Maternal mortality in Maghreb: problems and challenges of public health.

The epidemiology of Maternal Mortality (MM) associated with practical field specificities led, inter alia, to adopt consensus approaches developed by international community in order to control the situation (MM in 2015 of  303000 with 830 daily deaths by perinatal complications). Application degree of these approaches, while based on scientific evidence, remains country-dependent, with emerging problems within large geographical entities. This is the case of the Maghreb countries* that are facing concrete realities requiring better state commitment, allocation of resources and time, and improved accessibility to the continuum of care. Public health remains the leading discipline in maternal health offering expertise in analysis and intervention that will not be enough to implement effective programs, because it is essential to consider practical realities, often poorly known or ignored. The required efficiency needs a large, egalitarian and multi-disciplinary partnership with socio-anthropology, health economics, political science and political and community mobilization specialists. Strategies adopted by Maghreb countries* must be updated and adapted to national and then regional specificities by involving stakeholders in concerned sectors. In addition, to implant mechanisms ensuring best governance and actor's accountability, it is a priority to support quality assurance projects, institutionalize partnerships between different care levels and opt to accreditation of maternal health care structures and services. A depth reflection seam necessary for implementation of mobile health support schemes that provide maternal care with enhanced proximity and better adaptation to real needs of communities. * The article concerns exclusively the following 3 countries: Tunisia, Algeria and Morocco.