Making the Right Decisionsfor the Health of Girls and Women

Ruth Levine, PhD

Characteristics of Good Public Policymaking

Respectful of fundamental human rightsReflects the community’s valuesWeighs costs and benefits, near- and

long-termPromotes efficiencyAdapts as new evidence and ideas

emerge

Rapid Progress Toward Better Maternal Health Is Possible

We have a great deal of knowledgeBiomedical, behavioral

We have seen successesRapid declines in maternal mortality among

some populationsSustained improvements in maternal health

There is strong leadership and support now

What We Know

Maternal mortality is highly concentrated among populations 13 countries account for 70 percent of all maternal

deaths Poor, marginalized, disproportionately young

Death tends to occur around the time of delivery. Two-thirds of maternal deaths occur between onset of

labor or abortion and 48 hours postpartum or postabortion

Maternal mortality can be reduced through concerted efforts that address both clinical care and social factors

What We Know: Six Successful Approaches

Family planningSkilled careSafe abortion when and where legalPlacing priority on young peopleStrengthen health systems with a bias

toward girls and womenAdvance and protect the human rights of

girls and women

Family Planning

Reduces risks of “too early, too many, too late” Women can startchildbearing afteradolescence Women can space births Women can limit births after reachingdesired family size

Prevents use of unsafe abortion

Skilled CareSkilled birth attendant: “accredited health professional – such as a midwife, doctor or nurse – who has been educated and trained to proficiency in the skills needed to manage normal (uncomplicated) pregnancies, childbirth and the immediate postnatal period, and in the identification, management and referral of complications in women and newborns”

Variation in Skilled Birth Attendant Coverage

Source: UNFPA, 2002

Safe Abortion When and Where Legal

Unsafe abortion: global and regional estimates of incidence of unsafe abortion and associated mortality in 2003

42 million abortionsAnnually

…20 million unsafe

Strengthen Health Systems with a Bias Toward Girls and Women

Availability of quality family planning / reproductive health services

Financing, supervision arrangements that incentivize responding to the needs of girls and women

Youth-friendly health services • Specially trained staff • Respect for young people • Privacy and confidentiality honored • Adequate time for client and

provider interaction • Peer counselors available • Separate space and special times

set aside • Convenient hours and location • Adequate space and sufficient

privacy • Youth involvement in program

design

Advance and Protect the Rights of Girls and Women

“governments express grave concern for the unacceptably high rates of maternal mortality and morbidity [throughout the developing world], acknowledge that [maternal health] is a human rights issue and commit to enhance their efforts at the national and international level to protect the lives of women and girls worldwide” – United Nations Human Rights Council, June 17, 2009

Characteristics of Good Public Policymaking

Respectful of fundamental human rightsReflects the community’s valuesWeighs costs and benefits, near- and

long-termPromotes efficiencyAdapts as new evidence and ideas

emerge Strategic, evidence-based focus on reducing maternal deaths