More from the Global Maternal Health Conference in Delhi.
See below for my recap of the third and final plenary of the conference.
Ann Blanc, Director of the Maternal Health Task Force, welcomed attendees of the Global Maternal Health Conference to the third and final day of the conference. She recalled the Safe Motherhood Conference held in 1987 in Nairobi–and said, “Experts at the Nairobi meeting did not expect to be here today. They would have thought that by now preventable maternal mortality would be a thing of the past.”
Lynn Freedman, Director of the Averting Maternal Death and Disability program at Columbia University and moderator of the final plenary, opened the session with a statement that she said few could argue with: Many of the pieces are in place to make preventable maternal mortality a thing of the past; technical knowledge, money, political will, and big improvements on the great challenges of implementation. What we need now is accountability. The title of plenary three was Maternal health accountability: successes, failures, and new approaches.
Insights from plenary three panelists:
Sigrun Mogedal, of the Ministry of Foreign Affairs in Norway, discussed bi-lateral and mulit-lateral aid for maternal health. She noted the current momentum around maternal health but reminded conference participants that we have been here before–and asked, “Why should now be different?” She pointed out that consensus in New York is not the same as action on the ground. The missing piece needed for more action on the ground is accountability–and this is a matter of hard domestic policies. She said that bi-lateral and multi-lateral debates “take up too much space.” The global must serve and respond to the local, NOT the other way around.
Helena Hofbauer, Manager of Partnership Development at the International Budget Project, raised questions about aid effectiveness–and discussed national governments’ commitments to spending on maternal health. She described the work of the International Budget Project to use budget analysis to address persistent inequalities in maternal mortality. She said that the budget is a nation’s single most important overarching policy document. Helena asked, “What would happen if people actually asked the government how much and specifically on what they are spending to improve maternal health?” The International Budget Project did ask these questions on behalf of citizens, and the response was “deplorable”. In fact, the reply from Nigeria was that this sort of information is “sensitive and controversial” and from Tajikistan, “Please don’t bother the minister with these sorts of requests.” Helena declared, “This is, in practice, an accountability free zone.”
Nancy Northup, President of the Center for Reproductive Rights, talked about accountability within the context of a human rights and legal framework for improving maternal health. She described a paradigm shift from considering maternal health solely as a public health issue to now understanding it as a human rights issue. Nancy described the legal framework for how and why governments should be held accountable for maternal deaths–citing the right to life, health, equality and non-discrimination, privacy, spacing of children, to be free from cruel, inhumane or degrading treatment, and to education, information and the benefits of scientific progress. She described the process of litigation at the national and international level to demand individual compensation and systemic change–noting that demanding this sort of accountability is the next critical step in improving global maternal health.
Aparajita Gogoi, Executive Director of CEDPA India and the India National Coordinator for the White Ribbon Alliance, commented on accountability through grassroots advocacy. She said that working on the issue of accountability at the grassroots level occurs in three phases: gathering information, spreading awareness, and speaking out. She described a number of tools that can be employed to give local communities a voice including public hearings, check lists, verbal autopsies, and more. Aparajita talked about the importance of providing a safe setting for dialogue—a place where communities can voice concerns and demand action. She pointed out that crucial here, is that people with power are also present, take the concerns seriously, and are held accountable for taking action.
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Visit the conference site for archived videos from the conference.