Global Call to Action Towards Improving Maternal and Newborn Survival

Global health experts, including the Nigeria Health Watch, NHW, recently at the biennial International Maternal Newborn Health Conference, IMNHC, held in Cape Town, South Africa, issued an urgent call to action towards improving maternal and newborn survival. Sunday Ehigiator reports

According to a new report from the United Nations (UN), global progress in reducing deaths of pregnant women, mothers and babies has flatlined for eight years due to decreasing investments in maternal and newborn health.

The report shows that over 4.5 million women and babies die every year during pregnancy, childbirth or the first weeks after birth. This is equivalent to one death happening every seven seconds, mostly from preventable or treatable causes if proper care was available.

And according to the Director of Maternal, Newborn, Child and Adolescent Health and Ageing at the WHO, Dr Anshu Banerjee, “Pregnant women and newborns continue to die at unacceptably high rates worldwide, and the COVID-19 pandemic has created further setbacks to providing them with the healthcare they need.

“If we wish to see different results, we must do things differently. More and smarter investments in primary healthcare are needed now so that every woman and baby, no matter where they live, have the best chance of health and survival.”

The UN Report

The report, titled, ‘Improving Maternal and Newborn Health and Survival and Reducing Stillbirth’, assesses the latest data on these deaths which have similar risk factors and causes, and tracks the provision of critical health services.

Overall, the report shows that progress in improving survival has stagnated since 2015, with around 290,000 maternal deaths each year, 1.9 million stillbirths (babies who die after 28 weeks of pregnancy), and a staggering 2.3 million newborn deaths, which are deaths in the first month of life.

Impact of Covid-19 and Other Vices

The Covid-19 pandemic, rising poverty, and worsening humanitarian crises have intensified pressures on stretched health systems.

Since 2018, more than three-quarters of all conflict-affected and Sub-Saharan African countries report declining funding for maternal and newborn health.

According to the latest WHO survey on the pandemic’s impacts on essential health services, around a quarter of countries still report ongoing disruptions to vital pregnancy and postnatal care and services for sick children.

Just one in 10 countries, of more than 100 surveyed, was reported to have sufficient funds to implement their current maternity plans.

And according to UNICEF Director of Health, Steven Lauwerier, “Since the Covid-19 pandemic, babies, children and women who were already exposed to threats to their well-being, especially those living in fragile countries and emergencies, are facing the heaviest consequences of decreased spending and efforts on providing quality and accessible healthcare.”

Funding Shortfalls

No doubt, the Covid-19 pandemic, rising poverty, and worsening humanitarian crises have caused funding shortfall shortfalls globally, thereby leading to underinvestment in the sector.

Underinvestment in primary healthcare can devastate survival prospects. For instance, while prematurity is now the leading cause of all under-five deaths globally, less than a third of countries report having sufficient newborn care units to treat small and sick babies.

Meanwhile, around two-thirds of emergency childbirth facilities in sub-Saharan Africa are not considered fully functional, meaning they lack essential resources like medicines and supplies, water, electricity or staffing for 24-hour care.

Impact of Funding Shortfall

In the worst-affected countries in Sub-Saharan Africa and Central and Southern Asia, the regions with the greatest burden of newborn and maternal deaths, fewer than 60 per cent of women receive just four, of WHO’s recommended eight, antenatal checks.

“The death of any woman or young girl during pregnancy or childbirth is a serious violation of their human rights,” said, Director of the Technical Division at the United Nations Population Fund (UNFPA), Dr Julitta Onabanjo.

“It also reflects the urgent need to scale up access to quality sexual and reproductive health services as part of universal health coverage and primary health care, especially in communities where maternal mortality rates have stagnated or even risen during recent years.

“We must take a human rights and gender transformative approach to address maternal and newborn mortality and we must stamp out the underlying factors which give rise to poor maternal health outcomes like socio-economic inequalities, discrimination, poverty and injustice.”

Call to Action

It was against this backdrop that global health experts, including the Nigeria Health Watch, convened in Cape Town, to drive urgent action for the health of mothers and newborns by leading with evidence, sharing effective implementation strategies, reviewing joint progress, and nurturing collaboration and innovation.

Attendees heard directly from impacted countries, communities, and women about how the current plateau in progress affects real lives.

According to Chief of Health Services for the Ministry of Health Malawi and AlignMNH Steering Committee Co-chair, Dr. Queen Dube, she said the “call is about accountability, and this is something that we all must take responsibility over. We work in environments where a lot of women and families are not empowered.”

The conference was hosted by the Government of South Africa and AlignMNH – a global initiative funded by the Bill & Melinda Gates Foundation in collaboration with the United States Agency for International Development (USAID), and partnership with UNFPA, UNICEF, and World Bank. 

Approximately 1,700 delegates from 96 countries, including 28 official country delegations participated in more than 200 sessions focused on accelerating progress and fostering solutions for maternal newborn health.

Need to Invest in the Team and System

Speaking at the conference, USAID Assistant Administrator for Global Health, Dr Atul Gawande, stressed the need for countries to invest in the teams who deliver care and in the system.

According to him, “To save lives, we must strengthen the quality of care, not just by investing in individuals and their skills and commodities. But by also investing in the teams who deliver care and the systems in which they deliver it.”

The E-MOTIVE

Many emerging solutions to the multi-faceted problems presented were on display at the Technical Marketplace, including innovations in mobile imaging, AI-powered ultrasounds, and new clinical interventions.

One such promising intervention called E-MOTIVE released new results from a study that found accurate measures of blood loss using a simple, low-cost blood measurement drape, and applying comprehensive WHO-recommended treatments, resulted in a 60 per cent reduction in bleeding, which means women were far less likely to die.

“What got us here is not going to necessarily get us there. We have to continue to evolve systems and health services,” said Bill & Melinda Gates Foundation Deputy Director of Maternal, Newborn, and Child Health Dr Jeffrey Smith.

“That’s why this conference is so important–because this community needs to continue to learn and evolve as we reduce mortality.”

If current trends persist, more than 60 countries are not set to meet the maternal, newborn and stillborn mortality reduction targets in the UN Sustainable Development Goals (SDG) by 2030.

Coming together at IMNHC 2023, and every two years thereafter, will mark important milestones at our current midpoint of the SDGs.

About IMNHC 2023

The International Maternal Newborn Health Conference (IMNHC) was powered by AlignMNH and the Government of South Africa, in collaboration with BMGF, UNFPA, UNICEF, USAID and World Bank, and includes the leadership of Governments from around the globe and additional support from partners.

The IMNHC is in support of working collectively to achieve the goals of the Every Newborn Action Plan (ENAP) and Ending Preventable Maternal Mortality (EPMM). The World Health Organisation has provided technical guidance in support of the conference.

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If we wish to see different results, we must do things differently. More and smarter investments in primary healthcare are needed now so that every woman and baby, no matter where they live, have the best chance of health and survival