Global Maternal-Child Health, Can we Win the Battle?

It is becoming clear that despite positive trends, and individual country successes in reducing maternal and infant mortality, globally, MDGs 4&5 will not be achieved by 2015. In fact, the trends in sub-Saharan Africa are not positive, indicating that “business as usual” is unlikely to prove effective and that new approaches must be explored.

WHO's strong directive guiding policy makers (and women) towards facility births continues to be challenged in the knowledge that first-line referral sites rarely have the human or commodity resources required to change outcomes. Additionally, with home births by TBAs representing one-third of all deliveries in the developing world, the waning recognition provided to these workers may produce the opposite effect -- even as more skilled health care workers are being trained.

Education and mobilization of women in the community remains a relatively untapped, powerful source of change. Community recognition of the impact of misoprostol, antibiotics, and perhaps calcium, plus education in basic lifesaving skills, could accelerate mortality reductions for women and infants. When coupled with programs at primary health care sites such as team training, simple check-lists, and access to basic drugs and resuscitation equipment, the opportunities to effect positive change are maximized. New technologies, including point-of-care testing/immediate treatment, care directives by cell phones, and diagnostics to provide early alerts for intervention are already being field-tested.

Our distinguished panel will share examples of model programs and new technology opportunities that may yield the greatest opportunity to impact mother-infant mortality and morbidity within a sustainable framework.