Detours and shortcuts on the road to maternal mortality reduction

Although progress has been slower than we hoped at the official founding of the Safe Motherhood Initiative in Nairobi Kenya in 1987 many accomplishments have also been achieved which are set forth in other articles in this Series. However some worrying developments in programme strategies have occurred during the past few years. Some of these strategies are advertised as shortcuts on the road to safer motherhood. They often have intuitive appeal and they satisfy the real sense of urgency to make progress. Unfortunately they might not lead us to substantial long-term gains and could in fact be detours rather than shortcuts. Detours are not necessarily dangerous but they can waste time and resources (financial human intellectual and even emotional) that could be used more effectively. Moreover people could think that maternal mortality is being addressed in a substantial way when this is not the case. These strategies are often promoted by international agencies and donors and governments are pressured to adopt them. (excerpt)