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COMMENTARY: Good News on Mother’s Day   
A Commentary by CEDPA President Carol Peasley May 5, 2010 — As Mother’s Day approaches in the United States, we should pause to applaud some good – even great – news. As reported in the British medical journal, The Lancet, global maternal mortality has declined significantly: from 526,300 women in 1980 to 342,900 in 2008. For those of us working in the global health field, this was remarkable news, as prior research had no significant improvement for more than a decade. So, let us applaud this success and thank those who have worked so hard over the decades to achieve it. They have proven that investments in global health make a difference. This includes the kind of work CEDPA is doing in places like northern Nigeria, where we facilitate community-based emergency ambulance services, as well as the advocacy work we support in India and Nigeria to enhance the voices of women in pushing their governments to increase investments in women’s health. Speaking of voices, as I read the Lancet article, my thoughts went immediately to the 26 women who were at CEDPA last fall to attend a reproductive health leadership workshop. They so eloquently spoke about the challenges they face – and they reminded me of the countless women I have met around the world who have not had adequate reproductive health care. I remain haunted by those memories. Simultaneously, I also remain inspired by their extraordinary commitment to make a difference. Take a listen to them – they will make the Lancet article far more real. We also need to look more deeply at the details of the research. Global progress has been impressive, but it is not universal. Only 23 developing countries are on track to achieve the Millennium Development Goal 5, to reduce maternal mortality by 75 percent between 1990 and 2015. Some such as China, Egypt, Ecuador and Bolivia are making great strides. Others are making progress, but far too slowly. And, tragically, some countries are seeing maternal mortality increase, often because of high HIV infection rates. This is especially true in southern Africa – with Zimbabwe’s maternal mortality rate nearly tripling since 1990. As a “wanna be” health researcher, I couldn’t resist looking at the detailed tables in the Lancet article. The numbers come alive and so clearly tell side stories: the effects of HIV infections in some countries, and even the apparent effects of governance and women’s rights in keeping maternal mortality rates high in other places. For example, I can’t help but wonder what impact Afghanistan’s failed governance and collapsing infrastructure had on maternal mortality, which spiraled high between 1990 and 2000. I also, of course, wanted to look at the factors that contributed to improved maternal health. Four are cited: increased availability of skilled birth attendants who can provide emergency services; higher educational levels for women; improved incomes; and lower fertility rates. This last factor is an especially important message that should come out of the Lancet article. Family planning is critically important – and we must do a better job of telling that story. When women have access to family planning services, they can delay and space pregnancies – and thus ensure that they are better able to give birth to healthy children and not be injured themselves while giving birth. Family planning services save lives! So, as we celebrate Mother’s Day and the significant results reported by The Lancet, let us also reaffirm our commitment to continued and even enhanced investment to reduce maternal mortality in every country – even here in the U.S. where mortality rates have slightly risen and are unacceptably high (twice as high as in Europe or Canada). This means more investment in health systems, in HIV prevention and care, in family planning, in emergency obstetric care, in girls’ education, and in the economic empowerment of women. Then it truly will be a happy Mother’s Day! |
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