Council Commentary

International Maternal Health Day: The Need for Quality Care

It is no secret that women and girls have far less access to the quality health services they need.  The denial of their reproductive and maternal health rights can lead to maternal death and illness, unintended pregnancy, and the transmission of sexually transmitted diseases.

That’s why, this week, the Population Council, along with our partners, urged the United Nations to officially recognize April 11 as the International Day for Maternal Health and Rights. Recognizing maternal health and rights with a commemorative day will shine a global spotlight on the needs of women.

The Population Council is at the forefront of research that enhances the lives of women and girls by improving their access to quality maternal health services. By addressing three critical issues, safe pregnancy and delivery; postpartum maternal care; newborn and infant health; we can ensure women and girls are given the right to quality services at all stages of their lives.

Yet today around 800 women still die every day from preventable causes related to pregnancy and childbirth. Preventable causes. Take pre-eclampsia. It is the second-most common cause of death for pregnant women, despite the fact that a low-cost, easy to administer drug exists to treat it. The drug, magnesium sulfate, is only $.35 per ampoule and is available in most developing countries. Research conducted by the Council in Nigeria from 2008-2011 demonstrated that providing training on magnesium sulfate to health service providers resulted in a 40% reduction in women dying from pre-eclampsia. Yet five years later, far too few women experiencing pre-eclampsia are given the drug – either because it’s unavailable in facilities, unaffordable from private markets, or because health providers lack confidence in proper administration of it. The Council's Ending Eclampsia project promotes the availability and correct use of anti-hypertensives and magnesium sulfate for the detection and treatment of pre-eclampsia and eclampsia. Through the project, we will be raising awareness, increasing dialogue, and advocating for policy and program changes that expand access to the drug. We will change the global dialogue about pre-eclampsia and save women’s lives.

Pre-eclampsia and eclampsia are not the only issues that women face during child birth. Millions of women worldwide face complications associated with obstetric fistula, a devastating condition that can result in lifelong stigma and shame for women if not treated properly. The Council’s Fistula Care Plus project is working to address the barriers that prevent women from seeking care, the main barriers being the long distances to health facilities, transportation costs, and lack of awareness that fistula is treatable. For many women, they know that treatment centers exist but they still can’t or don’t seek care. Even something like the cost of travel to a health center can prevent a woman from seeking the care she needs. To make fistula treatment a reality for all, barriers to access, like transportation and awareness of treatment options, need to be addressed. Our interventions are providing community and provider awareness, financial support for transportation costs, and social support and counseling to minimize stigma associated with fistula.  

In many settings, women have access to care but don’t seek it. Why do so many pregnant women choose to give birth at home though they may know seeking professional care puts them at a lower risk for delivery complications? From 2011 – 2014, The Council conducted research in Kenya under the Heshima project, to understand how disrespect and abuse at the hands of trained professionals often discourages women from seeking the care they need. We don’t often associate abuse with hospitals but the research tells a different story. In many low- and even high-income countries women voiced concern over discrimination, non-confidential care, and physical abuse while seeking care or treatment. Our findings informed a bill drafted by policymakers that aims to eliminate disrespect and abuse during childbirth, and our researchers adapted an attitudes transformation document – originally developed by Ipas – used in trainings and counseling sessions with facility nurses to help them cope with the stress of working in under-resourced facilities. The Council also conducted community dialogues and trained community members on their rights to quality and respectful health care. With these interventions, changing attitudes towards respectful maternity care is possible.

The call to action is clear. In order to address the most pressing global challenges that women and children face, we must ensure gender equality and quality access to care and sustainable, viable solutions. Join us in urging the United Nations to officially recognize April 11 as the International Day for Maternal Health and Rights. Together we can make comprehensive, respectful, and rights-based maternal care available to all.