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Institute Senior Advisor Anita McBride, Fellow Mark Dybul on Maternal and Child Health

February 3, 2013

Last week, Anita McBride and Mark Dybul, M.D., together with actress Christy Turlington, spoke at Representative Kay Granger’s Capitol Hill Briefing about FEMME, a new CARE model program in Peru which reduced maternal deaths by 50 percent. Mrs. McBride, Senior Advisor to the Bush Institute (and chief of staff to Laura W. Bush during the Bush Administration) moderated the discussion, which took place in front of the press, representatives from NGOs, and staffers from 27 Congressional offices.

“Nearly every minute of every day a woman dies from complications related to childbirth or pregnancy, “ Mrs. McBride told the briefing in her opening remarks, but Millennium Development Goals “that address health for women and children have seen little progress and have not improved nearly enough.” In comparison to the historic efforts that have addressed HIV/AIDs, which can be measured “in programs like PEPFAR that have saved 2.4 million lives,” saving women’s lives in childbirth is simpler because: “Some basic interventions can change these statistics and we don’t have to wait for a medical breakthrough to save women’s lives. The reality is we know how to prevent nearly all maternal deaths. - the presence of a skilled birth attendant can mean the difference between life and death for a mother and her newborn”

Dr. Dybul, who was U.S. global AIDS coordinator in the Bush Administration, gave the historical context for programs like CARE’s FEMME model. He spoke of how a new paradigm for the delivery of essential health services to families, communities and nations emerged with PEPFAR (founded in 2003) and PMI (the President’s Malaria Initiative, founded in 2006). These programs emphasized partnership, not paternalism, and supported people in African countries not only financially but by entrusting them to find innovative solutions to their health problems. As a result, PEPFAR has saved millions of lives and has given hope and stability to families and the communities in which they live. Many African political leaders have told Dr. Dybul how PEPFAR connected them to their people in new ways, enlivening democracy as well as public health. Dr. Dybul paid tribute to the bi-partisan nature of the work on global health from its beginning in the Bush Administration and continuing in the Obama Administration, and reflected in bi-partisan Congressional support.

The three interventions most likely to reduce maternal mortality, Dr. Dybul reminded the audience, are treatment of bleeding, treatment of hypertension, and the empowerment of women to avoid unwanted pregnancies. Hypertension and hemorrhage account for 50% of maternal mortality. Unwanted pregnancies are responsible for another 30%, occurring often in resource-poor settings because of rape and sexual abuse. Dr. Dybul noted that protecting women from violence and giving instruction in family planning, including birth spacing and contraceptives, would not only address gender equality, but reduce maternal mortality by 30% without the need for medical intervention.

Dr. Dybul concluded by describing a new phase in the Millennium Development Goals program, which concentrates on women and children’s health as an entry point to improve national health services as a whole. This is what is most exciting to him about CARE’s work in Peru – how saving the lives of mothers starts with themselves, but leads immediately to an improvement in the health and well-being of her other children, of her family as a whole, in the community in which she lives and the national economy which thrives on healthy families, but can be crippled by working people who are too sick to work, or die and leave parentless and vulnerable children behind.

You can read more about the success of CARE’s FEMME program in Peru at http://www.care.org/campaigns/mothersmatter/downloads/Peru-Case-Study.pdf., and elsewhere on CARE’s Web site, www.care.org.