glossary

Abortion : Termination of pregnancy (expulsion or extraction of embryo/fetus) before 22 weeks of gestation or fetus weighs less than 500g. Abortion may be spontaneous (due to natural causes, such as miscarriage) or induced.

Amenorrhea : The absence of menstruation. Amenorrhea is physiological during pregnancy and lactation, and after menopause; it often occurs following a change of climate, work or environment; or it can be a symptom of disease.

Anemia : A condition in where there is a reduction in the number of red blood cells or in the amount of hemoglobin (concentration <110 g/l) present in them. Anemia can be caused by excessive blood loss, by not eating enough foods rich in iron and folic acid, by malaria and other parasitic diseases.

There are 3 degrees of anemia:

    • Moderate (70-109 g/l)
    • Severe (40-69 g/l)
    • Very Severe (<40 g/l)
Antenatal Period : The period from conception until the onset of labor, approximately 40 weeks.

Caesarean Delivery : Removal of the baby and placenta through a surgical procedure through a cut in the abdominal and uterine walls.

Case Fatality Rate : The number of fatalities (deaths) from a specific disease in a given period per 100 episodes of the disease in the same period.

Childbearing Years : The reproductive age span of women, assumed for statistical purposes to be 15-44 or 15-49 years of age.

Clean Delivery : Clean delivery is one that is attended by health staff in a medical institution or by a trained birth attendant at home observing principles of cleanliness (clean hands, clean surface, clean cutting of the cord).

Community Mobilization : Community mobilization uses deliberate, participatory processes to involve local institutions, local leaders, community groups, and members of the community to organize for collective action toward a common purpose. Community mobilization is characterized by respect for the community and its needs.

Contraceptive Prevalence : Percentage of couples currently using a contraceptive method.

Disability-adjusted Life Years (DALYs) : A measure used to express how a healthy life is affected by disease; it combines the years lost because of premature death and disability.

Domestic Violence : In recent years, the term "domestic violence" has begun to include other forms of violence including abuse of elders, children, and siblings. The term "domestic violence" also tends to overlook male victims and violence between same-sex partners. The more specific term "intimate partner violence (IPV)" is utilized more and is defined as actual or threatened physical or sexual violence, or psychological/emotional abuse by a spouse, ex-spouse, boyfriend/ girlfriend, ex-boyfriend/ ex-girlfriend, or date. Some of the common terms that are used to describe intimate partner violence are domestic abuse, spouse abuse, domestic violence, courtship violence, battering, marital rape, and date rape.

Eclampsia : A condition particular to a pregnant or newly delivered woman, characterized by convulsions, followed by more or less prolonged coma. The woman usually has hypertension (high blood pressure), edema (swelling), or proteinuria (abnormal amounts of protein in the urine). The convulsions may occur before, during, or immediately after birth. It happens in about 5% of all pregnancies; occurs most often during the first pregnancy, but can happen during any pregnancy. Up to 25% of eclampsia happens during the postpartum period.

Ectopic Pregnancy : Pregnancy outside of the uterus; a life-threatening condition that can cause massive internal bleeding or spontaneous abortion. The pregnancy must be surgically terminated.

Edema : A condition where excess fluid is absorbed by the body tissues causing swelling. This is due to: 1) an excess production of body fluids; and/or 2) failure of proper excretion and absorption mechanisms.

Episiotomy : An incision of the perineum (vaginal opening) at the end of the second stage of labor (birth of the infant).

Ergometrine : A drug used to prevent or control bleeding, its mechanism of action focuses increasing uterine contractions, which is also found naturally in some teas and herbs.

Essential Obstetric Care (EOC) or Comprehensive Essential Obstetric Care (CEOC) : Provides not only the means to manage emergency obstetric complications when they happen, but it also includes procedures for early detection and treatment to prevent the progression of problem pregnancies to the level of emergency.

    • Essential Obstetric Care (EOC)/Comprehensive Essential Obstetric Care (CEOC) - Includes all services at the Basic Essential Obstetric Care (BEOC) level plus:
    • Surgery (e.g., caesarean section, curettage, etc.)
    • Anesthesia
    • Blood transfusion
    • Basic Essential Obstetric Care (BEOC) — Includes specific interventions to manage "emergency" obstetric complications at a health center. Interventions include:
      • Antibiotics (injectable)
      • Oxytocic drugs (injectable)
      • Sedatives/anti-convulsants (injectable) for pre-eclampsia and eclampsia
      • Manual removal of the placenta
      • Removal of retained products
      • Assisted delivery
    • Emergency Obstetric Care (EmOC) — Responds to unexpected complications such as hemorrhage and obstructed labor with blood transfusion, anesthesia, and surgery. It does not include the management of problem pregnancies, monitoring of labor, or neonatal special care.
Comparison of Essential Obstetric Care (EOC) with Basic (BEOC) and Emergency Obstetric Care (EmOC)
BASIC EOC EOC/CEOC EmOC
  Surgical obstetrics x
  Anesthesia x
  Blood replacement x
x Management of problem pregnancies  
x Medical treatment x
x Manual procedures x
x Monitoring of labor  
x Neonatal special care  

Exclusive Breastfeeding : Feeding of an infant till age 6 months exclusively with breast milk and no other fluid or food (not even water) is given. Initiation of breastfeeding of infant occurs within one hour of birth.

Family Planning : The conscious effort of couples to regulate the number and spacing of births through artificial and natural methods of contraception. Family planning connotes conception control to avoid pregnancy and abortion, but it also includes efforts of couples to induce pregnancy.

Female Genital Cutting (FGC) : All procedures involving cutting away all or part of the external female genitalia or other injury to the female genital organs whether for cultural, religious or other non-therapeutic reasons. There are different types of FGC. In the first, the clitoris is partly or completely removed. In the second, the clitoris along with small skin folds of the outer genitals is removed. In the third type, infibulation, the outside genitals are cut away and the vagina is sewn shut. A small hole is left through which urine and blood can pass. Other types include the piercing, pricking or incising of the clitoris and/or labia, stretching of the clitoris and/or labia; scraping of tissue surrounding the vaginal orifice or the introduction of corrosive substances or herbs into the vagina.

Fertility : The actual reproductive performance of an individual, a couple, a group, or a population. See fertility rate.

Fertility Rate : The number of live births per 1,000 women of reproductive age, usually taken as 15-44 years, in a given year.

Fistula : An abnormal opening between two cavities (vagina/bladder, or vagina/rectum), which can lead to incontinence (inability to retain urine and/or feces).

The Five Cleans : Infections during childbirth are a major cause of maternal death. They can be prevented if the Five Cleans (childbirth and delivery practices) is adhered to:

    • Clean delivery service
    • Clean hands (of birth attendant)
    • Clean cord tie
    • Clean blade
    • Clean cord stump (without anything applied to it).
Five Major Direct Medical Causes of Maternal Death :

    1. Hemorrhage: Excessive bleeding during pregnancy or childbirth especially postpartum. Significant and uncontrolled loss of blood, either internally or externally from the body. Antepartum (prenatal) hemorrhage is that which occurs after the 20th week of gestation but before delivery of the baby. Postpartum hemorrhage is the loss of 500ml or more of blood from the genital tract after delivery of the baby

    2. Unsafe abortion: Induced termination of pregnancy by an unqualified or unlicensed person.

    3. Sepsis: Infection in the blood stream.

    4. Eclampsia: A hypertensive disorder of pregnancy accompanied by proteinuria (albumin in the urine), convulsions and body swelling.

    5. Obstructed labor: Baby is not passing through the birth canal and medical intervention is required, and often requires a caesarean section (surgery).

Folic Acid : A Vitamin B complex nitrogenous acid needed for the development of normal red blood cells. Deficiency of folic acid before pregnancy can result in neural tubal defects in the newborn/fetus.

General Fertility Rate : This is a fertility rate as it expresses the births relative to the number of women of reproductive age. It substantially controls for age and sex structure by relating the births to roughly the women at risk of having them.

Births during the year
Women 15-44 or 49 at mid-year x 1,000

Genital Prolapse : A condition in which the vaginal wall or uterus descends below their normal positions; part of the bladder or rectum may protrude from the vagina.

Gonorrhea : A sexually transmitted disease (STD) caused by the bacterium Neisseria gonorrhoea. A common cause of urethral and vaginal discharge and of discharging eyes in newborns. During pregnancy, gonorrhea infections can cause premature labor and stillbirth.

Gravida : Refers to the number of times a woman has been pregnant. It does not matter at what point during the pregnancy the pregnancy is terminated. Nor does it matter how many babies were born from the pregnancy. A multigravida woman is a pregnant woman who has previously had more than one pregnancy.

Gross Reproduction Rate (GRR) : This is a period measure very similar to the Total Fertility Rate (TFR) except that it considers only female rather than all births. Therefore, it uses female age-specific fertility rates. The GRR can be interpreted as the average number of daughters a woman would have if she survived to at least age 50 and experienced the given female age-specific fertility rate (ASFR).

Hemorrhage : Significant and uncontrolled loss of blood, either internally or externally from the body. Antepartum (prenatal) hemorrhage is that which occurs after the 20th week of gestation but before delivery of the baby. Postpartum hemorrhage is the loss of 500ml or more of blood from the genital tract after delivery of the baby. Primary postpartum hemorrhage occurs in the first 24 hours after delivery. Secondary postpartum hemorrhage occurs from 24 hours after delivery up to 6 weeks postpartum. A woman can lose 500 cc of blood in one minute. A woman can lose all of the blood in her body (5 Liters) in 10 minutes.

Herpes : There are two types of genital herpes: herpes simplex virus-1 and herpes simplex virus-2. The herpes simplex virus (HSV) a common cause of genital blisters and ulcers. During pregnancy, herpes may cause miscarriage or stillbirth.

Human Immunodeficiency Virus (HIV) : A virus that attacks the body's immune system, making the body unable to fight infection. It can cause AIDS, which is the last stage of HIV infection. HIV is the most dangerous sexually transmitted infection. Worldwide, over 36 million people were infected with HIV at the end of 2000, 95 percent of them in development countries.

Hypertension : High blood pressure usually above 140 (systolic)/90 (diastolic). It has various causes, such as heart disease, kidney disease and pre-eclampsia. A differentiation should be made between pregnancy-induced hypertension, which occurs in pregnancies without previous history of hypertension and that is associated with pre-existing hypertension.

Incomplete Abortion : An abortion whereby any products of conception remain in the uterus.

Indicators : Quantifiable measures of program performance and impact.

Infant Mortality Rate (IMR) : The number of deaths of infants under age 1 per 1,000 live births in a given year.

Deaths under age 1 in year x 1,000
Live births in year

Information, Education and Communication (IEC) : Activities designed to increase awareness or promote a certain health intervention or behavior.

Informed Choice : The client's ability to freely choose a contraceptive method from a range of options based on accurate and useful information and an understanding of her/his own needs.

Integrated Services : Availability of multiple health services. For example, family planning and STD treatment through a single facility.

Intrapartum Period : Within the period of labor and delivery.

Labor : First stage labor includes dilation of the cervix. Second stage encompasses delivery of the fetus. Third stage is expulsion of placenta and membranes.

Lactational Amenorrhea Method (LAM) : A family planning method that relies on breastfeeding as natural protection against pregnancy for up to six months after childbirth. Women who use LAM must fully breastfeed or nearly fully breastfeed to protect themselves from pregnancy.

LAM is defined by three criteria:

  1. the woman's menstrual periods have not resumed, AND
  2. the baby is fully or nearly fully breastfed, AND
  3. the baby is less than 6 months old.
When any of these three criteria is no longer met, another family planning method must be introduced in a timely manner to ensure healthy birth spacing.

Laparotomy : The surgical opening of the abdomen; an abdominal operation.

Lifetime Risk of Maternal Death : The probability of becoming pregnant and the probability of dying as a result of the pregnancy cumulated across a woman's reproductive years.

Live Birth : Complete expulsion or extraction from its mother of a baby, irrespective of the duration of the pregnancy, which after such separation breathes or shows any other evidence of life such as beating of the heart, pulsation of the umbilical cord or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached.

Low Birth Weight : The weight at birth is less than 2500 g.

Manual Vacuum Aspiration : A method of removing tissue from the uterus by suction for diagnostic purposes or to remove the elements of conception.

Maternal Morbidity : Illness or disability occurring as a result of or in relation to pregnancy, childbirth or in the postpartum period.

Maternal Mortality : The death of a woman while pregnant, during delivery or within 42 days (six weeks) of termination of pregnancy, irrespective of the duration and the site of pregnancy. The cause of death is always related to or aggravated by the pregnancy or its management; it does not include accidental or incidental causes.

Maternal Mortality Rate : The number of women who die while pregnant or during the first 42 days following delivery per 100,000 women of reproductive age in a given year for any cause related to or aggravated by pregnancy, but not from accidental or incidental causes. The rate reflects the maternal mortality ratio and the fertility rate; it is influenced by the likelihood of becoming pregnant and by the obstetric risk.

Number of maternal deaths in a year
100,000 women of reproductive age in the population

Maternal Mortality Ratio : The ratio reflects the risk women face of dying once pregnant. The number of women who die during pregnancy or during the first 42 days after delivery per 100,000 live births in a given year from any cause related to or aggravated by pregnancy, but not from accidental or incidental causes.

Number of maternal deaths in a year
100,000 live births in a year

Midwife : " A midwife" has successfully completed the prescribed course of studies in midwifery and has acquired the requisite qualifications to be registered and/or legally licensed to practice midwifery. She must be able to give the necessary supervision, care and advice to women during pregnancy, labor and the postpartum period, to conduct deliveries on her own responsibility and to care for the newborn and the infant.

This care includes preventive measures, the detection of abnormal conditions in mother and child, the procurement of medical assistance and the execution of emergency measures in the absence of medical help. She has an important task in health counseling and education, not only for the woman, but also within the family and community. The work should involve antenatal education and preparation for parenthood and extends to certain areas of gynecology, family planning and childcare. She may practice in hospitals, clinics, health units, domiciliary conditions or in any other service." (Joint ICM/FIGO/WHO definition, 1992).

Neonatal Death Rate : The number of deaths in the first 28 days of life per 1,000 live births in a given year.

Neonatal deaths in first 28 days of life in a year
1,000 live births in a year

Net Reproductive Rate (NRR) : The average number of daughters that would be born to a woman (or group of women) if she passed through her lifetime conforming to the age-specific fertility and mortality rates of a given year. This rate is similar to the gross reproductive rate (GRR) but, takes into account that some women will die before completing their childbearing years. An NRR of 1 means that each generation of mothers is having exactly enough daughters to replace itself in the population. See also total fertility rate and replacement-level fertility.

Obstetric Emergency : A severe, life-threatening condition that is related to pregnancy or delivery that requires urgent medical intervention (EmOC) in order to prevent the likely death of the woman.

An obstetric emergency:

  • May occur any time during a pregnancy, delivery or up to six weeks after childbirth may occur suddenly without any warning
  • Is life-threatening
  • Requires urgent action
  • The patient must be taken to a hospital or first referral unit without delay.
Oxytocic Drug : A drug that stimulates contractions of the uterus. It is used to both induce and accelerate labor or to prevent or treat postpartum hemorrhage.

Parenteral : Drugs administered by injection or intravenous infusion (drip).

Pelvic Inflammatory Disease (PID) : PID is a progressive infection that harms a woman's reproductive system. It occurs throughout the pelvic area, the fallopian tubes, the uterus, the uterine lining and ovaries. PID can lead to sterility, ectopic pregnancy and chronic pain.

Perinatal Death : Death of a fetus occurring between the time a fetus weighs at least 500 g (or after 22 completed weeks of gestation) and the seventh day after birth of a live-born infant.

Perinatal Mortality Rate : This rate avoids the difficulty of defining a live birth and combines late fetal and early neonatal deaths.

Stillbirths + Deaths under 1 week x 1,000
Still + Live births

Placenta : The organ that develops on the inner wall of the uterus and supplies the fetus with all its life-supporting requirements and carries waste products to the mother's system.

Post-Abortion Care : Includes emergency treatment of incomplete abortion and potentially life-threatening complications. It also refers to post-abortion family planning counseling and services.

Postneonatal Mortality Rate : The annual number of deaths of infants ages 28 days to 1 year per 1,000 live births in a given year.

Postpartum Period : After childbirth; the period from the delivery of the placenta through the first 42 days after delivery.

Postpartum Hemorrhage : The loss of 500 ml or more of blood from the genital tract after delivery of the baby, usually occurs in the first 2 to 4 hours after delivery but can occur later. In anemic mothers, a lower level of blood loss should be the cut-off point for starting therapeutic action.

Primary postpartum hemorrhage is all occurrences of bleeding within 24 hours of the delivery of the baby. Secondary postpartum hemorrhage is all cases of PPH between 24 hours after delivery and 6 weeks postpartum. (Prevention & Mgmt of PPH, WHO 1989)

Pre-eclampsia : A condition in pregnancy manifested by hypertension, edema and/or proteinuria (excess protein in urine).

Prenatal Period : The period between conception and birth (same as antenatal).

Proteinuria : The presence of >300 mg/l or more of albumin, a protein substance, in the urine, which is often associated with pre-eclampsia and eclampsia.

Puerperal Sepsis : Infection of the genital tract occurring at any time between the onset of rupture of membranes or labor and the 42nd day postpartum or abortion, in which two or more of the following are present:

  • Pelvic pain
  • Fever of 38.5 or more
  • Abnormal vaginal discharge (e.g., presence of pus)
  • Abnormal smell/foul odor of discharge
  • Delay in the rate of reduction of size of uterus (<2cm/day during first 8 days)
Puerperium : The period following delivery when the womb returns to normal; normally six weeks after birth.

Rate : A measure of the frequency of some event in a defined population at a specified time. In a rate, the numerator is a subset of the denominator.

Ratio :  A measure of the frequency of one group of events relative to the frequency of a different group of events (e.g., the number of abortions per 1,000 live births — abortion ratio).

Replacement-Level Fertility : Replacement-level fertility is the level of fertility at which women in the same cohort have exactly enough daughters (on average) to "replace" themselves in a population.

Reproductive age : 15-49 years for a woman. See also childbearing years.

Reproductive Health : State of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. Reproductive health therefore implies that people are able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. Implicit in this last condition are the right of men and women to be informed of, and to have access to safe, effective, affordable and acceptable methods of family planning of their choice, as well as other methods of their choice for regulation of fertility which are not against the law, and the right of access to appropriate health-care services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant. (ICPD Programme of Action, A/CONF.171/13, paragraph 7.2).

Reproductive Tract Infection (RTI) : RTI is a general term including sexually transmitted infections (STIs), infections caused by an overgrowth of organisms normally present in the genital tract, and iatrogenc infections acquired during improperly performed medical procedures.

Retained Placenta : A placenta that remains inside the uterus after delivery for greater than 2 hours.

Safe Motherhood : The goal of safe motherhood is to ensure that every woman has access to a full range of high-quality, affordable sexual and reproductive health services, especially maternal care and treatment of obstetric emergencies to reduce death and disability.

Septic Abortion : Abortion-related uterine and pelvic infection.

Service Standards : Organizational rules that specify qualifications and acceptable levels of performance for personnel.

Sexually Transmitted Disease (STD) : Any infection that is acquired through sexual contact in a substantial number of cases. See also Sexually Transmitted Infection (STI).

Sexually Transmitted Infection (STI) : Any infection that is acquired through sexual contact in a substantial number of cases. See also Sexually Transmitted Disease (STD).

Skilled Birth Attendant : Refers exclusively to people with midwifery skills (for example, doctors, midwives, nurses) who have been trained to proficiency in the skills necessary to manage normal deliveries and diagnose, manage, or refer obstetric complications. Ideally, the skilled attendants live in, and are part of, the community they serve.

Social Mobilization : Social mobilization involves planned actions and processes to reach, influence, and involve all relevant segments of society across all sectors from the national to the community level, in order to create an enabling environment and effect positive behavior and social change.

STD/STI Management : The care of a client with an STD/STI; this includes activities such as history-taking, physical examination, laboratory tests, diagnosis, treatment and health education about treatment and prevention, follow-up assessment, and referral when indicated.

Stillbirth : The death of a fetus weighing at least 500 g (or when birth weight is unavailable, after 22 completed weeks of gestation or with a crown-heel length of 25 cm or more), before the complete expulsion or extraction from its mother.

Stockout : No supplies are left of a given product or products.

Syphilis : The effect of syphilis on a fetus is very serious. If untreated, the risks of stillbirth or serious birth defects are high. Birth defects include damage to the heart, brain, and skeleton as well as blindness. It is very important for pregnant women to consider testing for syphilis early. Pregnant women with syphilis can be treated to prevent damage to the fetus.

Tetanus : An acute infectious disease due to Clostridium tetani growing anaerobically at the site of injury. It is found in cultivated soil and manure, and therefore likely to infect accidental wounds. There is a state of more or less persistent, painful tonic spasm of some of the voluntary muscles.

Total Fertility Rate : The average number of children that would be born alive to a woman (or group of women) during her lifetime if she were to pass through her childbearing years conforming to the age-specific fertility rates (ASFR) of a given year. See also Gross Reproduction Rate (GRR) and Net Reproduction Rate (NRR).

Sum of ASFRs
1,000 		  x 5

Traditional Birth Attendant (TBA) : A traditional birth attendant is a person (usually a woman) who assists the mother during childbirth and who initially acquired her skills delivering babies herself or through apprenticeship to other traditional birth attendants. The TBA is generally an older woman, almost always post-menopause and has borne one or more children herself. She lives in the community in which she practices.

Trained Traditional Birth Attendant (TTBA) : A trained TBA is a TBA who has undergone a short course of training conducted by the modern healthcare systems to upgrade her skills.

Unsafe Abortion : Defined as a procedure for terminating an unwanted pregnancy either by persons lacking the necessary skills or in an environment lacking the minimal medical standards, or both. Unsafe abortions are characterized by the lack or inadequacy of skills of the provider, hazardous techniques and unsanitary facilities.

Uterine Prolapse : A condition in which the uterus protrudes into, and sometimes out of, the vagina.

Uterine Rupture : Tearing or bursting of the uterus may follow obstructed labor, or may occur during pregnancy or labor following previous caesarean section.

Vagina : The tube that forms the passage between the cervix/uterus and the vulva. It receives the penis during sexual intercourse and serves as the delivery passage for birth and for menstrual flow.

Vaginal Discharge : The symptom or syndrome where women present with an abnormal discharge from their vagina. It can suggest vaginal infection or a cervical infection.

Vaginal Fistula : A hole that develops between the vagina and the rectum or bladder, often as a result of obstructed labor. Openings in the birth canal that allow leakage from the bladder or rectum into the vagina. Often as a result of obstructed labor.

Violence Against Women : Any act of gender-based violence that results in physical, sexual or mental harm or suffering to women.

Sources

"Ensure Skilled Attendance at Delivery". New York, NY: Safe Motherhood Initiative.

"Fact Sheet No. 241: Female Genital Mutilation". Geneva: World Health Organization, 2000.
http://www.who.int/mediacentre/factsheets/fs241/en/index.html

"Fact Sheet No. 245: Essential Obstetric Care". Geneva: World Health Organization, 2000.
http://www.who.int/mediacentre/factsheets/fs245/en/index.html

FAQ 3, "Frequently Asked Questions on: The Lactational Amenorrhea Method (LAM)." Washington, DC: LINKAGES, 2000.

Glossary, Reproductive Health Outlook (RHO). PATH.
http://www.rho.org/html/glossary.html

Guidotti, Richard, David Jobson. Detecting pre-eclampsia: practical guide using and maintaining blood pressure equipment. Geneva: World Health Organization, 1992.

Huddart, Jenny, Joyce Lyons, Donna Bjerregaard. Integrating Reproductive Health into NGO Programs. Volume 2: Safer Motherhood for Communities. Boston, MA: Initiatives, Inc., 1999.

Mother-Baby Package: Implementing safe motherhood in countries. Geneva: World Health Organization, 1996.
http://www.who.int/reproductive-health/publications/MSM_94_11/mother_baby_package_safe_motherhood.pdf

"MotherCare Policy Brief 1". Arlington, VA: MotherCare.
http://mothercare.jsi.com/pubs/PolicyBriefs/policy_brief1.htm

Nachbar, Nancy, Carol Baume, Anjou Parekh. Assessing Safe Motherhood in the Community: A Guide to Formative Research. Arlington, VA: MotherCare, 1998.

The Prevention and Management of Postpartum Hemorrhage. Report of a Technical Working Group 3-6 July, 1989. Geneva: World Health Organization, 1989.

The Prevention and Management of Unsafe Abortion. Report of a Technical Working Group, 12-15 April, 1992. Geneva: World Health Organization, 1992.

Reproductive Health During Conflict and Displacement: A Guide for Programme Managers. Geneva: World Health Organization, 2000.

Reproductive Health in Refugee Situations: An Inter-Agency Field Manual. Geneva: United Nations High Commissioner for Refugees, 1999.

Ross, Susan Rae. Promoting Quality Maternal and Newborn Care: A Reference Manual for Program Managers. Atlanta, GA: CARE, 1998.

World Health Organization (WHO). "Reduction of Maternal Mortality, A Joint Statement