By Dr. Christine Sow, Executive Director, Global Health Council
In 2000, the world set out ambitious goals to meet the needs of the world’s poorest. Of the eight Millennium Development Goals (MDGs), one was specifically focused on improving maternal health, with the target to reduce by three-quarters the maternal mortality rate and to ensure universal access to reproductive health services. The fact that maternal health received specific attention within the MDG agenda was significant in and of itself: it represented a long called-for recognition of the tragic state of women’s health.
Despite the clear targets set out in the MDGs, progress made on the goals to improve women’s health has been slow. Since 1990, the maternal mortality rate has dropped by 45%, but in 2013, 289,000 women still died in childbirth.1 Most of these deaths are occurring in sub-Saharan Africa and Southeast Asia, where services are unavailable or are of poor quality. And around the world, women still face impediments to postponing childbearing or spacing their pregnancies.
Improving access and quality of health services for women is not only the right investment to make, but it is also a cost-effective investment. It bears repeating that women are central to healthy families, and ultimately healthy communities. Losing a mother in childbirth deprives a family of income and any surviving children of nutrition and education.
The UN has estimated that the global financial impact of maternal and newborn deaths to be $15 billion per year in lost productivity; investing a dollar in family planning saves at least 4 dollars not treating complications from unplanned pregnancies.2 The World Bank estimates that for every 1,000 girls who get one additional year of education, two fewer women will die in childbirth.3
With the sun setting of the MDGs at the end of the year, the world’s attention has now turned to the content and structure of the Sustainable Development Goals (SDGs), the next development framework. Only one of these seventeen goals is specifically dedicated to health, which makes it all the more critical to re-emphasize the importance of maternal health and rights within the broader development agenda.
The SDGs have similar goals as those laid out in the MDGs: reduce preventable maternal mortality to less than 70 per 100,000 live births and ensure universal access to sexual and reproductive health services. These are laudable goals and we should work to ensure that poor women everywhere are able to access the same high quality health services as women of means. Geography, ability to pay and other social determinants of health should not necessarily equate with a sentence of death or disability.
The SDGs provide another strategic opportunity to ensure that maternal health is placed at the forefront of development, even if it appears under the rubric of the broader health goal. Many of the other goals also have relevance to health, and more importantly, to women’s health and empowerment. For example, SDG goal 8 “Promote inclusive and sustainable economic growth, full and productive employment, and decent work for all,” cannot be achieved without the active participation of healthy women in the workforce.
The challenge now is to ensure that maternal health continues to receive the attention under the SDGs that it had under the MDGs. While laudable, this next generation of development goals runs the risk of diluting attention to those in greatest need of health services and who are also the hardest to reach. We must continue to advocate for and insist on programming around maternal health; it is the right and most effective strategy for women, communities and families.
1 “Trends in Maternal Mortality: 1990-2013,” WHO, UNICEF, UNFPA, The World Bank, and the United Nations Population Division. http://apps.who.int/iris/bitstream/10665/112697/1/WHO_RHR_14.13_eng.pdf?ua=1.
2 “Investing in Our Common Future: A Joint Action Plan for Women’s and Children’s Health” WHO. http://www.who.int/pmnch/topics/maternal/201006_jap_pamphlet/en/.
3 “Global Vulnerability Calls for Global Response.” UN Secretary General Ban Ki-Moon. Speech. Forum on Global Health: The Ties that Bind. June 15, 2009.