About 40 women, somewhere in the world, die in pregnancy every hour, 343 thousand a year by current (admittedly rough) estimates. It's a tragic reality but one we can do something about. We know the causes well and meaningful action can reduce mortality (and lifelong injury to mother and child) swiftly and dramatically. There is a huge range in rates of maternal mortality (calculated as annual estimated deaths per 100,000 live births), from the worst places -- 1575 in Afghanistan and 1570 in the Central African Republic -- to 3.9 in Italy and 4.6 in Sweden (the US comes 39th with 16.7). The huge gaps have to do with medical knowledge and care and social attitudes but it really boils down to political will -- how important is it to address the problem and where does it fit on a priority pecking order?
This challenge should be a natural for religious leaders and communities. Honoring motherhood and families represents pretty solid common ground among most religious traditions. Prophetic voices can galvanize communities and leaders to act on their moral principles. What is more, many of the actions needed to save lives fall squarely within spheres where faith actors and ideas can truly make a difference: setting health priorities, spreading knowledge, and pressing for changes in attitudes that degrade women. Sometimes faith is at the forefront but sadly more often than not it is not at the center of dealing with what is recognized as a global shame and a global priority for action.
Working with faith communities to promote safe motherhood: that was the topic of a practical, roll-up-your-sleeves gathering in Washington DC at the Woodrow Wilson Center earlier this month sponsored by the Maternal Health Task Force UNFPA http://unfpa.org/public/, Christian Connections for International Health, the World Faiths Development Dialogue (my NGO), and the Wilson Center. Focusing on places crying out for action (Pakistan, Nigeria, Yemen, and Bangladesh) a diverse group looked for ways to make sure that faith communities are truly part of the action.
Here are 10 action ideas that emerged from two days of discussion.
(1) Insist on a place at the table when halting maternal mortality is on the agenda, at national and international levels. Figuring out which tables count is complicated but with maternal health now demanding global action, faith leaders and institutions should raise their hands, their voices, and their resources, and volunteer their support to the cause.
(2) Several cited their three top priorities as "coordination, coordination, and coordination." Overlapping, duplicative projects are sadly all too common. No one particularly wants to be coordinated but pragmatic and thoughtful coordination mechanisms, at all levels, are a vital step on the path to better results.
(3) Recognize that what is at issue is the system, and engage there. Primary health care systems need urgent action but so does community care, education of adolescents, women, and men to recognize danger signals during pregnancy, for example.
(4) Challenge governments to act and to see faith leaders and communities as true partners. The flip side is that governments need to engage faith communities, especially where they seem reluctant to value the lives of mothers and women or skittish in confronting causes of mortality.
(5) Knowledge is a powerful tool so good, sensitively framed information, is essential. With maternal death an ancient reality, modern knowledge about what makes a difference (skilled birth attendants, delivery in a facility) can be presented in ways that galvanize action. Checklists, spiritual teachings, and modules in theological training institutions are examples of what can work.
(6) Inspiration from best practice (and lessons from bad experience) is clamored for by those working to save lives and they value well functioning networks that allow them to exchange and learn. Facilitating networks within faith communities and in interfaith settings is a great move.
(7) Taking inspiration to solid evidence, evaluation and monitoring, is another need. While some faith institutions have world class evaluation practices, there is still a common view that filling out forms is useless bureaucracy when there is life-saving work to be done. But knowing what really works is vital so a push for sensible, well adapted evaluation is sorely needed.
(8) New technologies: mobile phones, social media,for example, are opening new ways to identify weak spots and bring rapid action and support and faith communities need to embrace them as potential tools.
(9) Presenting action in terms of human rights can be a powerful tool, highlighting the value of each person's life and forcing all to come to grips with what equality of access and care means. The group was divided, sadly, on whether human rights was a clarion call to action or too divisive to highlight. In some settings rights talk is read as western focused, emphasizing the individual against the community, and opening cans of worms on reproductive rights and sexuality that some would prefer to leave closed. There's a crying need for dialogue here.
(10) Life for mothers is appealing in its universal message and potential as a powerful common cause but addressing maternal death leads quickly to less unifying issues. The desperation that comes with unwanted pregnancy leads many women to unsafe abortion. Young brides have far higher mortality rates than mature women. Thus family planning and maternal health are inextricably tied. Rape and domestic violence are also linked as are social practices that mute women's concerns and voices. So these tough topics need to be confronted and discussed in sensitive but purposeful ways.
This thoughtful agenda can engage any faith community anywhere in some way, whether it is within a congregation or contributing to global action. This is an urgent, demanding cause, and while there are no simple solutions, no magic wands that can bring change, there are a host of potential avenues that can profoundly change the lives of women and families. Let's move.