Leave no one behind – the case for global maternal health action.

Leave no one behind – the case for global maternal health action.

 

In an article published originally on Broad Agenda, Send Hope Not Flowers Board Director Tara Taubenschlag focuses on the need to address maternal mortality rates in conjunction with broader gender equality measures.

Every two minutes, somewhere in the world, a woman dies from complications due to pregnancy and childbirth. That’s more than 300,000 women each year. 99 per of these deaths are preventable, and 98 per cent of deaths occur in developing countries.

These women are the backbone of their communities. They are not only mothers; they are often the teachers, health care providers and leaders in their communities. Further, as the Women’s Economic Empowerment report emphasises, women’s participation in all spheres of life is essential to sustainable and durable peace and to the realisation of human rights. When a mother dies during childbirth, it has a profound impact on the entire community.

The highly-anticipated second report , ‘Leave no one behind: A call to action for gender equality and women’s economic empowerment’  of the United Nations Secretary-General’s High-Level Panel on Women’s Economic Empowerment was released in March 2017. The report identifies practical actions for taking the economic agenda forward.

As UN Secretary-General António Guterres higlights: “Women’s economic empowerment is at the heart of the 2030 Agenda. We will not achieve the Sustainable Development Goals if there is no accelerated action to empower women economically.”

The report stresses that while over the past two decades there has been some progress in closing gender inequalities in education, there still is much to do to achieve the full and equal participation of women in society and in the economy.

SGD3 & SGD5 – the need to address both equally.

Sustainable Development Goal 3 – reducing maternal mortality rates, has links to Sustainable Development Goal 5 [SDG 5] which aims to achieve gender equality and empower all women and girls by 2030. One of SDG 5’s targets is to ensure universal access to sexual and reproductive health and reproductive rights.  According to the Women’s Economic Empowerment report, the World Bank estimates that costs associated with violence against women amount to an estimated three per cent of global GDP due to lost productivity. Meanwhile, approximately 35 per cent of women worldwide are victims of physical and/or sexual violence in their lifetimes.

This could be further complicated by the reinstating and expansion of the Mexico City Policy by the US Administration, also known as the ‘global gag rule’, which will have devastating consequences on the health of women and girls around the globe. Restriction of access to safe family planning violates women’s rights to health, life, education, dignity, and information.

Each year, more than 65 000 women die world-wide as a consequence of unsafe abortion, and over five million women suffer injury, in many cases permanent. To put this another way, 13 per cent of all deaths in pregnancy are due to unsafe abortions. There is that withdrawal of safe termination of pregnancy does not reduce abortion rates, but rather makes it less safe for women. Unintended pregnancy and unsafe abortion kills women and orphans families.

According to the United Nations Department of Economic and Social Affairs, every dollar spent on family planning saves between two and six dollars in that need to be invested in other development goals, such as education, health, water, sanitation, immunisation, malaria, and women’s economic advancement programs.

The Women’s Economic Empowerment report affirms that ‘Women’s economic empowerment is the right thing to do and the smart thing to do’. However, progress requires local and global action by all parts of society to achieve scalable and sustainable change. I challenge the next United Nations Women’s Economic Empowerment report to go one step further, to look at women’s maternal health outcomes in conjunction with their economic empowerment agenda.  Because we need concrete action to accelerate progress towards Sustainable Development Goal 3 of reducing global maternal mortality first, in order for women to truly achieve full and equal economic participation… leaving no-one behind.

I help run the maternal health charity, Send Hope Not Flowers. We are a small voluntary board of like-minded Canberrans who have come together to do what we can to help more mothers survive childbirth in developing countries.

Our team comprises co-founders Professor Steve Robson – specialist obstetrician and gynaecologist, and Emma Macdonald – Associate Editor of HerCanberra, Alex Fahey – entrepreneur, and myself, a corporate communications specialist. We have one main goal; to reduce maternal mortality through projects which are long-term, sustainable and empowering for women in developing countries, such as education and training of midwives and birth attendants or supplying basic obstetric equipment to assist with birth.

Our concept is very simple. When a baby is born in Australia, there is a better way to celebrate than sending flowers. For the cost of a bunch of flowers, you can send a beautiful, personalised birth card to a mother explaining that a donation in her honour has gone to help save the life of another mother somewhere in the world.

The Sustainable Development Goals [SGD Goal 3] sets a target of reducing the global maternal mortality ratio to less than 70 per 100,000 live births by 2030. So far, progress in developing countries – particularly those on our doorstep like Papua New Guinea – has been too slow to achieve this.

The disparity in maternal health outcomes between women in Australia and Papua New Guinea, Australia’s closest neighbour, is incomprehensible.  As our understanding of the science of pregnancy has advanced, death during pregnancy has become a rare event for us. In Australia, 7.1 women in every 100,000 births die per year, compared with 500 out of 100,000 in Papua New Guinea.

The Women’s Economic Empowerment report highlights the powerful role of private and civil society partnerships and encourages new collaborations, promoting new commitments that will carry the work forward.

This is what we are working towards at Send Hope Not Flowers.

Through our partnerships, we fund practical, long-term and sustainable projects which empower women and improve maternal health outcomes in some of the most remote areas in the world.

Our partnership with Australian doctor, Barry Kirby, is a case in point.

mums
Dr Barry Kirby conducting health checks for women in PNG.

Dr Barry Kirby has spent a decade devoting himself to assisting the women of Papua New Guinea – in particular, pregnant women in and around the 160 scattered islands that make up remote areas of Milne Bay Province.

In 2010 he undertook a ground-breaking in-depth study into the reasons why so many women were dying during childbirth. He meticulously retraced the last hours of 31 women who died during or shortly after labour.  In many cases the common cause of death was bleeding, infection, and prolonged obstructed labour – all of which can be addressed cheaply and with minimal resources.

Dr Kirby found that the women were reluctant to leave their village for a supervised birth at a health centre because they felt “shy at presenting in an impoverished state and not having baby supplies or clothes” and they lacked the $5 equivalent cost for a health centre birth or money to buy food while they were away from their village. Geographical challenges have a deep impact in this region too.

Send Hope Not Flowers partnered with Dr Kirby on a simple and cost-effective pilot program providing ‘Baby Bundle Gifts’ to encourage village women to access a supervised birth at a health centre throughout the Milne Bay Province rather than alone in their village.  The Baby Bundle includes funds to cover food and health centre costs as well as a collection of basic supplies for mothers and their newborns.

In a published in the Australian and New Zealand Journal of Obstetrics and Gynaecology, the use of “Baby Bundle Gifts” in the Milne Bay Province has resulted in an 80 per cent increase in the number of expectant mothers receiving medical assistance during labour, and has seen the death rate drop by a staggering 78 per cent.

barry'sbundles
Dr Barry Kirby and a plane load of baby bundles ready for delivery to some of the most remote arts of PNG.

In a country that faces the second highest maternal mortality rate in the Asia Pacific region after Afghanistan, the findings bring hope to global efforts to address the Sustainable Development Goals of reducing maternal deaths around the world.

Over the past five years, we have continued to work with Dr Kirby in Papua New Guinea, along with other experienced doctors and midwives from Australia and various Pacific nations including the Solomon Island, Indonesia, Vanuatu and East Timor. Every project we support is underpinned by scientific evidence, and we aim to evaluate all our project outcomes.

However, we still have a substantial task ahead. There are a great many barriers to tackle both directly and indirectly. Barriers highlighting layers of disadvantage ranging from geographical remoteness and a lack of maternal health education, through to the underlying issue of women’s rights and sexual violence against women in communities, all need to be addressed. Further, this needs to be a global agenda with public and private partnerships driving it together.

Tara Taubenschlag is the Managing Director of CMAX Advisory and a Board Director for Send Hope Not Flowers.