To help reduce the maternal and infant death rate, Terre des hommes works, within the context of malnutrition, on the improvement and promotion of mother and child health. The biological unit of mother and child are inseparable, and the health of the young child is inextricably linked to that of its mother. All our prevention work with young children (less than 3 years old) therefore also includes prevention work with women of child-bearing age.

Young children, including the foetus and breast-feeding and pregnant mothers are particularly vulnerable to malnutrition risks as they are all in a phase of rapid growth. Maternal nutrition also has to be re-enforced. In addition to antenatal care, reproductive health activities, particularly in the area of family planning, need to be encouraged at the time of delivery and following the birth.
Terre des hommes relies on the initiative “Safe Motherhood”, launched by the World Health Organisation in 1987, to develop its interventions.


Safe Motherhood
Out of the 500,000 maternal deaths per year, the majority are in developing countries. Whilst millions of women survive complications, they are left suffering from acute or chronic pain, or even a permanent handicap. The complications that the women suffer from, during pregnancy or delivery, also affect the foetus. About 8 million infants die each year, half of these deaths occur in the first months of life and a significant proportion within the first few days after birth. The millions of children that survive are nevertheless affected by physical or mental problems for the rest of their lives.

Most of the complications linked to pregnancy can be effectively avoided or taken care of without the need for onerous technology or medicine. Available and accessible sanitary care and a system for managing complications are all that is required.

In order to ensure a safe pregnancy, three areas need to be addressed simultaneously. To reduce the number of high risk and unwanted pregnancies, the number of complications, and the mortality rate of women suffering from complications.
Improving the availability and access to family planning information and services reduces the number of high risk and unwanted pregnancies and also leads to a reduction in the number of maternal deaths. The amount and severity of the complications can be slowed down by guaranteeing access to quality care, during and after delivery, to all women. Finally, access to obstetrical care helps to reduce the mortality rate amongst women suffering from complications.

There are simple measures to be taken before and during the pregnancy, during the delivery, and after giving birth, for the mother and the new-born.
1. Before and during the pregnancy: advice and the provision of a family planning service; prevention and management of sexually transmitted diseases; vaccinations; antenatal registration and care; treatment of existing conditions (for example malaria); nutrition and diet advice; iron supplements; recognition, early screening and management of complications.
2. During delivery: safe and hygienic delivery; recognition, early detection and management of complications at health centre or hospital.

3. After delivery – mother: recognition, early detection and management of complications at health centre or hospital; postpartum care (promotion and support of breast-feeding); information and family planning service; prevention and management of sexually transmitted diseases; vaccinations.
4. After delivery – newborn: resuscitation; prevention and management of hypothermia; early and exclusive breast-feeding; prevention and management of infections.


Reproductive health
Reproductive health is generally considered to be a primary objective throughout the entire world. It affects the lives of men and women, from conception to birth, through adolescence right up to the elderly, and it covers access to healthcare, health protection as well as the prevention and treatment of illnesses.

The required conditions for a population to enjoy good reproductive health are:
- a favourable environment – politically, legally and culturally
- knowledge provided to individuals in order for each one to manage and protect their own reproductive health
- provision of a large range of quality health services – accessible, appropriate, efficient and at an affordable price.

These conditions assume the participation of a number of different groups – government, private sector, NGO, and of course people that want to protect their own reproductive health. Most of these countries have for a long time supplied reproductive health services – family planning and maternity care – but these often work independently from each other. The challenge is to integrate them and put in place complete reproductive health programmes.