Observations on “Linking Reproductive and Maternal Health Supplies”
Population Action International (PAI) in partnership with the Maternal Health Task Force at EngenderHealth recently launched a new initiative to facilitate greater attention to the issue of reproductive health supplies, specifically maternal health supplies. The two groups hope to facilitate the integration and engagement of maternal health groups into the Reproductive Health Supplies Coalition (RHSC), creating broad-based support for maternal health supplies challenges and ensuring that adequate maternal health supplies needed to achieve MDG5 are consistently present and accessible.
On December 8th, I attended “Linking Reproductive and Maternal Health Supplies,” a meeting organized, chaired and hosted by PAI. The meeting marked the first step of the overall initiative. Between 25-30 people attended the meeting from such organizations and projects as PATH, CARE/USA, Save the Children, JSI/Deliver, Family Care International, Pathfinder, Ipas, ACCESS-FP, and the White Ribbon Alliance.
The purpose of the meeting was for PAI to solicit the participants’ relevant perspectives and experience. PAI first briefed the participants on its Maternal Health Supplies Project (funded by the MHTF) and its prior experience with the history and evolution of the Reproductive Health Supply Coalition (RHSC).
The participants then engaged in a lively and wide-ranging discussion about the merits and challenges of working to focus interest on “maternal supplies,” i.e., those needed to help address the various major causes of maternal morbidity and mortality. Participants brought perspectives from advocacy, research, policy, and service delivery, and also commented on the structure and utility of the Reproductive Health Supply Coalition.
The consensus of the group was that such an effort was well-worth undertaking, but would likely be more difficult than the RHSC effort because maternal health is broader and thus more supplies would be needed.
I raised the issue and importance of clarifying up front what “supplies” they were going to address and advocate for, pointing out that the linguistic ambiguity in the RHSC effort has complicated the effort. Is it about “commodities” or “contraceptive security?” What are the “supplies”? How do they relate to “product”? What are “contraceptives? Where is vasectomy and female sterilization in the RHSC calculus? And how, vis-à-vis “commodities” they need to address “equipment,” “instruments,” “drugs,” “expendable supplies,” etc.
The discussion that then ensued focused on such considerations as: why maternal health supplies have not been addressed systematically before; the complexity of the issue; how that very complexity makes it hard to distill a message down for policymakers, decision makers and donors (but such messages need to be found); how “supplies” is just one part of the problem–it’s health system issues, the ways services are provided (and paid for), and so on. I.e., sometimes the “supplies are there” but the services still are not. There was also discussion of whether or not an MH-specific “kit” was needed (the feeling was that such kits could be very useful in advocacy, but it was unclear what instruments and other supplies might be in the kit, and whether this was feasible, given the complexity of the major causes of maternal morbidity and mortality and what is entailed in addressing those conditions (e.g., eclampsia, hemorrhage, sepsis) when they occur.
The consensus around this part of the discussion was that addressing maternal supplies in an organized way analogous to the RHSC was a worthwhile endeavor, that the participants’ respective organizations were glad to be collaborating on the effort, and that they had gotten off to a good start. I agree.