The following appeared in The Daily Beast on October 5, 2012.
The end of summer marks the end of “baby season” in the United States, the months when most American babies are born. While the season is a time of celebration for millions here at home, it is a time of great danger for women in the developing world, where maternal mortality rates are staggeringly high. The World Health Organization conservatively estimated that in 2010, 287,000 women died during pregnancy and childbirth around the world. What makes this figure more unfortunate is that most of these deaths are preventable. All that’s needed is commitment—and the right approach. At Bloomberg Philanthropies, we have both.
We start with a simple premise: that no one should have to die giving birth. Modern medicine has removed the vast majority of risks associated with childbirth, and relegated them to medical history books. Like smallpox, a major disease eliminated in my lifetime, maternal mortality can be a thing of the past. But this goal is only achievable if we can find ways to make the kind of maternal care we take for granted in developed countries available to mothers everywhere. The fact is, too many women live too far from a medical professional with the equipment and training to save her life.
This week, we took a major step toward meeting this need by announcing a joint $8 million reinvestment in a maternal health program in Tanzania with the H&B Agerup Foundation, an innovative organization committed to improving maternal and child health. Combined with a prior investment we made, the total commitment is now $15.5 million. We expect these funds will impact tens of thousands of women and children in the next three years alone. Helen Agerup and I were joined in this announcement by United Nations Secretary-General Ban Ki-moon and Tanzanian President H.E. Jakaya Mrisho Kikwete, who has been a key partner in the initiative.
The project, which began in 2006, has the potential to revolutionize the way women give birth in Tanzania, Sub-Saharan Africa, and throughout the developing world by addressing a key cause of maternal death: a lack of timely access to quality emergency obstetric care. The program does this by pursuing two tracks, each of which bring such care closer to expectant mothers in some of the most isolated parts of the country.
First, we have upgraded and equipped existing village-level health centers so they can conduct comprehensive emergency obstetric care. We have constructed operating rooms in nine remote health centers, shortening the distance women must travel for care, including safe Cesarean sections. Second, the program has so far trained more than 100 nonphysicians in the most remote areas of Tanzania to perform lifesaving obstetric procedures. These assistant medical officers and nurse midwives are located in rural areas where doctors are rare and obstetricians are almost nonexistent.
The program’s initial results have been excellent. Since its launch six years ago, the number of women who safely deliver a child in Bloomberg-upgraded health centers has more than doubled, from 3,500 per year to 9,000 per year. We’ve seen a significant increase in the number of lifesaving C-sections, and the number of maternal deaths from bleeding and other complications in our project sites has been significantly reduced. In one district alone, maternal deaths declined by 32 percent in just two years.
Tanzania was chosen as the test site for our strategy for a number of reasons. First, there is great need. Almost 8,500 Tanzanian women die from complications during pregnancy and childbirth each year—that’s almost one death every hour. And for every death, another 20 women suffer injury or disability. Second, Tanzania has existing medical infrastructure that can be upgraded to serve as birthing centers. Finally, and perhaps most important, we chose Tanzania because its government is supportive of policies that allow trained nonphysician clinicians to perform these lifesaving procedures—an important step toward producing a meaningful reduction in maternal death. This support is critical, and no organization can hope to have a lasting impact by acting alone.
The program’s success led us to this week’s announced three-year reinvestment. During those three years, we conservatively project that more than 50,000 women and children will be positively impacted. We also believe the project will become a replicable model in Tanzania—and potentially around the world.
Bloomberg Philanthropies’ efforts to improve mothers’ health are part of a larger global effort to meet the United Nations’ Millennium Development Goal of a 75 percent reduction in maternal mortality ratios by 2015. While we are well behind that goal, our work in Tanzania shows that progress is possible—with the right strategy, and the commitment of the right partners.