Safe Motherhood: A Review - Family Care International

International Advocacy and Agreements for Safe Motherhood
among the most hotly-contested issues at the
ICPD and FWCW. Several informants recalled
that a small, vocal minority of delegations
from conservative member states made a
sustained effort to prevent consensus on
language calling for action on unsafe abortion
and on making reproductive health services
available on a universal basis.
Finally, it was noted that safe motherhood
served an important political purpose for
addressing some of the more controversial
issues in the Programme of Action. Framing
the reproductive health agenda as critical to
reducing maternal mortality made it possible
to discuss and achieve agreement on issues
that were sensitive or controversial, such
as unsafe abortion, and enabled delegates
to embrace the comprehensive approach to
reproductive health.
The Millennium Summit and
Millennium Development Goals
Safe motherhood’s inclusion in the
Millennium Development Goals was
both a recognition of its centrality to poverty
alleviation and a compromise.
The UN Secretary General’s document that
created a framework for the Millennium
Summit, We the Peoples: the role of the
United Nations in the 21st century, did not
contain a reference to maternal health. It
was noted that the omission of the safe
motherhood goal from We the Peoples was
an oversight rather than intentional neglect of
maternal health, which was later inserted into
the text of the Millennium Declaration.
One informant noted that there had been
so much good will on safe motherhood
built by the SMI’s 1997 and 1998 activities
that improving maternal health was widely
viewed as being key to alleviating poverty
and ensuring sustainable development. This
informant noted that, by keeping the focus on
safe motherhood and articulating clear goals,
the Initiative helped establish the foundation
for the MDGs. In addition, an informant noted
that the 1999 WHO/UNFPA/unicef/World
Bank joint statement on safe motherhood 24
was important for building support of a safe
motherhood goal.
Second, the safe motherhood goal was
seen by some as a “substitute” for the
reproductive health goal. One informant
recalled that the dynamic of the Millennium
Declaration process was markedly different
from that of the ICPD and FWCW. Unlike
the conferences of the mid-1990s, NGOs
were provided little access to the Summit,
limiting the possibility of advocacy.
Another difference was the format of the
negotiations: the overwhelming majority of
the Declaration’s text had been negotiated
through informal diplomatic discussions
well in advance of the Summit itself, further
limiting advocacy efforts. A small minority of
conservative governments threatened that, if
the reproductive health goal was included as
one of the Millennium Development Goals,
they would block the consensus. However,
these governments also indicated that a goal
on maternal health would be an
acceptable substitute.
Thus, the inclusion of an explicit Millennium
Development Goal on improving maternal
health was driven by the recognition of
its centrality to development and poverty
alleviation in general, as well as by
political compromise.
24 “Reduction of Maternal Mortality: A Joint WHO/UNFPA/unicef/World Bank Statement.” Geneva: WHO, 1999.
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