A new commentary from champions of the Safe Motherhood Initiative calls out the need for urgent, focused action from donors and countries as imperative to making progress towards ending preventable maternal mortality. The authors of the commentary include colleagues from EPMM/IMHM partner organizations USAID and White Ribbon Alliance. While the authors represent a range of perspectives on maternal health—coming from the international aid, civil society, and research communities—as members of the Safe Motherhood Initiative, they all agree that “no woman, no matter in what country she resides, should die of complications during pregnancy, childbirth or the postpartum period, nor lose her newborn in the process.”
The authors point out that in the effort to end preventable maternal mortality, “context matters” and describe a series of “societal, technical, and political shifts” that play a role in driving maternal health and survival outcomes. This list emphasizes the importance of the social, political, and economic determinants of maternal health when it comes to tracking progress towards ending preventable maternal mortality (echoing the key themes in the EPMM Strategies), and highlights the need for a set of validated, well-developed indicators that align with those determinants. The IMHM project aims to address this need by conducting research to test and validate indicators that focus on the more distal determinants of maternal health and survival.
The commentary’s authors also argue that focused efforts to engage funders and country decision-makers as well as increased attention to improving health systems and monitoring, are critical steps that can advance progress towards better health and better outcomes for all women. They write: “Each nation will need to set its own course with a rededication to the ‘unfinished agenda’ of ending preventable maternal mortality with context-specific actions. These include effective policies, adequate budgets, and state-of-the-art monitoring and quality improvement systems.” The IMHM project supports the authors’ perspective, partnering with in-country research organizations to test indicators for distal determinants of maternal health and survival, and holding national dialogues to ensure the indicators being developed and tested are both meaningful and useful to countries.
Ending preventable maternal mortality and eliminating disparities in the lifetime risk of maternal death by achieving the “grand convergence” of maternal mortality ratios between higher and lower income countries is possible, but will require an enormous concerted effort from a wide range of stakeholders. With still more than 300,000 maternal deaths each year worldwide, this is no time to drop the focus on maternal health. As Stanton, et al. remind us, “success will require that ending preventable maternal mortality remains a political priority.”