Monday, February 14, 2011

The Good News and the Bad News: Decreases in Maternal Deaths, But Not for Everyone

Mother and child in Ethiopia.
Over the past year, UNFPA and The Lancet released findings that offer a clear view of the maternal health interventions that save lives. This evidence affirms the efficacy of the most widely-used systems- and treatment-level interventions in the field. It clearly demonstrates good quality, comprehensive reproductive health services, including access to emergency obstetric care, family planning and antiretroviral (ARV) therapy, is key to reducing maternal mortality. And this complement of care must be delivered in strong, fully functional health systems.

Global reductions in maternal deaths are finally appearing at the population level, for the first time during my career. This holiday season, unlike any before, we can reflect on these accomplishments with renewed pride based on hard evidence, proof that our work is creating real global change.

However, the vast gains made in some countries, while great cause for optimism, must not be allowed to mask the much slower progress—even reversals—in others, most especially those experiencing conflict and crisis. Fragile states do not have the functional health systems and the necessary trained clinicians, medicines and equipment to reduce maternal death.

Now that we have the evidence to confirm that our interventions save lives, we must continue to apply this knowledge to those most in need. Women still become pregnant and experience life-threatening complications during war and in the aftermath of floods and earthquakes. They want to prevent pregnancy in these circumstances; they still want to space or limit their births. The proven interventions to prevent maternal death must be implemented or strengthened in countries experiencing or emerging from humanitarian emergencies.

Knowing what works isn’t enough. We’ll need the collective will and financial commitment to provide reproductive health care in crisis-affected countries that, to date, have been sorely lacking.

Women have a fundamental right to good quality care and a health system that can consistently provide it, no matter the crisis going on around them. When these are prioritized, we can expect an even more dramatic decline in women’s needless suffering and death.

Therese McGinn, DrPH, Director, The Reproductive Health Access, Information, and Services in Emergencies (RAISE) Initiative. The RAISE Initiative works to catalyze change in how reproductive health is addressed by all sectors involved in emergency response, from field services to advocacy, from local aid providers to global relief movements.