3 challenges to reducing maternal, newborn and child deaths

Flavia Bustreo, World Health Organization's assistant director-general on family, women's and children's health. Photo by: WHO

The numbers indicating progress on curbing maternal and child mortality are encouraging: The United Nations estimate such deaths have dropped by nearly half since 1990.

It’s exciting news, says World Health Organization’s Assistant Director-General on Family, Women and Children’s Health Flavia Bustreo, but “the work is not finished.” While parts of the two Millennium Development Goals on reducing maternal, newborn and child deaths — No. 4 and 5 — will be met by 2015, progress on the overall goals remains off track.

“It still gives us a lot to do … and the most important thing now is to channel the energy of the different partners in the interventions where we have seen the least progress,” Bustreo told Devex in an interview Tuesday, Sept. 25, following an event on the private sector and women’s health co-hosted by women’s health advocacy organization Women Deliver. She reflected on the progress over the past few years and the requirements to move forward most efficiently on making good on the MDGs.

The amount of money that you see being spent since the Global Strategy for Women’s and Children’s Health was established in 2010 — what are the ways in which you see the money that has been dispensed actually taking form on the ground?

It has taken on different forms. The most encouraging form has been the form that has been provided to governments, for them to be able to provide the services. So, the delivery facilities, the drugs and the commodities, and we have seen that in many, many countries happening. There has been also quite some significant money that has been channeled to new partners, to new initiatives and to new research.

Then, there is a third part of the money that has basically been spent, and is being spent, to initiate new projects that have innovation in them.

What challenges do you foresee in the next few years, looking first toward 2015 and then beyond that, when it comes to raising money, implementing money and continuing to lower maternal, newborn and under-5 deaths?

The first challenge I see is that we have made a first attempt at strengthening accountability. And last year we created a commission on information and accountability for women and children’s health, and we are now seeing the first results of this report done by an independent expert review group that is looking at the progress we are making. But it is not enough. We really have to continue to strengthen accountability, especially at the country level. So, engaging, for example, the parliamentarians to question the government: “Are you making progress or not?” Engaging the civil society voice to really become a stronger voice for accountability — this is number one.

The second part is channeling the resources in the areas, as I have said, where we have seen the least progress. I talked about family planning. There still is not enough progress on neonatal mortality — that is really very linked to maternal mortality. And we are seeing a significant number of babies that are born pre-term. So this early mortality that is also for the baby and for the mothers is one challenge.

The third challenge is continuing keeping women and children at the center. We know that in two, three years we will make some more progress. But it will not be the end of the work, so we are beginning to discuss which would be the ways we can keep women and children’s health at the forefront of the next frontier of the sustainable development goals, whatever they are called.

What can civil society do to get involved on the ground level?

On the ground level they absolutely have to participate in the accountability process. They have to get in touch with the people that are measuring whether the progress is happening or not, and then facilitating work with the parliamentarians to ask questions, working with the parliamentarians … often the parliamentarians in these low levels don’t have a lot of staffers so they can work with them. We have seen this, actually, in Uganda, working beautifully.

Check out our New York topic page to see more of our conservations with other global development luminaries who were in the city for U.N. week.

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    Amy Lieberman

    Amy Lieberman is an award-winning journalist based in New York City. Her coverage on politics, social justice issues, development and climate change has appeared in a variety of international news outlets, including The Guardian, Slate and The Atlantic. She has reported from the U.N. Headquarters, in addition to nine countries outside of the U.S. Amy received her master of arts degree from the Columbia University Graduate School of Journalism in May 2014. Last year she completed a yearlong fellowship on the oil industry and climate change and co-published her findings with a team in the Los Angeles Times.