By Girija Sankar, Global Health Action
The Global Maternal Health Conference, held in New Delhi, India from Aug 30-Sep 1 2010, was the first ever technical conference to focus exclusively on pressing maternal health issues around the world. It was also the first technical conference for me, a person used to participating in more academic conferences. I represented Global Health Action, an international NGO headquartered in Atlanta Ga, whose vision and mission is to improve the lives and health of communities around the world through training, capacity building and on-the-ground programs in community health and development.
I presented a poster on GHA’s maternal and child health project in rural Haiti-a five-year USAID funded project, with the objective of increasing and improving women’s access to pre and post-natal services in Petit Goave, Haiti. As I write this, I note with a sense of cautious optimism that according to the latest reports from the WHO, maternal mortality rates in Haiti have dropped from 670/100,000 in 1990 to 300/100,000 in 2008. Haiti, like many sub-Saharan countries has a long way to go, but it’s heartening to see that progress has been made, in no small part due to concerted efforts to improve maternal and child health through increased access to and quality of health services.
The conference, attended by well over a 1000 participants from around the world and with equal representation from academia, think tanks, and NGOs, was a true confluence of the latest in research, grassroots advocacy, policy planning and community based work on maternal health. Most presenters and panel speakers stressed that the Millenium Development Goal 5 o r MDG 5 (reduce by three quarters, between 1990 and 2015, the maternal mortality ratio and achieve, by 2015, universal access to reproductive health)is one goal that continues to fall short in many countries.
Many global/international conferences tend to run high on rhetoric and fall flat on achievements. I would argue that while this conference had rhetoric, it also spurred robust debate and dialogue on sensitive and critical issues such as the increasingly important role of midwives in maternal health care, the neglect of obstetric fistula, the continued dearth of skilled maternal health professionals and the need for skilled health providers at the community level.
Some of the best sessions that I attended though, had less to do with policy, planning or advocacy and more about evidence-based programming that delivered results. At the end of the day, results matter. Results do not always have to be positive, but unless and until health programs track progress and document results, no real progress can be made.
A session that stands out in my memory was the one on the role of media and publicity in maternal health programming. Market research in the Indian state of UP showed that no matter how good and classy public health messages were4, nothing could trump the primacy of human interaction (between client and service provider) in getting the message across about safe health practices, underscoring the need yet again for trained community-based health providers.
I also learned that progress can be slow and arduous but that it is indeed possible. For measurable progress, not just in maternal health but in any public health initiative, the following are absolutely essential:
1. The buy-in of local authorities: civil society organization HAVE to partner with local institutional mechanisms for any meaningful work and progress, and that
2. Training and supporting mid- and community-level health workers is critical to reducing maternal and infant mortality rates.
As Jill Sheffield of Women Deliver pointed out, maternal and indeed all public health programming around the world should be driven by the following motto: “Learning by doing and doing better by learning.” In other words, it’s not enough just to do but to learn while doing and doing better because of the lessons learned.
That’s the message I brought home with me to Atlanta and will strive to work by, with our programs in Haiti.