By John W Townsend, PhD, Chair of the Rotary Action Group for Reproductive, Maternal and Child Health
According to the United Nations Population Fund, despite a nearly 50% drop in global maternal deaths in the past decade—from over 300 maternal deaths per 100,000 live births to around 150 maternal deaths per 100,000 births—there are still many countries in sub-Saharan Africa and South Asia where the death rates remain unacceptably high. In 2020, about two-thirds of the 800 daily maternal deaths occurred in sub-Saharan Africa and about one-fifth occurred in South Asia. For example, a woman in Nigeria is 200 more times likely to die in pregnancy or childbirth than a woman in Europe. Tragically, areas that have high maternal death rates also tend to have high neonatal death rates.
We already know that most maternal and neonatal deaths are preventable. I want to draw attention to the partnerships that we must achieve if we are to deliver health and reproductive justice for women and their children around the world.
In 2006, Professor Dr. Mahmoud Fathalla, former Director of the WHO and President of the International Federation of Gynecology and Obstetrics, said: “[Women] are dying because societies have yet to make the decision that their lives are worth saving.”
If we are to change societies’ responses, we need a better understanding of the costs of inaction, the bases for engagement that bring us together, and the building blocks of health systems requiring significant investments.
At the outset, we need to understand the costs of failing to act responsibly and ethically. There are three that I would like to mention:
First, we need to be aware of the continued tragedy of preventable deaths and long-term disabilities of women and their children. For every woman who dies, 20 are seriously affected with complications that require further care by an underfunded health system. The women’s suffering continues, and their infants suffer as well.
Second, due to the cost of health care and consequences of lost income, many families fall into poverty, making their progress toward health and development more challenging and often impossible.
Finally, in the long term, women and their communities delay or lose economic, social, and political opportunities while they seek to give life.
So, in terms of our response, small projects that merely address specific elements of maternity care or isolated health centers are simply not enough. Public health impact is only possible with a significant scale of operations for improving women’s overall health, adequate long-term financing, and persistent monitoring of the building blocks of health systems to ensure that the promised benefits are realized.
Cooperation between Rotary, the UN, and country governments and civil society organizations is compelling.
- We have a common commitment to Sustainable Development Goals 2, 5, 10, and 17 related to improved health, the reduction of inequalities, and the promise of partnership.
- We have a history of working together on global polio eradication with efforts ranging from financing to ensuring the last mile vaccination coverage and surveillance.
- We call for scaling up high impact practices, including respectful care, maternal death reviews, and quality delivery and contraceptive services.
The Rotary Action Group for Reproductive Maternal Child Health (RMCH), in cooperation with the government and civil society partners in Nigeria, pursues reproductive justice by responding to voices of communities and empowering women. This multi-faceted, large-scale project focuses on reducing maternal and newborn mortality rates through family planning, training doctors and health workers, increasing public awareness, and improving access to quality maternal and newborn health services and medicines. RMCH’s project has been proven to be highly effective in participating regions resulting in significant reduction in maternal and newborn mortality.
The moving stories of women who survive challenging labor and delivery circumstances demand that we commit to saving women’s lives. Our call to action is focused on:
- Increasing investments in health systems, including supply chains, human resources, infrastructure, and information.
- Supporting gender equality to ensure women’s health and empowerment.
- Facilitating greater evidenced-based high impact practices.
- Engaging communities for their voice and meaningful contributions, as well as equitable access to benefits.
- Ensuring collaboration with critical stakeholders for sustainable development.
It is time for our societies to firmly say, with one voice, that enough is enough! We will not accept the deaths of our mothers, sisters, and daughters as inevitable cases around the world. Their lives, and those of their children, are worth saving and worth investing in.
Yet, we can only eliminate these preventable deaths and the huge losses to families and countries if we pursue reproductive justice together. So, let us commit to these partnerships to ensure that women’s lives are saved.
If your club is interested in supporting maternal and child health, learn how you can take action and contact the Rotary Action Group for Reproductive, Maternal and Child Health for support with project planning and implementation and help finding partners, funding, and other resources.