Put Women at the Center of Maternal Health
04 June 2010
Media Contact
Recent declines in maternal deaths, while welcome, are still too small given the world’s Millennium Development Goal to reduce maternal mortality by 75 percent and achieve universal access to reproductive health care by 2015. Only a few countries are on track to reach this target.
Significant reductions in maternal mortality could be achieved if health services (such as antenatal care, delivery by a skilled attendant, emergency obstetric care and postnatal care) were available to and used by all women during pregnancy, childbirth and its immediate aftermath. Eighty percent of maternal deaths are due to complications experienced by women during pregnancy, at delivery or within six weeks of post delivery.
But the women most in need of maternal health care often are the least able to access and use these services, if available. The reality is the poorest women in the poorest regions of the world, where virtually all maternal deaths occur, have the lowest maternal health care service access and use.
A mix of poverty and gender inequality shape how women seek, demand, access and use maternal health care. Higher poverty among women, lower education levels, lack of autonomy and mobility, and violence against women persist where maternal deaths are high and service use is low.
For example, in Indonesia, researchers found that women who had no stake in household assets (such as their home, vehicles, appliances, jewelry) were less able to make decisions about their maternal health care. Owning assets made women more likely to use antenatal care and deliver in a hospital or private doctor’s office.
Women’s needs and realities must be the central drivers of policies and programs to increase maternal health access and use. Although the premise is obvious – women at the center of maternal health – existing efforts to reduce the burden of cost, improve and expand services, while essential, may not be enough to guarantee access by the poorest, most disempowered women.
Efforts to improve maternal health outcomes must also find ways to empower women and overcome gender inequality. Education is especially effective. Numerous studies have shown that educated women are more likely than uneducated women to use antenatal, delivery and postnatal care. Employment opportunities for women can help them earn and control their income to purchase health care services for themselves. And empowering women through social support, networks and participatory learning also is proving to increase their use of maternal health care services.
These initiatives may not be within the purview of health care programs, but where these can be integrated they should. Partnerships with other sectors such as education and employment also can go a long way in empowering women and improving maternal health outcomes. Sound research can identify the needs and realities of poor women in order to effectively design and evaluate programs that can achieve the desired impact.
Broad, comprehensive strategies that address poverty and gender inequality are crucial, as are increased political will and greater investments to improve maternal health. The world’s mothers deserve nothing less.
For further reading, download the executive summary, Targeting Poverty and Gender Inequality to Improve Maternal Health »