Reverse the neglect of maternal mortality

Nicholas Kristof of the New York Times has often written on the shameful problem of maternal mortality. A few days ago he proffered a solution to the problem that goes beyond health system fixes.  Specifically women’s issues need political attention, and to do that, women need to be more involved in governance.

Kristof observed the U.S. experience that “after women’s suffrage became a reality, maternal mortality fell sharply. It seems that when women were accepted fully into the political system, then resources were also made available in the health system and they, less marginalized, were able to take advantage of them.” In countries with high maternal mortality, the right to vote is not enough, especially when voting may not actually determine political outcomes.

Malaria, of course, is responsible for an important portion of maternal mortality, whether directly through severe episodes when women have reduced immunity, or through anemia caused by the infection.  As we have often observed, of the main components of malaria control and elimination efforts, malaria in pregnancy (MIP) is the weakest leg of the stool.  Until national malaria programs, with pressure from malaria partners, make MIP control an equal priority with bednet distribution and treatment of small children, the destructive work of the disease will continue.

_38913701_elections1999_ap203b2.jpgKristof wishes that groups promoting Safe Motherhood initiatives will “hopefully … get strong backing from the Obama administration.” Not only are pregnant women with malaria at risk themselves, but their newborn children would have suffered from growth retardation in utero and being born of low birth weight, would be more likely to die before they can benefit from bednets and artemisinin-based combination therapy.

Not only do women in malaria endemic countries need to vote, the people they vote for need the political will to reduce maternal mortality by all means including preventing malaria in pregnancy.

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