From Inaction to Advocacy: Placing Women and Children at the Center of Sustainable Development

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By: Alicia Ely Yamin, Director of Policy, FXB Center for Health & Human Rights at the Harvard T. H. Chan School of Public Health

This post is part of our Translating Research into Practice Series, which features guest posts from authors of the MHTF-PLoS open-access collections describing the impact of their research since publication.

The sudden loss of a woman’s life during pregnancy or childbirth is both a terrible tragedy and a preventable injustice. With affordable access to a set of basic interventions, nearly all maternal deaths could be avoided. Of the 289,000 global maternal deaths estimated in 2013, the overwhelming majority occurred in developing countries, and sub-Sarahan Africa has the highest regional maternal mortality ratio, accounting for 62% of the global burden. While a maternal death is devastating in its own right, a mother’s death is not an isolated event; when a mother dies there are immediate and lasting repercussions for her children, her family, and the broader community.

Recently, the FXB Center for Health and Human Rights at the Harvard School of Public Health conducted a mixed-methods research study, the Impacts of Maternal Deaths on Living Children Studyin four countries in sub-Saharan Africa—Tanzania, Ethiopia, Malawi, and South Africa—in order to quantify the previously largely undocumented intergenerational health effects of maternal mortality and detail the mechanisms through which a mother’s death impacts child health, development, and well-being. Preliminary findings show not only greatly elevated rates of infant mortality, but increased risk of nutritional deficiency, poor educational outcomes, early marriage, and early pregnancy for the surviving children.

It is well established that patterns of maternal mortality within and between countries reflect deep social and gender inequalities that are reinforced at the household, community, and societal levels, and are reflected in systemic failures to prioritize the sexual and reproductive health needs of women. Based on our research, we argue that gender constructs are not only drivers of maternal death but that they also perpetuate intergenerational impacts on surviving children.

As the dawn of the Sustainable Development Goals fast approaches, it is important that we turn to evidence from the Impacts of Maternal Death on Living Children Study, and other research studies like it from Kenya and China, to inform advocacy efforts toward the inclusion of women’s reproductive health, and gender equality as a central, fundamental part of global development. Toward this end, we convened a panel of maternal health experts from the FXB Center for Health and Human Rights, the Harvard School of Public Health, Family Care International, The World Bank Group, and the International Center for Research on Women for a live webcast to discuss the implications of this research and strategies that advocates can use to mobilize influential donors and decision-makers to prioritize investments in sexual and reproductive health.

While our findings begin to show the intrinsic value of the often-discounted unpaid caregiving role that women play in sustaining households and its tremendous impact on children following a maternal death, especially in conditions of poverty, they also show that without integrated health and social service systems to support families suffering a maternal death, it will be impossible to achieve sustainable development and meaningful improvements in health outcomes. Our research underscores the importance of investing in women’s reproductive health to directly benefit women’s social and economic situations, but also to improve the circumstances for their children.