The current paper examines the realities of women delivering in resource-poor settings, and recommends cost-effective, scalable strategies for making these deliveries safer. Ninety-five percent of maternal deaths occur in poor settings, and the largest proportion of these deaths are women who deliver at home, far away from health care facilities, and without financial access to skilled providers. This situation will improve only when policymakers and programme planners refocus their attention on service delivery and financing interventions, with the potential to reach the largest portion of women living in places where mortality is the highest. We suggest three feasible interventions that can potentially minimise both demand and supply side problems of safe delivery: (1) misoprostol to treat postpartum haemorrhage, an easy to use and heat stable technology to reduce the leading cause of maternal deaths; (2) alternative providers, such as clinical officers, trained to offer emergency obstetric care services; (3) financing safe delivery through vouchers or other mechanisms that can be implemented in poor settings and made attractive to the donor community through output-based assistance (OBA).

Keywords: postpartum haemorrhage; maternal mortality; safe delivery; vouchers; misoprostol

Published In Global Public Health, Volume 4, Issue 6 November 2009 , pages 575 – 587

This comment in the explores the role of policy and research in using the prevention of postpartum hemorrhage and suggest a joint meeting by WHO and FIGO to revisit the 2009 statement by WHO which does not recommend the use of misoprostol at the community level.

This article is a response to letters sent in to Science regarding the article “Reassessing HIV Prevention” by Potts M, Halperin DT, Kirby D, Swidler A, Marseille E, Klausner JD, Hearst N, Wamai RG, Kahn JG, Walsh J. 2008 May 9;320(5877):749-50. 2008;

The authors argue, “Population-level disease control efforts must be evidence-based, culturally acceptable, and feasible (as male circumcision and partner reduction are).”

This revised and updated Atlas provides a comprehensive guide to modern contraceptive practice. The book is heavily illustrated with color photographs and line drawings that guide the reader through the various options available and provide a valuable educational resource. The supporting text offers a concise description of family planning in today’s world.

Family planning is needed, simple and inexpensive. This book provides an invaluable resource for the wide range of physicians and allied health workers who advise and deliver contraceptive care.

Evolutionary psychology posits that certain behaviours are universal because they helped the genes of a particular species to survive across the generations. In the case of human beings, such behavioral predispositions evolved to adapt us to the Stone Age rather the modern world. Patriarchy, we suggest, has deep roots in human evolution.

Published in Journal of Family Planning and Reproductive Health Care, July 2008

The largest investments in AIDS prevention targeted to the general population are being made in interventions where the evidence for large-scale impact is uncertain.

Published in Science 2008 May 9;320(5877):749-50