According to a 2015 World Health Organization report, a mother dies from pregnancy-related complications every 104 seconds. Each time a mother dies, her baby — and even some of her other children — often die as well.
Of the 830 daily global maternal estimated deaths in 2015, 550 or so happened in sub-Saharan Africa, 180 in Southern Asia, and only five in developed countries. To put this into perspective, the risk of a woman dying from maternal-related causes during her lifetime is roughly 33 times higher when living in a developing country as opposed to a developed one. We see this same stark contrast between urban and rural areas and rich and poor classes.
We have made progress to be sure. Annual maternal deaths have declined from approximately 532,000 in 1990 to about 303,000 in 2015. Yet, this decline only reaches half of the United Nations’ Millennium Development Goal (MDG) of reducing the maternal mortality ratio by 75 percent between 1990 and 2015.
These deaths are largely preventable. Due in part to a lack of maternal health education and poor medical care, especially in poor and rural areas, women keep dying during childbirth. Clearly, something needs to be done.
Stephen W. Gibson, retired university professor, and Daniel Wilde, CPA and MBA student at Brigham Young University, have put together a team to make a small dent in the problem. Their research focuses on creating meaningful change in the Philippines, a country of 98 million that desperately needs it. Every day approximately seven mothers die from pregnancy-related complications in the country, leaving about 23 children motherless. By comparison, approximately 1.6 mothers die of these types of complications per day in the United States, which has a population of 323 million. These Philippines-based figures are likely even higher as many maternal deaths go unreported, according to UNICEF.
Fortunately, the government of the Philippines is taking a proactive approach to solving the problem. Philhealth, the country’s universal health care system, which was introduced in 1995, boasts over 80 percent coverage nationwide. Furthermore, the 2013 clarification of the law (National Health Insurance Act 2013) requires that even unenrolled women and their babies “have financial access to health services that will ensure their survival and well-being.” Even so, the issues of maternal mortality run deeper than financial roadblocks. One in four births still takes place at home.
Gibson and Wilde believe the solution may lie in increasing the number and quality of birthing centers and in addressing the organizational problems of existing centers, which don’t stock adequate supplies of everything from syringes and gauze to linens and vaccines. The country is home to hundreds of these centers already, yet rural areas need hundreds more in order to reduce the mortality of mothers and newborns.
A team of six MBA students led by Wilde is currently conducting a survey of more than 200 birthing centers to ascertain geographical, operational and financial trends and opportunities. Preliminary results of this survey show that these centers have very viable business models, but that there is much room for financial and operational improvement. The team has been able to validate this by working directly with a rural birthing center that, managed by a certified midwife, has increased year-over-year monthly deliveries by 50 percent, from an average of 44 to 66 per month in just six months of mentoring.
We will follow the development of these birthing centers and will write another column about this topic in the coming months.
John Hoffmire is director of the Impact Bond Fund at Saïd Business School at Oxford University and directs the Center on Business and Poverty at the Wisconsin School of Business at UW-Madison. He runs Progress Through Business, a nonprofit group promoting economic development.
Daniel Wilde, Hoffmire’s colleague at Progress Through Business, did the research for this article.
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