Reducing maternal mortality: the role of matrons?

Maternal mortality remains a major global health issue for which little or no progress is recorded in many countries. The international community is mobilised on this issue and many ongoing initiatives. Currently there is a debate on the role of matrons in the fight to reduce maternal mortality. These traditional midwives preceded any form of delivery assisted by health professionals. We cannot recommend calling upon matrons on a large scale as there is not enough evidence of their impact, even after they have undergone continuous professional development or been trained. Their role is established with regards to perinatal health. For mothers, matrons can contribute to the improvement of health practices during the pregnancy, and during and after delivery and childbirth. Whilst some laud calling upon matrons who have undeniable cultural legitimacy, others consider them as a barrier to reducing maternal mortality. This commentary supports that the tendancy to call upon their services is inexorably decreasing as a result of both urbanisation and improvement of access to health services. The role of matrons in places where access to health services is poor is not debatable as no other alternatives exist. Maternal mortality persists in countries or regions where inequalities in access to health services exist. The principle of equity dictates that we reduce these inequalities as soon as possible and is the only way to reduce maternal mortality at the global level. (Global Health Promotion, 2011; 18(4): 35-38)