and culturally appropriate EONC protocols; 2. Achieve universal coverage for
institutionalmaternal health services; 3. Achieve universal coverage of infertility and subfertility care for personswho require it.
Tentative indicators
1. Percentage of primary healthcare centres that have implemented updated and culturally appropriate EONC protocols; 2. Percentage
of childbirths attended in health institutions; 3. Percentage of infertile or subfertile couples and individuals receiving assisted
fertility treatments.
Related instruments,
forums andmechanisms
SDG 3, “Ensure healthy lives and promote well-being for all at all ages”; target 3.1: “By 2030 reduce the global maternal mortality rate
to less than70 per 100,000 live births”.
Comments
1. The aspects relating to the inclusion of pregnancy termination and health services, in the cases covered by law, are spelled out in
PM 42, which also seeks to ensure that primary healthcare services have care protocols to deal with unsafe abortion. The matter of
compassionate obstetric care is developed further in PM 45; 2. This measure is complementary to PM 37 on access to comprehensive
SRH services, PM 40 onmaternal mortality, PM 42 on access to safe abortion services, and PM 45 on the detection of problems during
pregnancy, including at the preconception stage.
