Safe Motherhood: A Review - Family Care International

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The informants reported unanimously that
the inclusion of an explicit goal on safe
motherhood was a precedent-setting event
that elevated safe motherhood from an
overlooked public health problem to a central
development goal. This section discusses
the factors that led to the inclusion of safe
motherhood in the ICPD Programme of
Action and how this commitment has been
reaffirmed and expanded upon in subsequent
international agreements.
• Regional conferences organized by the
Safe Motherhood Initiative in the Arab
region, Southern and Francophone Africa,
South Asia, and Latin America in the late
1980s and early 1990s, as well as a range
of national workshops and conferences,
raised the profile of safe motherhood, and
helped to pave the way for the inclusion
of a holistic approach to safe motherhood
in the ICPD Programme of Action. Because
of these meetings, there was familiarity
with and support for safe motherhood
when the preparatory ICPD meetings took
place. For example, many of the ICPD
Preparatory Committee and regional
meeting governmental delegations included
ministry of health staff and parliamentarians
who had participated in the SMI regional
meetings, and they were strong advocates
for safe motherhood. Further, the SMI’s
wide dissemination of messages and
other outcomes from the regional SMI
meetings helped to raise awareness of safe
motherhood among policymakers, NGOs,
and the media.
• The leadership of the ICPD secretariat
(UNFPA) and key individuals played a
critical role in securing commitment to safe
motherhood at the Cairo Conference. One
informant noted that, since its first decade,
UNFPA has been involved in efforts to
improve maternal health and that UNFPA
dedicated a significant portion of the time
allocated to the ICPD regional preparatory
meetings to discussions of the centrality of
safe motherhood to reproductive health and
development. In addition, Dr. Fred T. Sai’s
strong leadership as ICPD Chair and his long
history of involvement in maternal health
played a critical role in securing the safe
motherhood goal.
• During the ICPD preparatory process, a large
coalition of NGOs focused on sexual and
reproductive health, eventually numbering
more than 1,000 organizations from all
regions of the world, concentrated its
efforts on lobbying for strong commitments
to a comprehensive approach to sexual
and reproductive health, of which safe
motherhood was an intrinsic element.
One informant noted that much of the
draft language contained in the coalition’s
proposals was incorporated verbatim into
the ICPD Programme of Action. The NGO
coalition, along with European and African
governmental delegations, worked with
the conference secretariat to highlight the
importance of a strong agreement that took
a life-cycle approach to reproductive health,
population, and development.
All informants reported that, given the
awareness of safe motherhood that was
raised prior to the ICPD, the Programme
of Action’s safe motherhood goal enjoyed
near-universal support. 23 However, achieving
consensus on addressing a leading cause
of maternal death—unsafe abortion—was
23 One informant recalled the Holy See being the only delegation that opposed the goal to reduce maternal deaths by 75% by
2015. This was based on the Catholic Church’s long-standing proscription against “artificial methods” of family planning,
which were recognized as being key to reducing unintended pregnancies and, by extension, maternal deaths.