GTR promotes campaign in the countries
Montevideo, June 2, 2023. Zero Maternal Deaths. Prevent the preventable with a multisectoral and equity perspective, is the name of the webinar that marks the end of the first part of the campaign of the Regional Task Force to Reduce Maternal Mortality (GTR, for its acronym in Spanish). In the next stage, the initiative will be adapted in the countries with the highest maternal mortality ratios in the region.
"The data show that there has been a setback in recent years in maternal mortality indicators and that inequalities continue in the most vulnerable groups, in groups of African descent, migrants and rural areas," said Gustau Alegret, a journalist from the international news channel NTN24, who moderated the session, which took the form of a discussion.
Following Alegret's introduction, Bremen De Mucio, regional advisor on maternal health at the Pan American Health Organization (PAHO), outlined the nine steps promoted by the GTR to reduce maternal mortality, which begin with the development of public policies to improve maternal health in particular and sexual and reproductive health in general, with the allocation of resources for this and with the use of evidence for the development of these policies and programmes.
For her part, Alejandra Corao, Regional Advisor on Sexual and Reproductive Health at the United Nations Population Fund (UNFPA), spoke about trends in maternal mortality ratios in Latin America and the Caribbean. In her presentation, Corao emphasised the countries where the highest number of maternal deaths are concentrated in the region - Brazil, Mexico, Haiti. Venezuela, Colombia, Guatemala, Bolivia, Peru, Argentina and Ecuador - and where the social inequalities associated with maternal mortality are most visible. The expert proposes looking at the data through the lens of inequality to explain why poor women, rural women, indigenous women and women of African descent die. "Maternal mortality is the bitterest face of inequality", she concluded.
Ariel Karolinsky, advisor to PAHO Brazil, gave a presentation on the Brazilian Bolsa Familia programme, which is linked to the first three steps recommended by the GTR, and detailed a study carried out in the South American country on this policy, which proves that gaps can be closed with conditional cash transfers. "Maternal mortality should be understood as a human rights issue, in addition to being a relevant public health issue," he said.
Mirna Montenegro, Technical Secretary at the Observatory on Sexual and Reproductive Health (OSAR) in Honduras, participated as a civil society representative on the panel. Montenegro referred to the mechanisms for citizen participation and accountability, a point that is also included in the GTR document with nine steps for the reduction of maternal mortality. "For us the issue of the right to healthy motherhood is the fundamental basis, no woman should die giving life. And for this we need many alliances (...). To defend healthy motherhood is to defend life and the family, because when there is a maternal death, the life of the family is totally affected", she reflected.
The webinar discussed the institutional and systemic racism that exists in societies that prevents many women, the most disadvantaged, from accessing services. In this context, the GTR members pointed out that the advocacy work they carry out seeks to reposition social determinants and highlighted the importance of the approval of norms, the implementation of policies, the monitoring of these public policies, as well as access to contraceptive methods, the prevention of unplanned pregnancies and the reduction of adolescent pregnancy.
At the end of the meeting, Alegret asked the panel what to do about the lack of resources for the implementation of actions, to which De Mucio responded that in maternal health we know what is successful, "the problem is that regulations are not always applied, there is a problem of monitoring and evaluation and of correcting what does not work", in addition to the need to prioritise maternal health, he said.
For her part, Corao said it is important to ensure that pregnancies are wanted, women should know when they have an obstetric complication and know how to get to the health service, as well as having access to the health service.
Montenegro stressed that "budgets are decided at a high level", so it is important to "prioritise resources and measure results and local participation". While Karoliski stressed that "there is a primary political responsibility, responsibility for doing, but also for not doing".
In the last minutes of the meeting, Corao reflected on the effect of the pandemic and pointed out that although its impact was notorious, the problem was already present. On the other hand, she pointed out that "not all women died, but the most excluded. I hope that we have learned to have resilient health systems and that never again will services be closed because of another pandemic".
Bremen De Mucio closed the webinar by informing about the next steps for the GTR: to continue to push the campaign in the region and to mobilise the maternal health agenda in countries with the highest maternal mortality numbers.
