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Maternal health: How do we make health systems work for mother and child?


Global progress on improving maternal and child health has been hard-won and deeply uneven. Researchers supported by IDRC focus on the root causes of inequities and how health systems can better meet the needs of women and children.

According to United Nations’ estimates, in 2010, some 800 women died every day from complications of pregnancy or childbirth, 99% of them in developing countries. Some 7.6 million children died before the age of five. While these numbers are high, they do reflect considerable gains for maternal and child health since countries agreed in 2000 to a set of ambitious development targets for 2015.

A closer look reveals that these gains are socially and geographically uneven. Maternal mortality is higher in rural areas and among poorer communities. Deaths in children under five are increasingly concentrated in sub-Saharan Africa and South Asia. In two-thirds of countries that have made progress on child mortality, the gap between rich and poor actually increased. This reflects inequities at many levels, and underscores the fact that health services are not reaching those who most need them.

In many regions, the inadequate care women receive stems from their low social status. From childhood on, girls have less access to education and poorer nutrition. As they grow older, they are excluded from economic and political participation, and suffer domestic violence. Too often, women are the last to eat, and the last to receive medical treatment.

Addressing the root causes of poor maternal and child health

Through its Governance for Equity in Health Systems (GEHS) program, Canada’s International Development Research Centre (IDRC) brings a unique perspective to maternal and child health in low- and middle-income countries. Going beyond a narrow focus on illness and treatment, IDRC promotes research that explores the root causes and systemic factors undermining women’s and children’s health. While women commonly die in childbirth and pregnancy from hemorrhage or infection, the underlying causes include malnutrition, domestic violence, and their lack of education and decision-making power. These conditions find fertile ground when poverty intersects with a lack of respect for women’s rights and needs.

With GEHS support, researchers in low- and middle-income countries are addressing how effective health systems are in meeting the needs of mothers and their children. They are using social and gender analysis to understand how health care is governed and implemented, how resources are allocated, and how the systems can support the empowerment of women.

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