Maternal-Newborn-Child Health: Questions and Answers

Is the focus on international maternal health activities strong enough?  A generation ago Alan Rosenfield, the guru of international Mother and Child Health at Columbia University, famously asked: “Where is the “M” in MCH? His “M” meant Mother. He was asking because he was an obstetrician who knew that women in developing countries faced many risks as a result of pregnancy and child-birth.  You can learn about the risks taken by one typical, poor girl by clicking on the Dangerous Stairway to Reproductive Health. 

How important is a mother’s death?  Maternal mortality rates are very high in developing countries – often 40 or 50 times the rate in industrialized countries such as Canada. Importantly, we now know that the death of a mother in a poor family in a developing country can be disastrous because her death can lead to the death of one or more of her young children. For example, a UNICEF study in rural Bangladesh showed the chances of children surviving to age 10 was as high as 89% when their mothers survived the birthing process, but as low as 24% when their mothers died as a result of pregnancy. Interestingly, the shocking result of a mother’s death shown in the Bangladesh study did not occur when a father of a newborn baby died: the impact of a father's death on child survival was negligible.

Who needs the MCH services?  As suggested in the UNICEF/Bangladesh report, we should invest much more on the survival of poor mothers in remote areas, not only because they deserve adequate health care, but also because mothers are very important to the survival of the youngest children in the family. And we should invest more on adolescent girls, thinking of them as “brides to be” and “mothers to be”

What is the best MCH strategy?  Managers of health activities should be guided by the Maternal-Newborn-Child Health (MNCH) Continuum of Care because it is based on solid evidence from fieldwork. Leaders for this strategy can come from a combination of community-based women plus decision makers at every level. Obtaining support of decision makers such as husbands, fathers, community leaders, religious leaders, government officials and politicians will require persuasive advocacy campaigns.  

Are we winning the MNCH battle? The enormous importance of women is being recognized in high places.  For example, The United Nations’ Millenium Development Goals 3, 4, 5 and 6 remind us of the importance of women in family economics, community decision-making, and prevention of disease, such as HIV/AIDS.  Donors such as the World Bank, UN agencies and progressive governments are strengthening their policies on women’s equity and women’s leadership of MNCH programs. In other words, we are beginning to see a larger, stronger “M” in MCH.

Do you need my assistance?  I specialize in managing MNCH programs and projects in developing countries, including all stages of the management cycle.  If you or your colleagues want my assistance, please email me at: jdavies@alephx.com. If you wish more information about me and my work, just visit www.johndavies.com then click on the CV/Resume button.

With my very best wishes for your successful MNCH programs and projects.

John Davies, DrPH
January, 2012

Do you need my assistance?  More information?
Email John Davies: jdavies@alephx.com