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A confidential system of enquiry into maternal mortality, based on that used in England and Wales, was introduced in Malaysia in 1991 with a view to identifying deficiencies in care and recommending remedial measures.

Despite its many advantages, the employment of women in economic activity in India has been associated with increased mortality for infants and young children. Simultaneously, narrower gender differentials in child mortality among employed women have been noted.

India is a signatory to the Alma Ata declaration and has committed herself to achieving "Health for All by the Year 2000". Since then, a lot of planning, effort and public expenditure has been devoted to improving the health of the people both in rural and urban areas of the country.

Every minute of every day a woman dies as a result of pregnancy or childbirth. The loss per annum of 500,000 women is mind boggling. A maternal death is the outcome of a chain of events and disadvantages throughout a woman's life.

In recent years, there has been increased recognition of the scope and significance of gynaecological problems experienced by poor women in developing countries.

Maternal death has been recognized as an area of maternity care that requires urgent attention. The most striking feature about maternal health today is the extraordinary difference in maternal death rates between developed and developing countries.

Acceptance and sustained use of family planning especially of modern spacing methods have generally been low in developing countries particularly in India. The use rate for modern spacing methods was only 6 per cent among the eligible couples in India in 1992 (IIPS, 1995).