Last weekend, The New York Times featured an op-ed by journalist Sam Loewenberg on research published last summer in PLOS Medicine, “Community Mobilization in Mumbai Slums to Improve Perinatal Care and Outcomes: A Cluster Randomized Controlled Trial.” For anyone interested in the challenges related to improving maternal health in cities, the PLOS article is a fascinating read and, in fact, it is part of the MHTF-PLOS collaboration on Maternal Health. Loewenberg highlights this article for a reason that comes up in many discussions of how to develop better maternal health interventions: the pressure to highlight only success, and, in particular, to downplay research findings that show interventions falling short of actually improving maternal and newborn health.
As Loewenberg writes:
The travails of the Newborn Health project aren’t unique. What is noteworthy is that when the project did not work as planned, the team reported it openly and in detail, providing potentially valuable information for other researchers.
It is a provocative point, and one that comes up often in our discussions of how to better address the biggest challenges for improving maternal health. In fact, it was a major topic at GMHC2013, as Lancet editor Richard Horton led the opening plenary session, which had the theme “Science for activism: How evidence can create a movement for maternal health. The session even included discussion of a hypothetical “journal of failures.”
What is more, the op-ed provides an interesting follow-up to the initial research article:
Last year they rebooted. They set up small centers that offer basic health services like immunization, feeding, family planning and help navigating the city’s convoluted health and social service systems. So far, providing concrete services, rather than just advice on collective organizing, seems to be more in tune with the needs of people in the slums.
Clearly, with a new phase of work underway in Mumbai, it remains to be seen whether the work in Mumbai will yield results. In the meantime, it is worth revisiting the original article along with this weekend’s op-ed. Together, they touch on many of the most compelling challenges for the field today.