Disease. Drought. Conflict. It is not your imagination; there are more emergencies today than in years past. Storms are growing more frequent and extreme in some regions, while other areas are becoming more arid, with growing seasons disappearing before farmers’ eyes. More competition for scarce resources means more displacement and more conflict.
The numbers are shocking. Each year, 2.8 million babies die during their first 28 days of life, while almost 800 women die every day in pregnancy or childbirth.
A vast majority of these deaths are preventable through simple interventions: providing mothers and their children with access to basic, quality health care, especially during pregnancy and childbirth; encouraging mothers to breastfeed; and treating diarrhea and pneumonia, two of the leading killers of children under 5 years of age.
Despite the impressive progress that has been made in recent years, achieving the Millennium Development Goals (MDGs) on reproductive, maternal, newborn and child health (MDGs 4, 5 and 6) by 2015 will require an all-out global push.
In June, the U.S. Agency for International Development (USAID) announced a major realignment of US$2.9 billion of its resources to “save up to half of a million children from preventable deaths by the end of 2015.” In addition, USAID introduced an ambitious strategy, Acting on the Call: Ending Preventable Child and Maternal Deaths, to dramatically increase progress in 24 countries that account for 70 percent of child and maternal deaths.
This is an important policy shift — one that has the potential to have great impact on development by saving the lives of 15 million children and nearly 600,000 women by 2020. FHI 360, a member of the Advisory Group for Acting on the Call, supports USAID’s commitment. We have seen how evidence-based interventions in maternal, newborn and child health are making a difference in communities around the world.
Worldwide, we have seen maternal deaths decline in recent years. In no small part, this is due to an underappreciated commitment by a highly valued global human resource: midwives. As the 30th Triennial International Confederation of Midwives (ICM) Congress begins in Prague, we must recognize that midwives provide a critical entry point for pregnant women and their newborns to receive life-saving health care services that are respectful and women-centered.
A range of services is necessary to protect and enhance women’s health and well-being before, during and after a pregnancy. Most maternal deaths are caused by the underlying health conditions of the mother before or during pregnancy, or by poor quality care in the critical hours and days before and after a birth.
Four key services comprise the continuum of care during pregnancy:
- Antenatal care with a skilled provider, ideally to include several visits beginning in the first trimester
- Delivery with a skilled attendant, including the routine monitoring of the progression of the delivery and the availability of drugs, such as oxytocin, for the prevention of postpartum hemorrhage
- Immediate emergency care for medical complications that arise during pregnancy and childbirth
- Postpartum and postnatal care for the mother and baby shortly after birth to ensure both are healthy and that the baby receives essential newborn care while the mother receives family planning counseling
Midwives throughout the world are capable of providing a range, if not all, of these services. But their role is more crucial in health care systems in low- and middle-income countries. In some regions, midwives are already making a dramatic difference by providing pregnancy and delivery services in low-resource settings. We need to ensure that regions without such midwifery-led services receive equal access.