White Ribbon Alliance


Turning a Vision into Action

June 29, 2014
by Betsy McCallon, Executive Director, White Ribbon Alliance Global Secretariat

On June 25th, USAID quietly launched the Maternal Health Vision for Action at the Acting on the Call forum, which was co-hosted by the Governments of Ethiopia and India, in collaboration with UNICEF, the Bill & Melinda Gates Foundation, and other partners. I say quietly because there was no ‘stage time’ allocated to it – the announcement was simply included in the handouts - yet its release is incredibly important as the Agency has not had a maternal health strategy since 2003 and much has changed since then.

The Vision sets out ten strategic drivers that will define the focus and investment from 2014-2020, and there is much to applaud. To begin, while the Vision clearly sets out to contribute to achieving the new target of an average maternal mortality ratio of less than 70 per 100,000 by 2030, it takes a more holistic view of maternal health than only focusing on survival. At least five of the strategic drivers address other key and cross-cutting areas, including:

  • the long-neglected area of maternal morbidity;
  • the focus on improving equity and reaching the most vulnerable;
  • a much greater emphasis on integration with family planning and on indirect causes of maternal deaths;
  • the promotion of respectful maternity care alongside improved conditions for health care professionals

  • There are a few concerns though that we will be following closely. While the word Accountability is in the header of one of the strategic drivers, this is primarily focused on improved data collection. Improving data – and more importantly what decision-makers do with the data – is essential, but it is only part of the picture. Governments and health systems must be accountable to those they serve, which includes listening to the evidence coming from citizens and civil society groups, and striving to make improvements and accelerate progress.

    The Vision’s Strategic Driver 1 mentions “advancing community mobilization efforts…to improve the quality of services and to hold health systems accountable”, but this bullet point is included under the heading of behaviors and norms. To be successful, there must be investment in local civil society movements that can galvanize communities to know their rights and demand them; this includes being listened to – rather than told – what quality and respectful services should look like.

    While USAID has always focused on a set of priority countries, I am increasingly concerned about the drive to hit target numbers that are defined by many development partners and the [likely unintended] lack of value that places on the lives of women and children in less populous countries or in those deemed marginally better off. I hope that USAID will continue to focus on seeing results, as well as demonstrate leadership in ensuring that every woman everywhere realizes her right to a safe and healthy pregnancy and childbirth.

    At the White Ribbon Alliance, we look forward to working with USAID to translate this Vision into Action.