You are here: Home > Work with us > Consultations > Choice for women: wanted pregnancies, safe births
> 3. Where we work
-
Bookmark this page
Where should we work?
Where should we focus our efforts to advance progress on reproductive, maternal and newborn health?
Read background information
Read options to consider
When posting your comment, please state whether it is an individual, group or organisational response.
Comments 
Comments closed
This consultation has closed.
Our thanks for all the comments submitted. All of the ideas and suggestions put forward will feed into our new policy, helping to shape the direction of our work.
Once the final policy document is released you will be able to find it at www.dfid.gov.uk
the advancement of reproductive,maternal and new born health is a raises a great concern to the community and therefore in my view,the focus should be centered within the community setting which in return will not only benefit the community but also give room for understanding of the day to day problems that do affect our communities
The need is greatest in the least developed countries, 37 out of 41 of which have recognised, in their climate change NAPAs and elsewhere, that rapid population growth is impeding their development and their ability to adapt to climate change. These should be helped to design national population programmes, transcending the normal “silo-programming”, and learning from the common experience of the most successful non-coercive fertility-reduction countries, such as Thailand or Costa Rica. At project level, integrated schemes linking population, environment and health concerns do especially well.
We should focus our efforts on countries that have a high fertility rate and are suffering shortage of food as a result. Such countries include Niger and Ethiopia.
Among the choices that you offer I would favor highest unmet need over lowest contraceptive prevalence because the latter is more strongly affected by social determinants and therefore would require an inter-sectorial approach to be truly effective. And I would combine unmet need with highest inequities for two reasons: first, in societies with high inequities there is already an elite which has demostrated the acceptability of a different way of life; therefore extending choice to the rest of the population is a low hanging fruit. Second: it is a matter of promoting justice and human rights.
I would like to add, however, that if you are really serious about rights and about safe abortion, you should not have a narrow and inflexible geographical focus because women everywhere have enormous deficits in these areas. Form this point of view, the criteria for selection should include political analysis both in terms of likelihood of change and potential impact beyond the country borders.
The gross injustice of inequitable access to comprehensive reproductive health information and care has the most pronounced effect in countries whose populations face the highest lifetime risk of maternal death, and that is where DFID can have the greatest positive impact. While reducing disparities affecting women in these areas, DFID can help build the evidence base for effective interventions, modelling approaches that can be replicated in other contexts and address all the indicators noted above.
While it is very difficult to decide from the list given, CMF feels it preferable to choose areas where there is evidence of:
• personnel and institutions in place who will be receptive to change in terms of maternity care and attitudes to women
• governments willing to be proactive on maternal health
• strong and engaged civil society
• faith leaders and institutions open to engage with the issue
As rural areas often suffer the most in terms of both care provision and maternal mortality rates, we would suggest an increased emphasis on addressing needs comprehensively in rural areas of countries that have shown progress in urban contexts.
Sadly, this may not always be in the areas of greatest need, so we would not see this as an absolute.
I would suggest providing support mainly in the areas where maternity facilities and neonatal care is not up to scratch. After all surely the goal is development, not just preventing people from being able to do somthing because you don’t want to spend the money to make it safe.
The British government should be commended for its commitment to development and the support for the Scale Up of Nutrition (SUN) Roadmap. The SUN roadmap is committed to assisting countries that request support from multi-sectoral partners to addressing malnutrition. It would therefore be logical for DFID to focus its energies and funds on these countries that have requested help as it presents an interesting model to tackle undernutrition during the critical window of opportunity – the 1000 days from conception to 2 years of age. This may assist in maximizing aid effectiveness in these countries that may serve as a future model for assistance in tackling multiple development problems using a multi-stakeholder approach in countries that are committed to addressing problems that impede national development. Again, DFID should deliver its efforts in both emergency and non-emergency contexts and provide appropriate min-long term funding lines for each as per contextual analysis.
DFID should put emphasis on reducing gender and class differences in access to health services. Our data shows that socio-demographic and economic variables influence women’s health seeking behaviour more than traditional health belief system. Despite an effective referral system women fail to receive emergency obstetric care due to lack of low cost transportation as well as inability to gather cash money (Khanum, S.M and Zaman, Taufik. `Constraints on Women’s Access to Emergency Obstetric Care in Bangladesh’, ongoing project funded by the University Grant Commission, Bangladesh). Access to health services will enable women to avail contraceptives as well.