Today marks the International Day for Maternal Health and Rights, when – in addition to calls for better healthcare provision for women before, during and after pregnancy – activists will call for the day to be officially recognized by the UN.
It’s true that more attention needs to be devoted to maternal health. According to WHO, more than 300,000 women (830 every day) die every year in pregnancy and childbirth, over 99 percent of them in low and middle income countries. Unfortunately, this burden of death is only part of the picture. A study published in the Lancet estimated that untreated pregnancy and birth complications lead to disability among 10-20 million women every year. The personal, social and economic costs of families being left without a mother, or with a mother whose ability to support her family is undermined by disability, still takes too great a toll. This is unacceptable in the 21st century, especially when so much of the burden is entirely preventable.
There has been progress in recent years; WHO estimates that global maternal deaths dropped by 43 percent between 1990 and 2015. However, the international community failed to deliver MDG5, the Millennium Development Goal that committed governments to reducing maternal mortality by 75 percent during the same period. The 2030 Agenda for Sustainable Development gives governments another chance to reduce the burden of poor maternal health, with SDG 3 – “Ensure healthy lives and promote well-being for all at all ages” – committing them to reducing the global maternal mortality ratio to less than 70 per 100,000 live births by 2030. Under SDG 3, governments have also committed to ensuring “universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes.”
Now is the time for individual countries to implement strategies to help them meet these goals. Overall efforts to strengthen health systems in low and middle income countries will help, particularly for women with pre-existing health conditions like diabetes. Better recording and use of health data would help governments identify the drivers of maternal mortality and disability in their country, and inform targeted policy decisions to reduce that burden. Greater professionalization of healthcare would also help; women are less likely to suffer adverse outcomes if they are receiving respectful care from properly trained care workers. Efficient and cost-effective models to increase access to emergency obstetric care in rural areas – like Vital Strategies’ Maternal Health program in Tanzania – can also be implemented more widely to deliver rapid and significant improvements in low and middle income countries.
We also need to do more to encourage women – and men – to plan to use the available healthcare facilities and support them to ensure that the costs of care, supplies or transport don’t pose a barrier. Far too many women still arrive at health facilities when it’s too late to save mother, child, or both – because they hadn’t planned to deliver there. Greater access to and use of family planning would also make a significant difference by enabling women to space their pregnancies in a way that supports their own health. In fact, this benefits the whole family because parents can ensure they have the economic resources and social support to best feed, raise and educate the children they have before deciding whether to add to their family. Better maternal health reduces the risk of miscarriage, stillbirth and neonatal deaths, too.
Yet in spite of all the evidence around the health, social and economic benefits of these strategies, there are still arguments around gender equality and reproductive rights that will hinder progress on SDG 3. UN recognition of the International Day for Maternal Health and Rights could help to break down the historic and cultural barriers that are preventing the acceptance and implementation of interventions to improve maternal health.
While recommitting to the work Vital Strategies already does in the field of maternal health, where we have been able to deliver change and save lives, today we join global calls for the provision of effective maternal health care to be recognized as a fundamental right for all women everywhere.