Dr. Harshad Sanghvi is Vice President and Medical Director of Jhpiego, a Baltimore-based, global health non-profit working to improve and save the lives of women and their families around the world. Jphiego is an affiliate of Johns Hopkins University.
Dr. Sanghvi shares his response to the recent maternal mortality study published in the Lancet:
For the many dedicated to saving women’s lives, a new study reporting a decline in maternal mortality is heartening news, an affirmation of the decades of work and investment in improving health outcomes for women across the globe. The study published in The Lancet (“Maternal Deaths Decline Sharply Across the Globe,” NYT, 4/13/2010) found that maternal deaths dropped from 526,300 in 1980 to 342,900 in 2008, a decline researchers attributed to lower pregnancy rates, greater access to education for women, improved nutrition and skilled professional care at childbirth.
But no one should mistake the findings for a reason to shift our focus from a most shameful truth – too many women are dying from conditions that are preventable or can be treated successfully. In 2008, 342,900 women died in the very process of giving life. Behind that number hides an even greater tragedy, the massive morbidity as a result of pregnancy and childbirth.
From my days working in Kenya, I can still picture a very young woman who had life threatening pelvic sepsis following childbirth in a remote part of the country. The woman managed to reach a mission hospital almost 3 days after giving birth at home. She had to have multiple abdominal surgeries, and finally a hysterectomy. As we prepared to discharge her, she told me that she would have rather died. We had saved her life. But she had certainly not recovered, like the millions who are left with energy sapping anemia following postpartum hemorrhage, or with renal damage following eclampsia or worse still with fistula.
The Lancet study highlights that we are on the right track. As we move forward, we must increase our emphasis on quality of care, so that women who have been convinced and motivated to seek skilled care are not met with health system failures. And we must ensure that the fullest potential of skilled professional care is realized by ensuring the rights of health care providers to be trained for the job they expected to perform, to a work environment that is supportive and to be motivated by being provided a living wage.
And to complement this , we need a package of community-based interventions including birth preparedness and complication readiness education, calcium supplementation and iron supplementation, misoprostol to prevent postpartum hemorrhage, all of which can be safely provided by community volunteers who are willing and able to take care to women where they are.
Women’s lives can be saved with evidence-based interventions and the will to implement them from home to hospital. With what we know and the work we’ve done, no woman should have to die giving life.