The Canadian Press - ONLINE EDITION

UN and partners ask for more money to save mothers despite little proof the strategies work

  • Print

LONDON - In the past decade, billions of dollars have been spent trying to save the lives of mothers in developing countries using strategies - usually inexpensive drugs - deemed essential by the U.N. health agency.

Yet two large analyses of maternal health programs- including one conducted by the U.N. itself - report that the efforts appeared almost useless, raising troubling questions about why all that money was spent.

However although some critics are calling for the pricey global initiatives to be significantly overhauled, maternal health programs are still being implemented despite little proof they work, the reports suggest.

The practices mainly involve things like ensuring women giving birth get cheap drugs such as magnesium sulphate to treat labour complications or pre-emptive antibiotics for those getting a cesarean section.

Even public health officials acknowledge they were taken aback by the studies.

"Nobody could have been more surprised than I was when we got the results," said Dr. Omrana Pasha of Aga Khan University in Pakistan, who led a study of maternal health interventions in six countries in Latin America, Africa and Asia.

"In clinical medicine, we would not prescribe a drug unless multiple trials show that it works," she added. "The FDA won't allow a drug to be marketed without that evidence. But things are different in public health."

At an international meeting of U.N. partners starting Monday in South Africa, health officials are getting ready to ask donors for even more money to pour into maternal health programs. Since 2009, the U.S. has invested more than $13 billion in maternal and child survival, hoping to save lives by supporting "high-impact" health interventions.

According to the research papers, including one done in 30 countries that tracked more than 300,000 women, scientists found no link between the supposedly life-saving interventions and the death rates of women giving birth. Areas that used the interventions didn't have better survival rates for mothers than areas that didn't.

The two papers published last year are the biggest to assess the effectiveness of maternal health strategies, although smaller studies have previously suggested the methods help. But they gained little traction, perhaps because there doesn't appear to be an easy fix.

Prime Minister Stephen Harper has made maternal and newborn health a major focus of Canada's foreign aid. He hosted an international conference on the subject this spring where he pledged an additional $3.5 billion over five years toward the government's initiative.

A spokesman for the prime minister said he can't comment directly on the reports because he had not read them, but said there had been "real, concrete results" achieved since Harper launched the Muskoka Initiative, with funding of $2.8 billion, at the G8 summit in 2010.

"Canada is well on its way to achieving our goals under Muskoka," said Jason MacDonald.

"Our (initiative) will save the lives of 1.3 million children and newborns, as well as more than 60,000 young mothers."

Experts, meanwhile, are largely stumped as to why their methods failed to prevent deaths.

"We assume that if women get these things, they will be saved. But it's too simple to say one plus one equals two," said Dr. Marleen Temmerman, director of WHO's maternal health department.

She isn't convinced the interventions don't work. She suspects there were problems implementing the strategies.

"Maybe the health facility has the medicine, but the man who has the key to the cupboard is gone," she suggested.

Temmerman also said it would be dangerous if donors abruptly slashed their support for maternal health initiatives.

"The message is not to stop investing, it's to invest money more wisely," she said.

Some experts said existing plans should be adjusted.

"These essential interventions are important but they are not enough," said Sandrine Simon, a public health adviser at Doctors of the World charity. "This is about more than buying the right medicines."

But others said major changes were required to save more women.

"We need to be more honest and serious about past failures otherwise we will keep making the same mistakes," said Bill Easterly, an economist at New York University. "It's not just the fault of countries receiving aid who aren't implementing the technology properly, it's the fault of Western aid agencies and donors who are not trying hard enough to get it right."

With files from The Canadian Press

Fact Check

Fact Check

Have you found an error, or know of something we’ve missed in one of our stories?
Please use the form below and let us know.

* Required
  • Please post the headline of the story or the title of the video with the error.

  • Please post exactly what was wrong with the story.

  • Please indicate your source for the correct information.

  • Yes

    No

  • This will only be used to contact you if we have a question about your submission, it will not be used to identify you or be published.

  • Cancel

Having problems with the form?

Contact Us Directly
  • Print

You can comment on most stories on winnipegfreepress.com. You can also agree or disagree with other comments. All you need to do is be a Winnipeg Free Press print or e-edition subscriber to join the conversation and give your feedback.

You can comment on most stories on winnipegfreepress.com. You can also agree or disagree with other comments. All you need to do is be a Winnipeg Free Press print or e-edition subscriber to join the conversation and give your feedback.

Have Your Say

New to commenting? Check out our Frequently Asked Questions.

Have Your Say

Comments are open to Winnipeg Free Press print or e-edition subscribers only. why?

Have Your Say

Comments are open to Winnipeg Free Press Subscribers only. why?

The Winnipeg Free Press does not necessarily endorse any of the views posted. By submitting your comment, you agree to our Terms and Conditions. These terms were revised effective April 16, 2010.

letters

Make text: Larger | Smaller

LATEST VIDEO

Paul Maurice post-game - September 22

View more like this

Photo Store Gallery

  • A monarch butterfly looks for nectar in Mexican sunflowers at Winnipeg's Assiniboine Park Monday afternoon-Monarch butterflys start their annual migration usually in late August with the first sign of frost- Standup photo– August 22, 2011   (JOE BRYKSA / WINNIPEG FREE PRESS)
  • Two Canada geese fly Wednesday afternoon at Oak Hammock Marsh- Front bird is banded for identification- Goose Challenge Day 3- - Apr 30, 2012   (JOE BRYKSA / WINNIPEG FREE PRESS)

View More Gallery Photos

Poll

Do you think Judy Wasylycia-Leis will greatly benefit from the endorsement by Winnipeg's firefighters?

View Results

View Related Story

Ads by Google