Leadership for Health: Speech from Jill Sheffield

The following is the speech Jill Sheffield prepared for the African First Ladies Health Summit in Los Angeles (a portion of this written speech was delivered).

Thank you. I’m honored to be included today at such a distinguished gathering.

My mission here is to DEFY the gloomy news of the world – the economic situation, poverty, AIDS, wars and the premature death of women in pregnancy and childbirth. We’re here to help change the future for Africa’s women and girls and their families. I’m here in the optimistic spirit of our new U.S. President, Barack Obama.

Like him, I want to talk about HOPE and PROGRESS. And I want to make you just as hopeful – and just as determined – that we can change the world for women, generate investment in women. Invest in women, because it pays!

The goal of this conference is to generate action. First Ladies are in a unique place in your home countries. And you know action is needed. While we have been speaking, in about 10 minutes, 10 women will have died in pregnancy and childbirth – one woman will have died every minute. Many more survive only to endure such pain and devastating injuries that, secretly, they wish they had died.

But these women can survive. We know what to do to save their lives. And when they survive, their families thrive. And then their communities can thrive, and their countries. It’s a virtuous circle.

Here’s the good news – we know what to do about maternal mortality. We know from twenty years of research what the major causes and what the solutions are. And we also know the costs of NOT investing in those solutions. The best news: nearly all mothers’ deaths from pregnancy worldwide are needless. And they are preventable. And they are preventable at a very affordable cost. No woman should die in the process of giving life to another human being.

For example, in Honduras, which is not a rich country, the government cut maternal deaths by 40 percent in seven years. They did it by deciding to make a direct attack on the five major causes. For hemorrhage, they invested in blood supplies and transfusion equipment. For infections, they distributed antibiotics. For high blood pressure, or eclampsia, they made it easier for pregnant women to get pre-natal checkups with paramedics. For obstructed labor, where the baby is too big to pass through the birth canal, most often caused by pregnancies in girls too young, delaying age at marriage and first births is one route. Another, more costly option, they invested in training surgeons and equipping clinics for caesarean sections. That same capacity for emergency care helped them deal with the fifth major cause of women’s deaths, damage from unsafe abortions. A major investment was to increase women’s access to family planning – because avoiding unintended pregnancies can prevent fully a third, perhaps even 40% of all mothers’ deaths. Forty percent! Just imagine that.

You may know that more than 42 percent of all pregnancies everywhere suffer complications. And in one of every seven pregnancies, those complications are life-threatening.

Think about that: one in every seven pregnancies worldwide can be a death sentence. What’s interesting is that this is true in every country around the world. But the survival rates are very different between rich countries and poor countries, and between the rich and the poor in all countries.

Where governments have taken the steps I’m going to tell you about – and those steps are not hard – mothers’ deaths have fallen sharply.

You know that several African countries are among the world’s most dangerous places to be a mother: in some of them, one in every seven or eight women can expect to die in pregnancy or childbirth. But with a decision to invest in women, three more of those women could live. Your region of sub-Saharan Africa now sees half of all the world’s maternal deaths. But we can change this. Invest in women – it pays!

At the moment the world loses 15 billion dollars every year in productivity that doesn’t happen because mothers and their newborns are dying – one mother a minute, four million newborns every year. That’s because mothers and their babies are so connected. A mother’s death always means deeper poverty and hardship for her family. It often means an early death for her other children, especially the newborns, and most especially for girls.

An investment [5-6 billion dollars] of one-third of that yearly loss could save three of every four women who are dying even as we speak. And just think what that could mean. Just consider what women deliver. Not just babies! The African farmer and HER husband produce 80 percent of Africa’s food. In Southeast Asia it is women who provide 90 percent of the labour for growing rice.

Around the developing world, women operate most of the small businesses. They are workers who deliver firewood and water, immunization and health care. They bring home income. The women of Africa carry on their heads or in their arms two-thirds of all the goods that are transported anywhere in Africa. Not trucks or planes, but women, and that’s according to Britain’s Department for International Development.

Women are at the economic heart of the developing world. And to do all this work, they need to be healthy. And that includes planning the number and spacing of their pregnancies. If they are able to time their children, they can make sure the family has enough income to give each one enough food, clothes, education and medicine.

Girls with options in their lives beyond childbearing can stay in school. And you all know how important that is. As Michelle Obama put it earlier this month when she was in London, “Getting a good education is so important. Communities and countries and ultimately the world are only as strong as the health of their women…and part of that health includes an outstanding education.”

Then they can become teachers, lawyers, judges, nurses, doctors. They can be filmmakers, corporate executives, foundation officers. They can be First Ladies! They can be presidents and prime ministers. They can be the assistant secretary-general of the United Nations!

That’s my message that I would seriously like you to take back to your countries: investment in women really pays off. To quote Sarah Brown: “it creates a virtuous circle, because it is mothers who build healthy families, communities and economies.” An investment in maternal health is an investment in social justice, in social stability and in economic growth. Mothers deliver the true wealth of nations.

Kofi Annan said it too in 2003: “study after study has shown that there is no effective development strategy in which women do not play a central role.”

So now I call upon you here today to make this your own personal mission. With your involvement – and your words in the right ears – your countries can save the lives of millions of women who would otherwise die in pregnancy and childbirth. And that means everybody wins.

As you make this case to the people in your countries who need to hear it, you can point out that many places besides Honduras have succeeded without much money – like Sri Lanka, and Kerala state in India, Tunisia and Malaysia. That’s because the cost is reasonable and return on the investment is enormous. For example, it costs $1.50 to provide a safe, uncomplicated delivery as opposed to the $20 to 30 dollars it costs when delivery complications become life-threatening. Who can afford to pay $20 when $1.50 would be sufficient?

The U.S. Agency for International Development studied 29 countries and USAID found that one dollar spent on family planning saved four dollars in spending for other development needs. Less than two dollars per person invested in women can prevent three-quarters of the maternal deaths in the 75 countries where 95 percent of those deaths now occur. Two dollars!

Here’s how you can help make this happen. You may know about the Maputo Plan. Africa’s leaders – your husbands – agreed in 2006 to integrate women’s sexual and reproductive health care into basic health systems all over Africa.

The plan outlines what needs to be done – antibiotics, checkups, training for nurses and doctors, emergency equipment and supplies, family planning. It has the right ideas. All that’s necessary is to take action on it.

You know that the heads of State will meet in Addis next January. That is the perfect opportunity to deliver real commitments of resources and political determination. Talk to your husbands about the Maputo Plan! Talk to your friends! Get them to join us in this effort! Remind them that women deliver! Women truly deliver the wealth of nations. It is not charity, but the most sensible kind of investment in the future.

Help is at hand…MDG framework, Governments, UN agencies, Civil Society organizations, Corporate Sector. All have a part to play. It all starts with the decision to take action coupled with determination.

We know what to do. We know how to do it. Africa’s girls, women and mothers are counting on us. We can do it. All we need to do is act. So let’s do it together.

It is time for progress, not just promises.
It is time to deliver for women.
To quote President Obama once again – Yes we can! Yes we can!

Thank you!