Global Health Spending: Why Maternal Health Is Not a Political Priority
"Why is it that some global health issues attract extensive political support, in the form of attention and resources while others remain neglected" questioned Jeremy Shiffman, associate professor of Public Administration from Syracuse University, at a March 4, 2009, conference sponsored by the Woodrow Wilson International Center for Scholars' Global Health Initiative. Shiffman was also joined by Ann Starrs, President of Family Care International, who evaluated the advocacy efforts within the safe motherhood initiative and made recommendations for building global political investments.
Why Maternal Health Matters: Presenting The Case
Opening the event, Shiffman highlighted the differences in political and financial support for global health issues–such as HIV, TB, and malaria–and compared them to the safe motherhood initiative. Unlike other global health concerns, the safe motherhood initiative has failed to attract significant global resources, which Shiffman argued is due to issue ascendance and the maternal health community's inability to "make the case" in regards to actor power, ideas, political contexts and issue characteristics.
In the past, the safe motherhood initiative has confused policymakers by providing diverging solutions to maternal mortality health systems and intervention disagreements among the global institutions that work on the issue. "Policymakers are more likely to act on issues that they think they can do something about", stated Shiffman. The maternal health community must take advantage of policy windows that will allow them to frame the safe motherhood message in a manner that is cohesive, evidence-based and inspiring to external audiences.
To ensure sustained resources, Shiffman argued that there are four key advocacy areas that the safe motherhood initiative must improve upon to generate sustainable political support: solidify policy community cohesion, develop external frames that resonate, build strong guiding institutions, and link grassroots civil society initiatives. Fortunately, Shiffman stated, "the messages now are clearer", and the safe motherhood initiative is learning how to advocate collectively.
Where Is The Money in Maternal Newborn Child Health
"There is a lot of room for optimism, what we need and what the big challenge is, is to turn political priority into financial commitments", argued Starrs. Generating political support through cohesive messaging and collective action has improved within the safe motherhood initiative, however, advocacy gaps remain and Starrs drew upon the work of the Partnership for Maternal, Newborn and Child Health to offer recommendations for building sustainable financial and political support.
Focusing on messages that resonate with policymakers is imperative to generating political support and phrases such as "Invest in Women, It Pays" help external audiences understand the significant contribution mothers play in the family, community and economy. Starrs shared that the safe motherhood initiative must learn from other successful global health initiatives, such as HIV, so that the political and financial communities can specifically address the issues of, "What is the price tag and what are the interventions that [the safe motherhood initiative] are promoting".
In order to build long-term sustainable development, maternal mortality interventions must be complemented by quality health care systems and include the participation of local community members. The window of opportunity is now and, "the next 12-18 [months] will be critical for safe motherhood advocacy, offering an unprecedented chance to redress errors of the past and take advantage of new opportunities" argued Starrs.
By Calyn Ostrowski
Gib Clarke, Coordinator, Global Health Initiative