Saving mothers' lives: what works: Judi Brown writes about the White Ribbon Alliance's International Conference on Safe Motherhood Best Practices, October 3-5, 2002, New Delhi, India.

• Auteur: Brown, Judi

The Conference was convened by the global White Ribbon Alliance for Safe Motherhood (WRA), in collaboration with the White Ribbon Alliance in India, as an initiative to strengthen links between the national and international coalitions committed to saving mothers' lives and provide a forum for sharing international Safe Motherhood best practices i.e. successful and replicable interventions.

In all, 467 participants, from more than 30 countries, attended this conference. Among midwives who attended the conference there were many from India and Pakistan; a contingent from the Philippines including former ICM President Alice Sanz de la Gente; and midwives from the African nations including Lennie Kamwendo from Malawi, who was an ICM Marie Goubran Award winner in 1999.

The conference objectives were to:

* Promote a greater understanding of Safe Motherhood Best Practices and ways to replicate these practices

* Increase knowledge and understanding of the role of social mobilisation, advocacy and coalition

* Enhance the institutional capacity of alliance members and increase understanding of the theory and practice of inter-organisational capacity building.

Speakers included representatives of the Indian Government, the British High Commission, WHO, the local WRA in India and Theresa Shaver of the WRA Global Secretariat.

India has a maternal mortality figure of 100,000 deaths annually; it is estimated that only 5% of women receive any sort of antenatal care. These are `sisterhood' estimates and more formal studies are now showing an under-reporting of deaths. Maternal deaths remain worldwide `individual and silent tragedies'.

The `three delays'

One of the salient points made was around deaths in labour and delivery that occur because of the `three delays': assessment, access and actions. A concern was expressed at this stage about the promotion by health professionals of the message that `pregnancy is normal'. This can have a negative effect for women in some communities where it is translated into total inaction--by male relatives--when the pregnant woman develops complications. The situation is compounded in communities where there are unequal gender/power relations and poor knowledge of health care providers and services. In the first delay of assessment the woman with complications must wait for male relatives to agree to transport her to a health facility. In the second delay of access there may be no transportation or the family will have no...