On the sidelines of the political posturing and rhetoric at the Partners’ Forum on Women’s & Children’s Health sponsored by the Partnership for Maternal, Newborn and Child Health underway at the prestigious Vigyan Bhawan in Delhi this weekend, there have been some illuminating discussions. The day before the event, there was a robust agenda of “Pre-Forum Technical Discussions” that better demonstrated the Forum’s theme (“From Pledges to Action”) than the Forum itself.
Hidden in the schedule was one rich and intriguing session that deserved better publicity. A group of young researchers from the Public Health Foundation of India (the MHTF’s partner in the Global Maternal Health Conference held in Delhi 2 months earlier) presented their findings of innovative interventions across India in several fields: maternal health, adolescent and sexual health, family planning, policy/advocacy, access and referral, and infrastructure. Using some simple criteria to define “innovative,” these researchers have compiled a directory of projects that are demonstrating success and deserve closer scrutiny. I joined the challenging q & a session after the presentations, questioning why there was no mention of any projects rolling out mag sulfate for the treatment of eclampsia/pre-eclampsia at the community level — the researcher in charge replied that she was dismayed to find no documentation of such work in India. I also asked if there was any work underway on using misoprostol without mifepristone for 1st trimester abortions — again, no data on any such effort. Clearly two opportunities for programmers that need to be seized.
After that session at the Indian Islamic Center, I tuk-tuked over to the conference venue to catch the last 1.5 hours of a consultation for the PMNCH NGO constituency where roundtables were set up for a prodigious group to break out and discuss a series of ill-conceived questions about how NGOs can/should be engaged in accountability for the Secretary-General’s Global Strategy for Women and Children — the Forum’s major document. The organizers’ efforts for inclusivity resulted in a discursive and often repetitive list of demands and strategies none of which seemed to call on the Secretary General himself to be held accountable. Cynics like me see the S-G’s Strategy to be one of his major campaign tactics to amass support for his re-appointment to a second term next year. The Strategy itself offers nothing new — it is mostly an adaptation of previous multi-lateral declarations, calls-to-action and a few treaties compiled in a new format. I assume that the Forum organizers were counting on the process of this NGO consultation to be more important any actions resulting from it.
A welcome change in tone and topic came immediately following in a session convened by the impressive mHealth Alliance, literally on the heels of their Summit held in Washington DC which my colleague Raji Mohanam has been blogging about here in the past few days. David Aylward, the head of the Alliance framed the conversation by presenting an overview of how new and existing information and communication technologies are re-shaping public health research and interventions. He then introduced Al Hammond, a social entrepreneur who’s company HealthPoint Services Global is piloting a hub-based mobile health care scheme for pregnancy women in Punjab. The session was designed to be interactive and it decidedly so. Participants included local and global NGOs, the telecom industry, health care rights advocates, and other mobile health project leaders. It was a challenging and often contentious conversation that seemed to inform Aylward and his Alliance significantly as they are rolling out a dedicated maternal health initiative. Their site has a place for projects to promote themselves and an ideas exchange that is designed to shape the initiative. Check it out.
The most provocative conclusion reached in the m4Health session addressed the ongoing shortage of doctors and nurses available to the poor and marginalized With absurd patient:doctor ratios growing more absurd as brain drains proliferate, one participant suggested that the ambition to train and deploy more trained health care professionals is short-sighted; instead of looking to more in-person treatments, it’s time to scale-up virtual treatments where fewer doctors and nurses can treat more patients ideally with an stronger emphasis on prevention. Necessity is indeed the mother of invention.