The Lancet has a special edition out looking at maternal mortality around the world:
According to the new Lancet series, the chances of a woman dying from childbirth over her lifetime is about one in 4,900 in high-income countries, while for women in sub-Saharan Africa the figure is one in 36. By contrast, according to the World Health Organisation, the UK figure is one in 5,800.
We entirely agree that the world would be a better place if there were greater equity in those numbers. As long as the equity is achieved by the terrible numbers becoming better, not by a degradation elsewhere. However, we are deeply unconvinced that this is the correct method of gaining that goal:
We call on all stakeholders to work together in securing a healthy, prosperous future for all women. National and local governments must be supported by development partners, civil society, and the private sector in leading efforts to improve maternal–perinatal health. This effort means dedicating needed policies and resources, and sustaining implementation to address the many factors influencing maternal health-care provision and use. Five priority actions emerge for all partners: prioritise quality maternal health services that respond to the local specificities of need, and meet emerging challenges; promote equity through universal coverage of quality maternal health services, including for the most vulnerable women; increase the resilience and strength of health systems by optimising the health workforce, and improve facility capability; guarantee sustainable finances for maternal–perinatal health; and accelerate progress through evidence, advocacy, and accountability.
We have absolutely nothing at all against those who know how to cut that carnage teaching those who do not. Indeed, think it an excellent idea.
And yet those lifetime risk rates of one in 36 - they are, like the absolute poverty in the places where those rates exist, the historical norm for human beings, even in fact rather better than that historical norm. Further, it is the poverty which is the cause.
No one does want mothers and or babies to die. It's a fairly fundamental driving force of being a human that we do our best for them. Yet what if it costs $60 to provide suitable maternity care? No, that's just a number plucked from the air - and we're in a society where GDP per capita is $600 a year. There are, tragically, still near 10% of all humanity trapped in economies of that level and destitution.
Given that urge to care for those mothers and babies we know very well that a society climbing up out of that poverty will devote more resources to those groups. We've seen it happen absolutely everywhere that any society has so climbed up out of that historical norm of destitution.
Thus we do indeed agree with the goal. But insist that the priority to achieve it has to be economic development. Because all else will follow once that is happening. Not just resources to maternity care - but to health care in general. Indeed, things like the "greater empowerment of women" and the like which some make so much of we insist all rely upon a society with some economic surplus, however small, which allows such empowerment. So too the end of child labour, the education of all children and so on.
There are thing which we can do to help - we know how to do some of these things and we should pass that knowledge on, of course we should. But that 10% of the world is still resource constrained. The basic answer has to be, therefore, to increase the economic resources available. This can also be expressed as helping them get rich.
Fortunately we know how to do that. This neoliberal globalisation stuff has, in recent decades, led to the greatest fall in that absolute poverty in the entire history of our species. We must therefore keep that engine of economic growth running - for the mothers and the children, you understand.