Memorandum submitted by the International
Rescue Committee
Maternal Health—How the international community
can improve maternal health in crisis and conflict settings
1. Given the prevalence of conflict and
natural disaster in many least-developed countries, MDG 5 will
not be met without concerted efforts by donors to find ways of
providing effective reproductive healthcare to disaster- and conflict-affected
women and their families.
2. This is a highly complex, but vital,
challenge. Tens of millions of people are currently either displaced
by disaster or conflict or are living in highly volatile conflict-affected
regions. Moreover, while on average residents of refugee camps
can expect to enjoy relatively good access to care, internally
displaced and non-displaced persons in conflict zones generally
receive very little in the way of services.
3. Ensuring adequate reproductive health
provision in conditions of conflict or displacement can not be
done cheaply or casually. Donors such as DFID need to invest significantly
in supporting effective sexual and reproductive health programmes
as part of their engagement with "humanitarian" and
"fragile" contexts, as well as in more stable "development"
contexts.
4. A large gap exists between recommended
practice and the reality in the field. As an influential donor,
DFID should aim to address this by ensuring the following:
4.1. that staff with the necessary clinical
qualifications and experience to address obstetrics are included
in any emergency response team;
4.2. that the availability of emergency
obstetric care is integrated into all assessments conducted by
all humanitarian assistance providers;
4.3. that support is provided to fill identified
gaps, either reinforcing existing referral facilities or establishing
new services as needed to meet the needs of conflict- or disaster-affected
women;
4.4. that data is collected on the six UN
Process Indicators in all humanitarian relief programs providing
Emergency Obstetric Care to measure progress in reducing maternal
mortality and morbidity, to support advocacy efforts and to leverage
resources;
4.5. that standard protocols for emergency
obstetric procedures based upon WHO, UNFPA, UNICEF and the World
Bank's Managing Complications in Pregnancy and Childbirth: A guide
for midwives and doctors are widely disseminated;
4.6. that regional training centres are
identified and supported;
4.7. that funds to cover the additional
costs of emergency obstetric care are included in grants made
to humanitarian relief programmes.
5. At the community-level, DFID can have
a rapid impact on maternal health outcomes by ensuring that clean
delivery kits are distributed to visibly pregnant women among
displaced populations and by supporting programmes to educate
community-level decision-makers about the signs of pregnancy complications
and the importance of quick transfer to save the life of a woman
and her baby.
14 September 2007
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