The Global Business Coalition on Health held its conference “Define Forward: Business, Health and the Road Ahead” on May 14-15, bringing together more than 700 corporate executives, government leaders, policy makers, civil society visionaries and media champions to explore the intersection of business and health. GBCHealth featured its first panel on maternal health, entitled “Milestone Moments on the Path to Healthier Motherhood.”
Christy Turlington Burns, founder of Every Mother Counts and director of the documentary film No Woman No Cry, kicked off the panel by reminding the group of three staggering statistics:
(1) Every 90 seconds of every day, a woman dies from a pregnancy-related complication; (2) Pregnancy is the number one cause of death of young women ages 15-19 in developing countries; and (3) 99% of maternal deaths occur in the developing world, the majority of which are completely preventable. Throughout her travels, Turlington Burns saw pregnancy-related death attributable to several factors: from the human resource shortage in Tanzania to social and economic barriers in Bangladesh, and from the lack of access to safe abortion in Guatemala to lack of health insurance coverage during pregnancy in the United States.
Gary Cohen, Executive Vice President of Becton, Dickinson and Company and moderator of this panel, reminded the room that MDG 5 shows the least amount of progress of all MDGs, with almost no progress in Sub-Saharan Africa. This means that women in the industrialized world have a 1 in 4300 chance of dying of maternal causes, and much higher in places like Sweden (1 in 14,100). But the chances are 1 in 31 women in the developing world, or specifically a 1 in 23 chance in Niger.
Yet it seems as if all sectors have started to take notice that prioritizing the health needs of girls and women is not only good for families and communities, but is central to thriving economies. The UN Secretary-General’s Every Woman Every Child campaign and GBCHealth’s Healthy Women Healthy Economies are both highly visible collaborative efforts to end maternal death and prioritize women’s health.
The panel included the following speakers:
• Sarah Brown, Global Patron of White Ribbon Alliance for Safe Motherhood
• Naveen Rao, Lead, Merck for Mothers
• Benjamin Schwartz, Senior Director for Health, CARE USA
• Rhonda Zygocki, Executive Vice President, Policy and Planning, Chevron Corporation
When asked about the role education can play in reducing the high rates of maternal death among adolescent and teen girls, Sarah Brown highlighted the importance of girls’ participation in school. When a girl is attending school, she is afforded safety, learning opportunities, access to lunches and vaccines, and increased status in her household. And while we have seen a decrease in maternal deaths in the last 20 years (from 543,000 in 1990 to 287,000 in 2010), these statistics are not decreasing for teen girls in the developing world. Access to schooling helps to reduce vulnerability to sexual violence, child marriage and exploitation. “Interventions are well-known and low-cost, and the interaction between health and education is crucial,” said Brown. Protective structures for girls must include parents and schools, and reduce the burden of care on teachers.
Chevron’s approach to maternal health has focused on prevention of mother-to-child transmission (PMTCT) within its workforce, especially in regions where HIV prevalence rates are high. Rhonda Zygocki explained that they took a systems approach to protecting the health of their employees through Chevron’s HIV and PMTCT policies, ensuring that these systems were infused with three core priorities: (1) Non-discrimination, (2) access to treatment, and (3) education, outreach and counseling. These priorities have guided their PMTCT activities, emphasizing education and breaking down to stigma surrounding HIV. This approach has allowed them to establish a culture of testing and treatment within their workforce, grounded in confidentiality, comprehensive care and support during all phases of pregnancy. Chevron’s milestone moment is this: Systems can work, and the proof is in the fact that they’ve had no new cases of mother to child transmission in the past 11 years in Nigeria. The business case is clear. Gary Cohen chimed in, stating that this gives us all hope of reaching zero new pediatric HIV infections by 2015.
Since the majority of maternal deaths are preventable, Naveen Rao centered his discussion around the four major causes of maternal deaths (post-partum hemorrhage, pre-eclampsia, infection and obstructed labor) and the three delays to care (seeking care, getting care and receiving care). As an example of an easy solution to the delays in getting care, Naveen cited an example out of Nigeria. The taxi drivers union made a decision to provide on-call drivers to transport women to delivery sites. Those who made themselves available were allowed to be the first person in the taxi line at the airport. The incentive did not require any direct cost and provided timely transport to a laboring woman, and proved worth it to save women’s lives.
In his travel to Bihar, India, Benjamin Schwartz observed a trend: women would deliver in the morning and leave the clinic or hospital hours later. Much more needs to be done to ensure that women receive the post-partum care they need, including immediate care following birth and the 3 follow-up visits as per WHO recommendation. CARE found that only 12% of women in Bihar received the care they needed, spurring on an innovative program designed to communities and facilities. They are piloting testing mobile phone algorithms with ASHAs (Accredited Social Health Activists) in Bihar, India, who are the first line of skilled care delivered to women in their homes. CARE is working to establish public/private partnerships to strengthen systems to provide family planning to women post-partum.
To close the panel, Gary Cohen asked three final questions of the panelists:
If you could remove one key barrier, what would it be?
What caused a light bulb to go off for you?
What is the impact of societal norms?
“Stigma and social norms are the biggest barriers access to treatment, counseling and education, and we need to break down these cultural perceptions in order to create a critical mass of positive role models for women.”
“Inequitable gender and social norms limit women’s ability to access care or preventive services they need. Changing social norms is difficult to do, some say, but we need to break down these inequities.”
“Saving the mothers’ lives means saving the lives of children through inexpensive and easy interventions. This is not a women’s issue, and men need to be in these conversations.”
“We know what is killing mothers, and we know why. And we end up standing around watching it happen. We need to decide whether mothers are worth the investment.”
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Flickr photograph via Fortune Live Media.