Manifesto for Maternal Health: Highlights From MSH

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By: Ciro Franco, Senior Principal Technical Advisor for MNCH

In celebration of the one-year anniversary of the Manifesto for Maternal Health, Management Sciences for Health (MSH) congratulates our global community, including ministries of health, their partners, and the women we serve and work with, on the progress made toward creating a healthier world for mothers and their babies. The manifesto communicates both passion and rationale, the two main drivers needed for profound change around the approach to maternal health and to women’s health more generally. It forces us to attend not just to the maternal aspect of women’s health, but to think of women’s needs more broadly.

For over 40 years, MSH has worked to improve health in countries throughout the developing world. Our maternal health projects strengthen all levels of the health system, including the community, providing care from pregnancy through the postpartum period. MSH supports the manifesto in its entirety, particularly its emphasis on integration and quality of care. However, we have found that aspects two and six of the manifesto—improving access to care for all women, especially those who are underserved due to political, geographic, or cultural barriers, and strengthening every level of the health system to support universal access to health care—are especially important when working in fragile states, where much of MSH’s work is focused.

For instance, in Afghanistan recent USAID projects implemented by MSH have reached every level of the health system and have contributed to the country’s astounding improvements in maternal and child survival over the past decade.

The USAID-funded Strengthening Pharmaceutical Systems (SPS) project works with the Afghan Ministry of Health to improve the rational use of medicine and better manage pharmaceutical services and products, including those necessary for healthy pregnancy, birth, and child health care. In collaboration with the ministry, SPS has helped establish a coordinated system to ensure necessary medicines and commodities are available at all points of service.

To address the dearth of qualified female health workers, the Leadership, Management, and Governance (LMG) project helped catalyze the development of midwives in Afghanistan, who have played a role in the decrease of maternal mortality from 1,600 per 100,000 live births in 2002 to less than 400 maternal deaths per 100,000 live births in 2010. As women are the best stewards of their own health, LMG focuses on moving more women into leadership and governance roles in the health sector. We believe that women in leadership roles will be more affective and assertive in guiding the “unseen women” of Afghanistan and other fragile states toward life-saving maternal and child health services.

The Afghanistan Technical Support to the Central and Provincial Ministry of Public Health project, which was operational from 2006-2012, partnered with the ministry to expand the basic package of health services, improved access to family planning and reproductive health services, and increased the percentage of female community health workers and the number of facilities with at least one female health worker.

These and other projects have worked in concert with families, communities, facilities, and the Ministry of Health to improve women’s access to quality health care in Afghanistan, with measurable, powerful results.

But in Afghanistan, as in the rest of the world, there is still work to be done to ensure every woman has access to high quality, safe maternal health services. Let us think concretely about how to use this anniversary to push women’s health to the forefront of the global health dialog.  At the country level, how can this manifesto become owned by civil society, professional organizations, nongovernmental organizations, and governments?  It has the potential to serve as a rallying cry, as a strong advocacy piece at various levels of government, including with ministries of finance or national assemblies, as well as ministries of health.

It is vital that this manifesto be transformed into something operational that people can use to mark their progress. It could be translated into a dashboard for each country that would show the gap in maternal health services to ministries and parliamentarians. Taking the manifesto to the next level, making it into something more operational, trackable, and with associated advocacy tools can help us all in our efforts to improve maternal and women’s health.

The MHTF is currently celebrating the Manifesto for Maternal Health’s one year anniversary through a blog series. Would you like to contribute? Connect with us on Twitter and Facebook. Or send us an email.