Scope
The Safe Motherhood program organised by Malaysia's Ministry of Health and the World Health Organization was launched in 1989. Pasir Mas was one of the district chosen for the project. It is now a decade after implementing Safe Motherhood Pasir Mas district initiative and although the journey was long but the results has been encouraging and the community response have been rewarding.

Background
Malaysia's experience in reducing maternal mortality span across three and a half decades of initiating, field testing, implementing and modifying strategies of health interventions. Initiatives have continued in the area of maternal health care, this include the national initiative on safe motherhood in the district of Malaysia Pasir Mas, a district with extremely high maternal death ratio was chosen to implement the strategies of the Safe Motherhood initiatives.

Main Activities
The use of color coding system as a methodology for assissing risk and expedities referral. Color coding improves the sensitivity by classifying mothers into high risk /low risk groups.

Problem identification and solutions by study group of the Pasir Mas initiative in managing pregnancy and delivery complications.

The birthings center in Pasir Mas offers delivery facilities to low risk mothers who are reluctant to use the hospital for delivery.

Evaluation Findings.
Qualitative evaluation with individual and group and among the health professionals involved in the program showed high acceptance of the strategies strategies.

There was also found to be a high level of involvement by family members, the community and health personnels in combating maternal deaths.

Management Features
Strategy: The program adopted the high risk approach system which seeks to provide maternity care for all, but more for those identifed at being at higher risk of pregnancy and delivery complications. In this process, all pregnant women in the clinic are categorised by a color system which denotes the level of health care needed.

Human Resource Management: The clinic manager conduct training for the nursing personnels and the risk approach system  on the management of ante natal cases. Training also takes place through on-the-job experience. Despite special motivational courses to general personnel and to inspire performance, staff turn over is high, particularly among doctors and the rural setting is an unattrractive factor for some staff.

Mobilizing resources: The budget comes from the Ministry of Health, WHO and UNFPA contributed funds and technical support to the safe motherhood program.

Leadership: The leadership of the national coordinator of the safe Motherhood Initiate in Malaysia and the hard work, dedication, commitment and preseverance of all health workers are the main ingredients to the successful implementation of the program.

Health education, information and motivation programs for women empower them to take responsibilities and informed choice for their pregnancy.

Education and involving men, family members and traditional birth attendants in the care of women during pregnancy and childbirth provide further support for maternal health.

The Quality Assurance (QA) program in the Initiative is a tool to measure, monitor and improve maternal health care, One of the QA indicators is the confidential inquiry to maternal death which was implemented to evaluate occurances of maternal deaths.