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The first panel’s charge was to discuss the impact of effective interventions that have saved women’s lives. But the moderator, Dr. Horton, wasted little time, challenging the crowd of maternal health professionals, business leaders and policymakers not to be complacent or satisfied with accomplishments this far.
“Now, we’ve had fine introductions, but we need to really focus in the next 25 minutes or so on what are we going to do differently when we leave this room. . . ,” he said in a rousing voice. “Because what we are doing currently is not working fast enough.”
Dr. Horton cited an analysis by the Institute for Health Metrics and Evaluation in Seattle that said only four countries out of 75 priority countries are going to reduce by 75 percent their maternal mortality ratio by 2012, as stated by Millennium Development Goal 5.
“Only four countries! Now that is an abomination despite all of the great work that you do, and many others do,” he told the breakfast meeting. “We are just not getting it right. So we need to pause, we need to step back and we need to honestly ask ourselves: ‘What has worked? What hasn’t worked?’ And when we leave this breakfast room this morning, what are we going to pledge to do differently?”
In response to questions, panel experts cited a range of successful interventions that included: an increase in skilled birth providers, strengthened health systems, integrated service approaches that reach the most underserved, introduction of humanistic care in clinics and family planning.
As the global health community moves forward, “we shouldn’t be reinventing the wheel. We know what works. We just need to scale it up,” said Dr. Sennen Hounton, the panelist from UNFPA.
Added Dr. Aparajita Gogoi, of the White Ribbon Alliance-India: “We have to hold everybody to account.”
With funding for global health flat-lining, Horton asked his colleagues what the role of donors should be in accelerating progress. Dr. Ariel Pablos-Méndez, Assistant Administrator for Global Health at USAID, said he expects a shift in the traditional paradigm to one of “greater country ownership” of the programs and interventions that are keeping mothers alive and healthy.
“Governments need to step up to the plate far more than they have in the past,” he said, adding that he is optimistic about the prospects of funding for global health “but with a different equation.”
The second panel, moderated by Dr. Besser, focused on the challenges ahead in maintaining the progress of the past 20 years. These challenges include scaling up evidence-based interventions; retaining skilled health care providers in communities that need them; assuring adequate supplies, commodities and tools for providers; strengthening health systems; linking science to interventions; keeping partners accountable; and developing data systems to measure and evaluate progress.
“We have the potential before us for a generational shift,” said Dr. Jeff Smith of MCHIP. “Women are not yet seeing the added value of going to a facility.”
While the past generation’s women gave birth at home, the key to bringing the next generation of women to facilities to give birth — and saving more women’s lives — is delivering quality care, Smith said.
Horton’s energetic imperative to the crowd earlier in the morning captured the enthusiasm of maternal health experts as the morning event concluded: “Act up and act now for women and children.”