Maternal & Child Health: How Rotary Can Contribute

To resolve the “interlocking issues of overpopulation, unsustainable development and human suffering”, The Rotary Foundation has identified six Areas of Focus: Peace and conflict prevention/resolution; Disease prevention and treatment; Water and sanitation; Maternal and child health; Basic education and literacy; and Economic and community development. These Areas not only highlight critical humanitarian issues, but help in achieving the mission of Rotary International to advance world understanding, goodwill and peace. 

 Among six Areas of Focus, Maternal and Child Health (MCH) that is “Reproductive Health” (RH) is most crucial in reducing poverty and advancing human well-being. RH encompasses the healthcare dimensions of preconception, prenatal and post natal   care in order to reduce maternal and child morbidity and mortality as well as unintended fertility. All three are not independent items, but rather involve a series of biological and social mechanisms in close interaction with one another. Higher use of RH services has positive effect on health indicators like Maternal Mortality and Infant Mortality and Total Fertility. 

 While the world’s population continues to grow by around 85-90 million annually, more than 200 million women, mainly from the poor countries, lack access to basic reproductive health services. Often, these women must travel far from their communities to reach a health facility, only to return home “empty handed”, due to shortages and stock-outs, as well as non availability of staff, as noted by the Population Action International. When women seeking reproductive health, including family planning services are turned away, they are unable to protect themselves from unintended pregnancies and sexually-transmitted infections, including HIV/AIDS. Consider the following facts: 

•  About 500,000 women died during and following pregnancy and childbirth. Almost all of these deaths occurred in low-resource settings, and most could have been prevented.
• Globally, ten million infants and children die each year before their fifth birthday. Ninety-nine percent of these deaths occur in developing countries.
•  53 million unintended/unwanted pregnancies take place every year;
•  40% of women in developing countries do not use contraception; and
•  80% of maternal and infant deaths could be prevented with access to reproductive health.

 Reductions in maternal and child mortality as well as unwanted fertility require interventions to improve service delivery, as well as community mobilization to improve use of reproductive health services. During the   London Summit on Family Planning (July 2012),   it was pointed out that if the global community can support developing countries to enable 120 million more women and girls to gain access to contraception between 2012 and 2020, it is estimated that cumulatively 300,000 fewer women and girls will die in pregnancy and childbirth and three million fewer infants will die from complications in their first year of life each year.

 Since Rotary presents a “great model for action”, as noted by Jeffrey Sachs, Director of Columbia University's Earth Institute, it can play a catalytic role in motivating the policy makers to focus their attention to resolve the issues of poor maternal and child health, as it did in case of Polio Eradication.  This is why the world is looking towards Rotary to take the challenge. Action is needed now. The Rotary Foundation has already recognized Rotarian Action Group for Population & Development (RFPD) as a resource centre for   Maternal and Child Health; and RFPD has been promoting public-private and civil society partnerships to improve maternal and child health. To expedite the process, RFPD and its regional units must work actively to educate policymakers, program managers, the media and the public about importance of maternal and child health. At the same time, RFPD must encourage Rotary districts to take up permanent projects that directly impact maternal and child health and women empowerment in collaboration with government agencies, non-governmental organizations and local leadership to ensure for more sustainability of our efforts. Finally, RFPD must be a leader in organizing international discussions on this important issue by involving leaders from developing and developed countries, donors, civil society groups and the private sector to come together behind a simple vision: to give women in the developing world the same access to lifesaving RH services as women in the developed world.

 Studies find that women and couples who can decide on the number, spacing, and timing of their children are better able to increase their household income and invest in their existing children. Country budgets go further. As fertility rates fall, pressure is relieved on a country’s health, education, water, sanitation and social services, and on scarce natural resources. It is estimated that every US$1 spent on family planning services yields between $2 and $6 in subsequent social sector cost savings in Sub-Saharan Africa and up to $13 in South Asia.  Rotary International   has the potential to transform the lives of millions of girls and women in the world’s poorest countries. All of us have a vital role to play in order to achieve our collective ambition.

 By: Rtn: Dr. Devendra Kothari Professor, Population Program Management