ABSTRACT
In the quest for a suitable basis for policy decisions relating to health, the reproductive process has been a major focus of attention. The extreme adversity involved in maternal death provided a natural reason for identifying maternal mortality as a measure of reproductive health. Infant mortality too was obviously tragic for families, frequent among the poor, and, like maternal mortality, unacceptable in a society with evolving humanistic obligations. The possibility of developing more adequate measures of reproductive success has undoubtedly formed part of the frame of reference of the investigators who have studied various pregnancy outcomes other than infant deaths. The concept of reproductive efficiency that is most compatible with values of a democratic society relates reproductive efficiency to a social goal of maximizing individual welfare in the area of fertility. The concept has two parts: that only wanted births will occur, and that the outcome of such births will be healthy children capable of survival.
