The Maternal Health Task Force (MHTF) is a three-year effort funded by the Bill and Melinda Gates Foundation. The group held a retreat to 'take stock of the field' of maternal health for three days in Tarrytown, NY. Unlike other end of project meetings, the meeting, called #MHBUZZ, asked five overarching questions about the field of maternal health and brought together 60 thinkers and activitists to tackle the questions. I was privileged to attend and hope that the incredible intensity of the discussion sparks ongoing discussion. One question brought forward and discussed by Wendy Graham is 'Do we really know what works?'. Wendy Graham works with Immpact, an international research initiative out of the UK focused on evaluating strategies and interventions for maternal health.
To me, virtually all other questions pale in comparison and I appreciated the fact that the retreat began with this very important inquiry. Other MHTF blog posts cover crucial questions like, to whom is the knowledge community accountable?.
Wendy Graham narrowed in on the question a bit further-- We know how to save lives--at the clinical level-- but do we really know what works at a population level? She asks, as we've asked in some earlier blog posts, have we gone mad for randomized control trials? Have our paradigms taken us down the wrong rabbit whole? Have we neglected areas not amenable to randomzied control trials? Professor Graham cited (Gaynor Maclean's 2010 article analyzing the last 20 years of Safe Motherhood activity](http://www.mendeley.com/research/historical-overview-first-two-decades-s...) saying that we've ended up with a bit of a jigsaw puzzle. Maclean notes that the early focus on medical interventions have given way over time to an approach that takes into account social and economic determinants more fully. Graham asked, putting up the statistics for declines in maternal mortality rates, what is really going on here?
The room at #MHBUZZ was filled with people who have spent their entire careers on the issue of reducing maternal and newborn mortality. There was a palpable feeling of some relief and some optimism, that a movement is underway, that MDG5 was a turning point for the globe and for women and that the 'factions' that bogged this movement down for quite a while there, were more at peace. At the same time, Young Champions of Maternal health supported by the Task Force presented their projects and their ideas and had an equal voice at the table, providing new perspectives and new energy.
Being extremely practical, I was less interested in the meta questions about 'is there really a maternal health movement' and 'to whom are we accountable'-- and wanted to spend virtually the entire three days on Wendy Graham's questions. But the important thing is that the question was asked and that many of those tackling the answers were in the room. More to follow!
I do think that the question of 'is there a movement' is less important in a way than the question of 'what is the movement, such as it is, asking for?', how can we be very precise about what women deserve at birth? Just raising awareness of maternal death as an issue is hard enough, but it is not enough. The question of exactly what works at a population level is the defining question that MUST inform the movement as well.