Presentation at the Global Maternal Newborn Health Conference, October 20, 2015
As part of the Every Woman Every Child movement, the United Nations Commission on Life-Saving Commodities (UNCoLSC) for Women and Children has specified magnesium sulfate, oxytocin and misoprostol as priority life-saving maternal health (MH) commodities. By improving the availability of these three medicines, it is estimated that maternal mortality could be reduced by 1.4 million over ten years worldwide. Development of a maternal health commodity security (MHCS) framework can help low- and middle-income countries (LMIC) to develop and implement strategies to secure MH commodities and strengthen their availability to women. A global desk-based review of peer-reviewed articles, UNCoLSC policy documents and relevant grey literature was performed. Key informant interviews in Burkina Faso, Ethiopia and Nigeria augmented the literature review. Data extraction from the various sources was standardized and manually coded into themes. MHCS is defined as “women and their health providers can equitably access and rationally use essential, quality, lifesaving, maternal health commodities made available and affordable throughout the continuum of care by inter-sectoral collaboration and integrated service delivery.” The 12 components of the framework parallel common health system organization. At the macro level, MHCS requires private sector engagement, quantifiable maternal health policies, and specific budgetary allocation for MH commodities. At the meso level, key strategies include strong logistic systems, resolving staff shortages, and task shifting. At the micro level, the framework identifies the need for advocacy campaigns to raise awareness and dissemination of education and behavior change materials. The MHCS framework is a tool that countries can use to identify weaknesses at various levels of the health system and develop strategies to address them. The next phase includes pilot testing in select countries to validate the components and refine the framework.