Reducing Maternal Mortality in Papua New Guinea: Contextualizing Access to Safe Surgery and Anesthesia

Papua New Guinea has one of the world's highest maternal mortality rates with approximately 215 women dying per 100,000 live births. The sustainable development goals outline key priority areas for achieving a reduction in maternal mortality including a focus on universal health coverage with safe surgery and anesthesia for all pregnant women. This narrative review addresses the issue of reducing maternal mortality in Papua New Guinea by contextualizing the need for safe obstetric surgery and anesthesia within a structure of enabling environments at key times in a woman's life. The 3 pillars of enabling environments are as follows: a stable humanitarian government; a safe, secure, and clean environment; and a strong health system. Key times, and their associated specific issues, in a woman's life include prepregnancy, antenatal, birth and the postpartum period, childhood, adolescence and young womanhood, and the postchildbearing years. Accepted for publication September 8, 2017. Funding: None. The author declares no conflicts of interest. This review was undertaken as part of work completed by Associate Professor Dennis at the University of Sydney as part of the completion of her Master of International Public Health. Reprints will not be available from the author. Address correspondence to Alicia T. Dennis, MBBS, PhD, MIPH, PGDipEcho, FANZCA, Department of Anaesthesia, The Royal Women's Hospital, The University of Melbourne, Locked Bag 300, Corner Grattan St & Flemington Rd, Parkville, Victoria 3052, Australia. Address e-mail to alicia.dennis@thewomens.org.au. © 2017 International Anesthesia Research Society

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