Health: Maternal Health

Baroness Nicholson of Winterbourne Excerpts

Wednesday 12th January 2011 Lords Chamber

[Baroness Nicholson of Winterbourne]

I thank the noble Lord, Lord Patel, for inspiring this debate. I pay my warmest tribute to the noble Lord, Lord Green of Hurstpierpoint, for his thought-provoking and powerful maiden speech.

The context of this millennium development goal is that maternal mortality initiatives should be incorporated within a preventive healthcare framework. On structure, an effective first step to reduce the incidence of maternal mortality would be to create integrated mother-child healthcare—MCH—units within primary healthcare centres to secure an increase in the accessibility and availability of MCH care.

To encourage attendance, the availability of MCH units should be widely advertised among the catchment area population through, for example, health education outreach programmes such as the women health volunteer programme.

Encouraging good health habits is essential. MCH units should be physically designed in a way that takes account of the patient’s needs for privacy and dignity. Ideally, such units should also have the capacity to accommodate other young members of the family while mother has her consultation. Emphasis should be placed on encouraging patients to return, to attend regularly when advised to do so, to encourage others to attend and to inculcate good health habits within the community.

Traditional birth attendants should be professionally trained. That must be a priority, with a view to increasing the number of births attended by skilled and professionally qualified birth attendants.

Local staff should be used to overcome sociocultural barriers. Programmes that are implemented by local health professionals are much more likely to be able effectively to influence situations in which a strict interpretation of traditional social practices inhibits the timely treatment of women in urgent need of medical assistance. An example of that might be the refusal to allow female relatives to be treated by male doctors.

I chair the AMAR International Charitable Foundation, which provides more than 1 million Iraqi people a year with primary healthcare. Our maternal mortality conference operates in the Iraqi marshlands, where local AMAR doctors who have presented case studies of avoidable maternal deaths have enabled tribal leaders to pledge actively to take responsibility for reducing the number of such cases.

If we follow up such steps with referral procedures, follow-up procedures, improved patient records and maternal mortality data as well as education for mothers, we will find that infant and child mortality, as well as maternal mortality, is comprehensively improved.