As we approach the 2015 deadline for the Millennium Development Goals, what does the future hold for international maternal mortality targets? The MHTF is pleased to be hosting a blog series on post-2015 maternal mortality goal setting. Over the next several weeks, we will be featuring responses and reactions to proposed targets from around the world. Please share your thoughts with us!
The importance of the global attention that maternal health was given when world leaders recognised that MDG5 was (and still is) the most offtrack goal of all is evident. The $70bn pledged since 2010 to ‘The Global Strategy for Women’s and Children’s Health’ is pivotal in the history of maternal, newborn and child health, and pledges which may not have been made without the broad MDG target and tracking of progress. We, as advocates for maternal and newborn health welcomed this fantastic news – finally women’s childbirth rights were being prioritised – but we know the real work comes when pushing for these promises to be delivered.
Indeed, a main challenge that civil society faces when pushing for such promises to be delivered is just how much any of these commitments are discussed in our parliaments and our media. Targets are useful, and absolute targets relative to the reality in the country are even more useful. As we move towards the deadline of the MDGs, we have lessons to learn from blanket targets being set in the international arena with little regard for whether they are attainable in the country. When targets are obviously not going to be achieved it can be demoralizing, even when progress is being made. Perhaps this is a contributory reason as to why accountability is so low on the commitments our governments make on the international stage. The targets are unattainable as are the promises made on how to achieve them, creating a cyclical process of underachievement.
The general consensus in Malawi is that our politicians, for the most part, are not even aware of the promises made on their behalf. Our President has been a champion for maternal health and has made impressive commitments to Malawi’s women and children, ensuring free care, strengthening of human resources for health and attaining the WHO standard for emergency obstetric care. Yet there are no numerical targets attached to these commitments, no clear plan as to how they will be achieved and weak accountability at the national level on commitments made. As a Global Board member of The White Ribbon Alliance, I am consistently hearing the same story from our members in many other countries where maternal deaths are high. Perhaps 2014 will see a tangible balance between targeted creation of demand for skilled care for childbearing women and the supply of all the necessary aspects of maternity care. We need the full package from adequate, well qualified and competent human resource to an enabling environment for the provision of quality care.
Targets are important. Commitments are encouraging. But we need the international community to invest in building civil society’s capacity to call their leaders and governments to account on making these promises a reality. Now is the time to build on the targets already set and drive home that unmet promises are not acceptable. We know change can happen when civil society pushes for accountability. The global stage needs a global audience.