ASSESSING THE MATERNAL HEALTH SITUATION

When designing a maternal health program, one needs to examine the
magnitude and causes of maternal death, the level of infrastructure,
accessibility and use of health services, and other efforts to address this
problem. In addition, there should be an environmental analysis to
understand the role of government, private providers and NGOs in the
area, and what donors are supporting to foster effective partnerships.
This section describes several ways to collect maternal health data
including some questions to use when appraising the maternal health situation
in a specific context and a framework to analyze the data.
A. Environmental Assessment
An environmental assessment, a broad review of the operating environment,
can be done as part of data collection, or it can be done initially
to get a sense of the situation and then done more in-depth during the
data collection phase. This will depend somewhat on the understanding
of the situation and the secondary data available. For example, it was
easy for CARE in Bangladesh to do an initial environmental assessment
because we have a long history in Bangladesh and there is ample data.
Regardless of when you decide to do the assessment, it is important and
can give valuable insight into where your organization can be the most
effective.
The first step of the assessment is to understand your own organization’s
strengths and weaknesses.
CARE is engaged in a broad-based effort to reduce poverty through programs
in agriculture, natural resource management, income generation,
education, health and emergency relief. These diverse efforts are unified
through the Household Livelihood Security Framework, which is the
organizing construct for CARE’s programming. This holistic approach
helps CARE bring together programs at the household level to work
towards poverty reduction.
A fundamental feature of CARE’s current and future health programming
is the foundation provided by the Health Security Framework. The second step of the assessment is understanding the essential components