Dr Flavia Bustreo was appointed Assistant Director-General for Family, Women’s and Children’s Health in 2010. Danielle Barron interviewed her in the lead-up to Safe Motherhood Week 2018
DB: Can you tell me what improvements you have seen in the area of maternal rights? Where do you see the gaps in maternal rights as they stand?
FB: Over the past six or seven years, we have really made big progress and strides in maternal mortality; of course we did not achieve the original SDG goal of reducing maternal mortality by three-quarters but we did reduce it by about 44 percent. The reduction and progress was actually almost entirely after 2010, because if you look at the data between 1990 and 2010 we had around 500,000 maternal deaths every year and now the latest data is around 300,000 deaths per year. So while we clearly still have a long way to go, the progress has been good, and for 20 years we saw no progress.
What is important now is that we continue with the progress we made since 2010 and we need to keep the accelerator on because with the present rate of change, it will take about 160 years before a pregnant woman in Africa has the same chances of carrying a pregnancy safely as a woman in a high income country like Ireland or the U.K. This inequity is what drives us.
DB: What do you see as the major issues currently facing women and threatening a safe motherhood experience?
FB: Absolutely, one point I’d also like to make is when we talk about Safe Motherhood Week, one aspect is maternal survival. The fact they can survive pregnancy and live afterwards to become fully caring mothers, starting from the beginning we need to arrive at a point where woman can decide when they want to become pregnant, with whom and being able to have a good quality of care throughout the whole pregnancy and that they can have a good birthing experience. It not just about reducing maternal deaths but it must be about improving the quality of pregnancy and childbirth and this is something that applies equally in Europe and Africa. Another issue I wish to signal, is the mistreatment and abuse of women during childbirth; a paper that was published two years ago and will be updated and published next year shows that mistreatment and abuse during childbirth is equally a problem in the developing and developed world. This mistreatment represents a violation of women regarding human rights.
DB: You are a leading global advocate for investment in the health, rights and wellbeing of girls and women. What form should this investment take and what solutions can it provide?
FB: Certainly the investment must begin with the strengthening of the healthcare system and the workforce that is able to accompany the woman with the motherhood experience, so that healthcare professionals can give the mother knowledge of birth control, family planning, what are the methods the woman can choose, and also that someone can accompany the mother during the experience of the pregnancy, so they can advise her during time of delivery, where to seek the delivery care. The skills and workforce delivery is key, we always indicate in our work that maternal mortality is a crucial indicator of the strength of the health system, because if you have a health system that can provide C-sections at night, at any time of the night when required, that health system is normally able to deliver many other things. Because in order to deliver a successful C-section you need to have electricity, a blood bank and you need to have a healthcare worker who can perform and is trained. All these elements enable a healthcare facility to deliver, for example, trauma care for patients or another other type of emergency that might occur.