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APHA Scientific Session and Event Listing

Recorded presentation

Jeremy Shiffman, PhD, Public Administration, Syracuse University, 306 Eggers Hall, Syracuse, NY 13244, 315-443-4928, jrshiffm@maxwell.syr.edu

Through the Millennium Development Goals (MDGs), United Nations member states have committed themselves to reducing the global maternal mortality ratio by 75 percent by the year 2015. This target is not likely to be achieved if India and Nigeria do not experience dramatic declines in maternal mortality, as these two countries rank number one and two in number of maternal deaths in childbirth, and together contribute nearly one-third of the global total.

What are the prospects for maternal mortality decline in India and Nigeria? The issue is more than a technical or medical concern: it is also political. Achieving reductions will be contingent upon generating the political commitment of national and local leaders, and in particular their willingness to devote significant public budgetary and technical resources to the cause.

This paper is a study of the political dynamics of safe motherhood in India and Nigeria. Employing a process-tracing qualitative case study methodology, in collaboration with domestic partners the author has conducted more than fifty in-depth interviews with safe motherhood stakeholders in these two countries, including key individuals in the respective Federal Ministries of Health, other relevant ministries, donor officials, non-governmental representatives, scholars and local level political leaders. The study also involves analysis of official and unofficial government and donor documents and local research reports.

Results indicate that policy windows for safe motherhood have opened up in each country, in part due to the pressure of the MDGs. However, the state of political priority for safe motherhood is embryonic at best in each country. The future of safe motherhood in India and Nigeria will depend upon the capacity and effectiveness of a network of national political champions for safe motherhood in the governmental, donor and NGO sectors in pushing the rest of the political system to prioritize this cause, and devote financial resources toward it. The broader implication of the study is to highlight that the achievement of the health goals of the MDGs is as much a matter of national and sub-national politics of developing country nation-states, as it is an international issue or a technical or medical concern.

Learning Objectives:

• Participants will recognize that safe motherhood is more than a technical issue - it is also political - and be able to analyze how political priority is generated for this cause in developing countries.

Keywords: Maternal Health, Politics

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation