Author: Nikola Benin
The conference “Together for the next generation: Research and innovation for maternal and newborn health” took place in Brussels on 8 December 2015. Around 200 researchers, policy makers, health practitioners, research funders, advocates, and NGOs active in low- and middle-income countries participated and contributed to make this conference a success.
EXECUTIVE SUMMARY In 2015, 303,000 women died due to causes related to pregnancy or childbirth, 2.7 million babies died before the age of 1 month, and 2.6 million were stillborn. While improvements in maternal and newborn health (MNH) have been achieved since 1990, more progress needs to be made in the years to come. The conference on research and innovation for MNH: assessed the successful actions which we know are contributing to better health of pregnant women and newborns both in Europe and beyond; discussed the role that research and innovation can play under the sustainable development goals (SDGs), taking into account the challenges that new lifestyles, migration and other large-scale changes may pose on a global level; asked what the current research gaps are, what more can be done, and what should be done differently in order to move from knowing to doing. The conference was carefully timed to take place within weeks of the announcement of the SDGs and the relaunch of the UN Secretary General’s Every Woman, Every Child Campaign. The meeting was also convened at the very end of 2015 – just as the final results of the MDGs were emerging, including estimates for the maternal mortality ratio and other important impact indicators. The meeting takes its place among other key conferences as one of the major scene setting fora in MNH research in the new SDG era. Innovation to improve maternal and newborn health Five key challenges were discussed for which innovative solutions need to be developed: 1. The double burden of malnutrition and obesity: Trends in nutritional status for girls, women and infants provide an important context for MNH today and into the SDG period. Solutions tend to have most impact on the poorest sectors of the population. 2. Adolescence – a critical life stage for MNH: Interventions that help girls stay in school, and equip them with capabilities early in their adolescence have been shown to be vital. Evidence also shows that the most effective interventions are often multi-sectoral, comprehensive with a focus on multiple outcomes, and incorporate a life cycle approach. 3. Research collaborations – still essential for MNH: The development of innovative solutions to both emerging and existing problems requires collaboration between academic researchers (from a variety of disciplines), clinicians and users (both women and their families and communities). 4. Quick turnaround cycles – not necessarily high tech solutions: The ability to develop rapid solutions to crises and constantly adapt/revise them is crucial to addressing persistent as well as emerging challenges to MNH, and can make the difference between life and death. ‘Low-tech’ solutions can be particularly effective in some settings. 5. The importance of prevention as an overall strategy: Interventions such as exclusive breastfeeding have been shown to be extremely effective in prevention of childhood malnutrition. Family planning also improves women’s chances for education, employment, family and economic stability, and the wellbeing of whole communities. Putting evidence into action: Implementation at scale How can research be done differently to ensure a better uptake of results? The following 5 solutions and key contexts were outlined at the conference: 1. Implementation research – understanding health systems and testing solutions in real life situations: A consensus exists on the key role of health systems to deliver solutions to entire populations (not just people living in intervention areas). So health systems research is a key pathway towards extending solutions beyond the pilot phase. 2. Public/private MNH services – the evolving situation: Important trends such as the fragmentation of public systems have been a critical barrier to progress. Richer groups do access private care, but the extent to which they do so varies widely by country, the quality of the care is variable, and private sector regulation is often difficult. 3. The IT revolution: The massive potential of IT to improve MNH indicates that the SDG era holds much promise. With the widespread availability of mobile technologies, m-health could provide new opportunities to improve MNH services, and research is needed to develop these new approaches. 4. The equity transformation: Equity will be the most important theme of the next generation of MNH research. Nothing short of a full transformation will be needed to place each and every woman and child at the centre of health system strengthening. 5. Migration and demographic change; evolving population trends: Demographic trends such as mass migration (and its associated lack of access to MNH services), population aging, later childbearing and urbanisation have profound implications for MNH. The numbers of urban poor are increasing, and improved access to basic health services is needed to reduce large and increasing inequalities in urban areas, and to ensure that women and children have access to care, especially around the time of birth.