Elevating Maternal and Child Health and Family Planning Under the Obama Administration

Maurice Middleberg

A Global Family Health Action Plan could integrate child health, maternal health, family planning and HIV prevention and meet US commitments to the UN Millennium Development Goals.

By repealing the Global Gag
Rule on his third day in office, President Obama took a huge first step
toward leading the world in addressing the health needs of the world’s
poorest women, children and families. Now it is time to get to work
on elevating what has been a stagnant American response on global family
health and work toward saving the lives of millions of women and children. 

On January 23, 2009, the new
president correctly lifted the Gag Rule, a policy that severely hindered
the work of international family planning organizations by banning funding
to any international organization that engages in a wide variety of
activities, including "providing advice, counseling, or information
regarding abortion, or lobbying a foreign government to legalize or
make abortion available." In a statement accompanying the executive
order overturning the Gag Rule, President Obama said: 

It is time that
we end the politicization of this issue.  In the coming weeks, my administration
will initiate a fresh conversation on family planning, working to find
areas of common ground to best meet the needs of women and families
at home and around the world. I have directed my staff to reach out
to those on all sides of this issue to achieve the goal of reducing
unintended pregnancies. They will also work to promote safe motherhood,
reduce maternal and infant mortality rates and increase educational
and economic opportunities for women and girls.

The president’s statement
shows a profound understanding of the linkage between the health of
pregnant women and mothers, the health of newborn and young children,
and access to family planning services. In previous remarks, President
Obama has lauded and pledged to expand presidential initiatives to fight
HIV/AIDS, TB and malaria – recognizing the sizeable effect they have
had not only in saving hundreds of thousands of lives, but also in improving
U.S. foreign policy. Now is the time for President Obama to elevate
the issue of global family health to that high level. 

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Experts from the global maternal
health, child health and family planning communities who are members
of my organization, the Global Health Council, have been meeting in
recent months to develop for a framework for a Global Family Health
Action Plan. The initiative would aim to drastically reduce the more
than 500,000 pregnancy- or childbirth-related deaths annually; the estimated
9 million children who die each year – largely from treatable or preventable
causes such as pneumonia, diarrhea, and vaccine-preventable diseases;
as well as the estimated 76 million unintended pregnancies each year. 

The Global Family Health Action
Plan also would serve as a model of coordinating delivery of a set of
specific interventions with the vitally important task of building health
workforces and strengthening health systems in developing countries.
Gender equity issues are of prominent importance for this initiative,
and the U.S. should seek to advance health interventions controlled
by women themselves. The plan also should support and coordinate with
other programs vital to family health – including nutrition, water,
and sanitation and reducing family violence – as well as be linked
to U.S. programs for HIV/AIDS, malaria, TB, and neglected tropical diseases.  

While a candidate, President
Obama clearly stated that the United Nations Millennium Development
Goals will become American policy under his administration. MDG 4 states
that the 1990 mortality rate for children under age 5 should be reduced
by two-thirds by 2015. MDG 5 states that the 1990 maternal mortality
rate should be reduced by 75% and that the world achieves universal
access to reproductive health by 2015. We have the tools for these laudable
goals to be achieved, but the United States must provide much clearer
and substantive leadership. President Obama during the campaign and
in his first days in office has provided solid indicators that he will
provide that leadership, and the civil society members of the global
health community stand ready to help deliver the results. 

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