On April 13th 2010, the New York Times published an article, Maternal Deaths Decline Sharply Across the Globe, about the recent findings published in the Lancet that suggest a dramatic reduction in global maternal mortality. Since then, the paper has published a series of Letters to the Editor. These letters come from leaders of organizations working on reproductive and maternal health and from health professionals working on maternal health on the ground in countries where maternal mortality continues to be a major problem.
A variety of opinions and sentiments are expressed in these letters that certainly add depth to the initial story published in the Times. Two themes pound through the letters: a new sense of hope that improvements in maternal health are possible and a sense of urgency that this battle has not yet been won–that now, more than ever, is the time for the maternal health community to stick together (despite squabbles among advocates over whether or not the Lancet should have published the paper when they did) and engage in concerted efforts (that include emergency obstetric care, HIV services, and expanded access to family planning) to achieve MDG5.
A careful look at these letters will stimulate a much more robust understanding of the myriad of factors contibuting to global maternal mortality—as well as the potential implications of the findings of the Lancet paper and necessary next steps towards achieving MDG5.
Some authors express cautious excitment that investments are (or might be depending on the author) paying off while simultaneously declaring that it is not yet time to celebrate; far too many women are still dying of pregnancy-related causes! Joanne Jorissen Chiwaula, director of the African Mothers Health Initiative describes her frustration with Chris Murray (one of the authors of the Lancet paper) for downplaying the importance of emergency obstetric care services in favor of playing up the importance of HIV services, when a comprehensive approach is really what is needed. Mary Robinson, president of Realizing Rights: The Ethical Globalization Initiative, calls attention to the relationship between maternal health and discimination against women, lack of reproductive choices for women, child marriage, sexual violence, unsafe abortions and inability to own property. She emphasizes the importance of considering maternal health in the context of human rights—and also points out the need to focus on strengthening entire health systems.
Take a look at a group of Letters to the Editor published on April 18th, and more on April 19th.
For readers comments on the initial story in the Times, click here.
And for Nicholas Kristof’s take on the new maternal mortality estimates, click here.