in extreme poverty, living on only $0.70 per day. poverty discourages women from seeking healthcare during childbirth. it is common for women to give birth at home for free instead of going to the hospital and being forced to pay “hidden" fees or ad hoc fees in order to receive care. this causes complications in childbirth. if a woman waits too long to seek care and experiences a complication during delivery, emergency attention is not given, and the woman, child, or both, face a higher risk of death. in angola, ad hoc demands at clinics are commonplace. kyllike christensson, co-author of "ad hoc demands," found while studying the social aspects of child birth behavior that it is not uncommon for patients to arrive at a hospital or a clinic in need of care and be forced to wait until payment is made. in many cases, women chose to have their children at home instead of go to a hospital. this reality, along with the negative level of confidence many women have of the clinicians, results in higher numbers of mmr and imr. policies to improve maternal health christensson explained that many international programs to improve maternal health are currently being developed and implemented in angola. the government has implemented programs that train midwife providers in order to increase the number of births attended to by a credentialed clinician. unicef has reported that the government is also investing money into education and health care. the money that is generated due to the large oil reserves in the country is being used to improve maternal and child health across the country. free clinics are available to pregnant women and women with small children. along with government programs in angola, many different non-governmental organizations are becoming involved with health care and maternal health. the christian children fund angola began a program in the country shortly after the end of the civil war. the program addressed malnourished children and specifically provided emergency obstetric care. programs like these vary in size and their ability to adequately reach large populations. however, they continue to be important in increasing maternal health throughout the country.