Today is a very special International Women’s Day because this year marks the thirtieth anniversary of the Safe Motherhood Initiative. The Safe Motherhood Initiative launched in 1987 at the Safe Motherhood Conference in Nairobi, Kenya as a global movement to reduce maternal mortality. The conference took place at a pivotal point in history for the maternal health community. Allan Rosenfield and Deborah Maine had just published their groundbreaking commentary, “Maternal mortality—a neglected tragedy: Where is the ‘M’ in MCH?” in which they astutely observed the lack of focus on the mother in global maternal and child health programs. Momentum was building among United Nations agencies and the World Health Organization (WHO) to address the fact that 500,000 women worldwide were dying from pregnancy and childbirth-related complications each year. The Safe Motherhood Conference provided an ideal opportunity to turn that momentum into action, and thus, the Safe Motherhood Initiative was established with the goal of reducing maternal mortality by 50% by 2000. Stakeholders identified three main strategies for meeting this goal:
- Strengthening community-based health care by improving the skills of community health workers and traditional birth attendants and screening high-risk pregnant women for referral to medical care
- Improving referral-level facilities to treat complicated cases and serve as a back-up to community-level care
- Developing an alarm and transport system to serve as a link between community and referral care
Maternal health gained considerable attention following the launch of the Safe Motherhood Initiative at several conferences including the International Conference on Population and Development in Cairo in 1994, the Fourth World Conference for Women in Beijing in 1995 and the Social Summit in Copenhagen in 1995, but the goal of reducing maternal mortality by 50% was not achieved by 2000. Challenges included data collection and measurement, limited political will and a lack of consensus on strategies for intervention.
In 2000, safe motherhood was reaffirmed as a global priority, as illustrated by its inclusion in the Millennium Development Goals (MDGs). One of the eight MDGs—MDG 5—was to improve maternal health, with two targets to accomplish by 2015:
Target 5a: Reduce the maternal mortality ratio by three quarters
Target 5b: Achieve universal access to reproductive health
In 2005, the Partnership for Maternal, Newborn and Child Health was formed to strengthen global advocacy, coordinate country-level action and promote a continuum of care perspective. The Lancet published its Maternal Survival series in 2006, which contained evidence-based strategies for reducing maternal deaths.
Over the last decade, there have been substantial efforts to continue the work of the Safe Motherhood Initiative. For example, WHO has published and updated recommendations for improving the quality of maternal health care, the Ending Preventable Maternal Mortality working group was established and The Lancet published another series on Maternal Health. New targets for maternal mortality have been set for the Sustainable Development Goals period (2015-2030), strategies to meet the targets have been proposed and there has been renewed commitment to holding stakeholders accountable for results.
The maternal health field has made considerable progress over the last 30 years, but more work is needed. The global maternal mortality ratio decreased by 44% between 1990 and 2015, but roughly 300,000 women around the world still die every year from preventable causes related to pregnancy and childbirth. Ending preventable maternal deaths is possible with continued investment in maternal health research, programs and policy at the global, national and local levels.
Join the International Women’s Day conversation on social media by using the hashtags #IWD2017 #WomensDay #BeBoldForChange.
Learn more about International Women’s Day.
Read the “Strategies for Ending Preventable Maternal Mortality” report.