Although it was intended to create space for the maternal health community to get together to discuss challenges and solutions so that we can improve programs, the Global Maternal Health Conference 2013: Improving Quality of Care in Arusha, Tanzania achieved much more than that. It was a momentum for change, inspiring a movement. What made it so special?
The research presented at the conference helped to break through some of the false dichotomies in maternal, newborn and child health: care delivered at home versus at a health facility, focus on the mother versus the baby, urban versus rural poor, and sexual reproductive health versus maternal health. This discussion helped to move the agenda forward towards a common platform for maternal health.
The plenary on “respectful” services brought to the fore the human rights, ethics, and quality of services perspectives of midwives, community groups and champions for governance and accountability. And the panel on urban maternal health brought in the social, economic determinants and the urban poor context.
To create a comprehensive, unified movement and move the reproductive and maternal, newborn, and child health platform forward we also need to include nutrition, infectious diseases (malaria in pregnancy) and family planning, find opportunities and entry points for integration in antenatal care, intra-partum and post-partum interactions, and tackle the most difficult implementation barriers at local levels, often fueled by gender inequalities. This recognition, which was well captured at the large plenary sessions, made this conference an important milestone for many scientists, health providers, program managers, policymakers and advocates.
A standing ovation followed Professor Mahmoud Fathalla’s presentation at the closing of the conference, as he brought us along on a historical journey dating back to the Lady of Laetoli who left the earliest known human footprints, 3.6 million years ago in Laetoli, Tanzania. He concluded by saying: “We thank and we appreciate; we regret and we apologize; we promise, and yes, we can.” The regrets refer to the fact that still 800 women die every day although women in the twenty-first century “do not have to give up their lives when they give us a new life”.
We can save lives and appreciate the drop in maternal mortality by 33 percent between 1990 and 2010; and yes, we can do more.
To create a comprehensive, unified movement and move the reproductive and maternal, newborn, and child health platform forward we also need to include nutrition, infectious diseases (malaria in pregnancy) and family planning.
Also helping to create a momentum for change was the high level engagement from political leaders in the region, with Hon. Salma Kikwete, the First Lady of Tanzania, and Hon. Mohamed Gharib Bilal, the Vice President of Tanzania, attending the conference, and the contribution of the Minister of Health of Rwanda, Hon. Dr. Agnes Binagwahos. Broad representation across geographies, disciplines, and age groups, including young researchers and activists, helped fuel the momentum as well. The many scholarships that the MH Taskforce had given to young researchers enabled them to travel to the conference and share their data.
A vision for moving forward
The meeting resulted in a manifesto which was presented by Richard Horton, editor of the Lancet, to contribute to the platform for moving forward and to the discussions about new global health goals, post 2015.
Included in the recommended actions going forward are: setting a new and challenging goal for maternal mortality post-2015; redefining the continuum of care to make women central to RMNCH, and include quality, HIV, malaria, and social determinants; reaching women who are socially excluded because of, for example, culture, geography, and education; listening to voices of women in policy and making sure women have a platform and power to shape their futures; addressing stillbirths and newborn mortality; strengthening measurement, information, and accountability about maternal outcomes; and, empowering women to connect to services when they need them through the power of mobile technology.
The community is energized coming out of this successful gathering in Arusha. What happens next will be both exciting and challenging.