Concerns about funding came on top of the list in an FT Twitter chat about Maternal and Child Health. The conversation took place during World Prematurity Day on November 17 and generated significant impact as part of the publication of the FT’s Birth magazine on maternal and child health. A poll conducted ahead of the conversation showed the majority of participants thought that the lack of finance was the biggest single requirement to improve maternal and child health.

Participants included: Andrew Jack, head of curated content and editor of FirstFT; Jude Webber, the FT Mexico and Central America correspondent; Lucy Hornby, the FT’s deputy Beijing bureau chief; Maggie Fick, the FT’s west Africa correspondent; Finlay Young, an FT contributor; and Oona Campbell from the London School of Hygiene and Tropical Medicine.

External participants included Babatunde Osotimehin, head of the UN population fund; Seth Berkley, head of Gavi, the Vaccines Alliance, Katja Iversen, head of Women Deliver, and other leading experts from Medecins sans Frontiers, Girls not Bridges, PATH and Unicef.

See the discussion here

There was frequent concern that governments were not doing enough — both donors and poorer high burden countries themselves.

The economic downturn has slowed progress, as Maggie Fick saw in northern Nigeria.

Other factors were also raised.

There are growing calls for universal health coverage, given so many countries require patients to pay from their own pocket. Such funding would also help better hire and train medical staff.

But there are concerns not all existing money is well spent, and governments should be held accountable.

There are big gaps, as Finlay Young saw in Sierra Leone.

Money can distort services, including the overuse of caesarean sections, described in China by Lucy Hornby.

There was much discussion around different innovative approaches, focused on the article showcasing five innovations with demonstrated impact now seeking support to scale up or serving as models to be replicated elsewhere.

There were calls to focus on innovative approaches from around the world, not just those developed laboratories in rich countries, to foster systems to develop new approaches, and for policymakers to ensure they used evidence to make the best choices.

Innovation needs to reach those people affected. That requires innovation in funding.

It also means investment to ensure adequate distribution.

Skin-to-skin “kangaroo care” for premature children — and a programme to finance training on its use in Cameroon — were widely discussed.

Other innovations highlighted included social health insurance for the poor in Nigeria.

Among existing approaches, several raised concerns about the continued poor levels of access to family planning for women who want it. A poll of readers showed the issue to be among the greatest barriers.

Other ways to improve health outcomes included the need for greater emphasis on breastfeeding.

And MSF stressed the importance of better access to basic care and a community-based approach to health.

Cultural issues affecting illness and death came up frequently. There was discussion on the role of men in influencing women’s health.

There were calls to recognise the importance of young people to tackling high fertility and ill health.

Women’s rights were frequently cited, including the need to end child brides, demanded by Desmond Tutu, who wrote an op-ed in the Birth magazine.

Women should be more centrally involved in decision making.

Women under 20 have a 50 per cent greater chance their child will be stillborn or die within the first weeks of life.

MSF stressed the need for skilled care for women at the time of delivery.

And more generally for suitably skilled, dedicated people to work in the field.

Unsafe abortion remains an important concern, causing unnecessary complications and death.

Aggressive anti-abortion measures continue to weigh heavily in El Salvador.

The head of the Vaccines Alliance stressed the role of vaccination to tackle infection in children.

There was also the need for heads of states to recognise the need to invest in their people.

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