Learning by doing and doing better by learning

Reflections on the first Global Maternal Health Conference,
30 Aug-1 Sep, 2010 in New Delhi, India
By Girija Sankar, GHA Program Manager

The Global Maternal Health Conference in New Delhi was the first ever technical conference to focus exclusively on pressing maternal health issues around the world. It was also the first technical conference for me, a person used to participating in more academic conferences.

I represented Global Health Action and presented a poster on GHA’s maternal and child health project in rural Haiti - a five-year USAID-funded project, with the objective of increasing and improving women’s access to pre- and post-natal services in Petit-Goave, Haiti. As I write this, I note with a sense of cautious optimism that according to the just-released reports from the WHO, maternal mortality rates in Haiti have dropped from 670/100,000 in 1990 to 300/100,000 in 2008. Of course that was before the earthquake, and Haiti, like many sub-Saharan countries has a long way to go, but it is heartening to see that progress has been made.

The conference was a true confluence of the latest in research, grassroots advocacy, policy planning, and community based work on maternal health. Most presenters and panel speakers stressed that MDG 5 is one goal that continues to fall behind in many countries. Many global/international conferences run high on rhetoric and fall flat on achievements. I would argue that while this conference certainly had plenty of rhetoric, it also spurred robust debate and dialogue on sensitive and critical issues such as the role of midwives in maternal health care, the neglect of obstetric fistula, the continued dearth of skilled maternal health professionals, and so on. 

However, Some of the best sessions that I attended had less to do with policy, planning, or advocacy and more about evidence-based programming that delivers results. At the end of the day, results matter. Results do not always have to be positive, but unless and until health programs track progress and document results, no real progress can be made.

A session that stands out in my memory and notes is the one on media and publicity related to maternal health programs. Market research in the Indian state of Uttar Pradesh showed that no matter how good and classy public health messages are, nothing can trump human interaction in getting the message across about safe health practices, underscoring the need yet again for trained community-based health providers.

I also learned that progress can be slow and arduous but that it is indeed possible. For measurable progress, not just in maternal health but in any public health initiative, the following are absolutely essential: (1) the buy-in of local authorities - civil society organization MUST partner with local institutional mechanisms for any meaningful work and progress; and that (2) training and supporting mid- and community-level health workers is critical to reducing maternal mortality rates.

As Jill Sheffield of Women Deliver said, maternal – and indeed all – public health programming around the world should be driven by the following motto: “Learning by doing and doing better by learning.” In other words, it’s not enough just to do; rather, one must learn while doing and do better because of the lessons learned. That’s the message I brought home with me to Atlanta and will strive to work by going forward.