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COMMUNITY INTERVENTIONS TO REDUCE MATERNAL MORTALITY

IN LOW-RESOURCE AREAS

Henrique Djosci Coêlho de Sá1

Vinicius Costa de Mello Farah2

Lucca Fernandes Alevato3

José Sérgio Martins Neto4

Paulo Víctor Elias Sobrinho5

Abstract: Maternal mortality, dened as the death of women during pregnancy, childbirth or in

the postpartum period, continues to be a serious public health problem, especially in low-resource

1 University of Gurupi

2 Souza Marques College

3 Souza Marques College

4 Souza Marques College

5 Universidad Sudamericana

6 Souza Marques College

7 Souza Marques College

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areas. Factors such as limited access to quality healthcare, lack of infrastructure, shortage of qualied

professionals and socio-economic inequalities contribute to high mortality rates. In many of these

regions, community interventions have been key to reducing maternal mortality by providing direct

assistance to pregnant women, promoting health care education and strengthening the link between

in low-resource areas to reduce maternal mortality, evaluating their strategies, challenges and the results

obtained in improving maternal survival rates. This study is a systematic review that investigates the

effectiveness of maternal health interventions in low- and middle-income countries, focusing on skilled

birth attendant programs, community transport, and technological innovations. The analyses were carried

These actions are especially important in remote areas, where access to health facilities is limited.

Another key aspect of these interventions is the promotion of safe practices during childbirth and the

strengthening of emergency transport systems, ensuring that pregnant women at risk can be transferred

to health centers equipped to deal with complications. The introduction of simple technologies, such

as clean delivery kits and essential medicines, has shown promising results in reducing infections and

hemorrhages, which are primary causes of maternal mortality. Awareness campaigns also play a crucial

role, educating the population about the importance of prenatal care, proper nutrition and birth assistance

in controlled environments. These initiatives aim not only to improve knowledge about maternal health,

but also to combat cultural and social barriers that can prevent pregnant women from seeking medical

care in a timely manner. It is concluded that community interventions have proven to be an effective

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safe delivery practices and raising awareness about antenatal care are strategies that have contributed

signicantly to improving maternal health outcomes. However, for these interventions to be sustainable

and scaled up, continued public policy support, adequate funding and the integration of these actions

with formal health systems are essential.

these deaths occurring in low- and middle-income countries, mainly in regions of sub-Saharan Africa

and South Asia (Hounton et al., 2015).

mortality, promoting the training of local health agents and the strengthening of health systems at the

of traditional birth attendants and community health workers, who play a crucial role in antenatal and

childbirth care. These interventions have shown promising results in improving access to basic care,

reducing obstetric complications, and increasing coverage of essential services such as vaccination and

medication administration to prevent postpartum hemorrhages and infections (Kruk et al., 2016).

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health services due to lack of transportation or geographical distance from health centers. Interventions

that create community networks for emergency transport, or that establish mobile clinics in remote

areas, have been shown to be effective in reducing response time and preventing preventable maternal

deaths (Sacks and Kinney, 2020).

for communication and monitoring of pregnant women, has shown potential to overcome structural

barriers and improve the surveillance and treatment of maternal complications (Nabukenya et al., 2020).

interventions in low- and middle-income countries, focusing on skilled birth attendant programs,

community transportation, and technological innovations. The analyses were carried out in databases

such as PubMed, BMC Pregnancy and Childbirth, and African Journal of Reproductive Health, using

data from articles published between 2015 and 2021.

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health.

or mobile technology on maternal health.

the implementation of multifaceted strategies adapted to local realities. One of the main challenges

faced by these regions is the lack of adequate infrastructure, which results in limited access to quality

maternal healthcare. In this sense, the training of traditional midwives and community health agents has

proven to be an effective intervention to overcome this barrier, as these professionals are often closer to

pregnant women and can offer basic care and referrals in emergency situations. Studies have shown that

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the presence of trained midwives is associated with a signicant reduction in maternal mortality rates,

especially in rural regions, where access to hospitals is limited (Gupta et al., 2021).

access to emergency care quickly and efciently. One of the problems often encountered in low-

resource areas is the lack of adequate transportation for obstetric emergencies. To mitigate this problem,

several community interventions have focused on establishing emergency transport systems, often in

collaboration with the community itself, such as the use of community transport vehicles or motorcycle

taxi networks to get pregnant women quickly to health centres. These strategies have shown success in

countries such as Uganda, where maternal mortality has been reduced in regions that have implemented

problems and encourage the search for appropriate care. Such educational interventions signicantly

raise awareness of the importance of antenatal care and reduce cultural and social barriers that prevent

women from seeking care (Yaya et al., 2019).

interventions. The use of mobile technology, such as health apps and text messaging, has allowed for

more effective monitoring of pregnant women in hard-to-reach areas. These technologies facilitate

communication between community health workers and hospitals, improving response time to obstetric

emergencies. In addition, mobile apps help in the collection of data on maternal health, allowing for

a more accurate assessment of local needs and the formulation of more targeted interventions. A

study conducted in Kenya demonstrated that using SMS to remind pregnant women of their antenatal

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outcomes (Zurovac et al., 2018).

and culturally sensitive. Cultural and social barriers, such as stigma regarding seeking formal health care

or resistance to the use of contraceptive methods, can make it difcult to implement interventions. Thus,

programs that involve the community from the beginning and that are adapted to local cultural norms

tend to have greater acceptance and effectiveness. In this way, interventions that integrate traditional

health practices and respect local values are more successful in reducing maternal mortality, as they

promote community engagement and trust in health services (Kruk et al., 2016).

CONCLUSION

resource areas has proven to be an effective and necessary approach, especially in regions where access

for greater adherence to health programs, and overcoming stigmas associated with maternal health are

complex, but not insurmountable. By promoting health education and community engagement, it is

possible to signicantly reduce maternal mortality and improve health outcomes for both mothers and

babies. In addition, the integration of new technologies, such as mobile applications, points to a future

in which the monitoring of pregnant women and communication between health teams can be further

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strengthened, considering the particularities of each context. Only with a joint and continuous effort,

involving governments, health professionals and communities, will it be possible to reduce maternal

mortality rates in low-resource areas and provide more equitable and quality care for all pregnant

Outcomes in Rural Burkina Faso.” BMC Pregnancy and Childbirth, vol. 15, 2015.

Kruk, M.E., Kujawski, S., Moyer, C.A., et al. “Next generation maternal health: external shocks and

health-system innovations.” The Lancet, vol. 388, no. 10057, 2016.

Sacks, E., and Kinney, M.V. “Respectful Maternity Care: A New Maternal Health Service Delivery

practices in low-resource settings.” Journal of Maternal Health, 35(3), 258-267.

Nabukenya, J., Mirembe, F., & Asaba, R. (2020). “Community-based transport interventions and

maternal mortality reduction in Uganda.” African Journal of Reproductive Health, 24(1), 112-120.

Yaya, S., Ghose, B., & Udenigwe, O. (2019). “The role of education in improving maternal health in

sub-Saharan Africa.” BMC Public Health, 19(1), 89-96.

Zurovac, D., Sudoi, R. K., & Akhwale, W. (2018). “Mobile health technology in maternal care: Impact

on antenatal care attendance in Kenya.” Global Health, 14(4), 79-85.