JAMA : the journal of the American Medical Association
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Maternal mortality is one of the great neglected problems of health care in developing countries. The World Health Organization estimates that approximately 500,000 women die each year from pregnancy-related causes, more than 98% of these deaths occurring in the developing world. Maternal mortality rates in developing countries are as much as 100 times higher than those seen in industrialized countries. ⋯ It is suggested that no new or costly technologies are needed; rather that appropriate priority-setting and allocation of needed resources are essential to the solution of the problem. There are few interventions that hold much hope of success at the village level, although antibiotics, ergonovine maleate, and sedatives might be usefully utilized, after appropriate training. Overall, however, networks of maternity care facilities, trained personnel, and means of transport are necessary to provide needed emergency maternity care services.
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The consequences of childbearing for adolescent parents, their children, and society are severe. We have focused exclusively on one consequence of adolescent sexual activity, namely, pregnancy. In so doing we are not denying the presence of other serious consequences of sexual activity, including sexually transmitted diseases, particularly the acquired immunodeficiency syndrome. ⋯ They also are in influential positions to improve the availability of preventive contraceptive services through development of community-based services. The Robert Wood Johnson High-Risk Youth Programs are an excellent example of the types of community-based services that should be provided for adolescents. Physicians can serve as an educational resource about a wide spectrum of health issues for young persons and their families and communities.(ABSTRACT TRUNCATED AT 250 WORDS)