In Uganda, my home country, 17 mothers and 106 newborns die every single day during pregnancy and childbirth. The government has promised to improve maternal and newborn health, but despite their commitment, health centers across the country remain understaffed and ill equipped, and in many regions women continue to travel for hours to receive lifesaving care.
Unfortunately, this situation is not unique to Uganda, and is familiar to far too many communities around the world. Citizens want their leaders to be held accountable. They want transparency and inclusiveness.
However, governments often do not act because they lack reliable information about the factors and conditions that contribute to maternal and newborn deaths. To address these gaps, governments should create a feedback loop by systematically engaging communities in an ongoing dialogue to monitor the quality and availability of critical health services.
In the global context, there are more than 3.2 million stillbirths each year, and the rate in sub-Saharan Africa is ten times that of developed countries. Yet, stillbirths are largely invisible in global health indicators, policies and programs. In many developing counties, women who experience a stillbirth—a baby born with no signs of life at or after 28 weeks of gestation—keep it a secret, which means that the causes cannot be examined and addressed. Most of these deaths are preventable, but governments cannot act without reliable and well-sourced information.
Reaching out and engaging communities in a dialogue is the first step to a solution, and this approach has worked. For example, White Ribbon Alliance Uganda convened citizens to discuss their rights and gaps in the government’s commitment to better their local health facilities; the Alliance supported citizens to petition district and national decision makers, in addition to national policymakers, and trained citizen reporters and advocates, to monitor progress and budget allocations. As a result of these efforts, citizens developed a better understanding of their rights and were able to advocate with confidence to the local and national officials to take action and provide lifesaving services in their health centers. Most importantly, citizens were able to provide information that was crucial for policymakers to make better, more informed decisions.
I believe that we can make a lot of progress towards ending maternal and newborn mortality not just in Uganda, but around the world. We need to recognize the problem, come together as a community, work with our governments to help them enact better policy, and hold them accountable to making change happen.
Photo: © 2014 by Jonathan Torgovnik/Reportage by Getty Images, under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) http://creativecommons.org/licenses/by-nc/4.0/