In July 2016, global leaders gathered for the second annual Safe Mothers and Newborns Leadership Workshop (SMNLW) hosted by the Maternal Health Task Force (MHTF) in partnership with the Barcelona Institute for Global Health (ISGlobal) and The Aga Kahn University and sponsored by the Bill & Melinda Gates Foundation. The participants represented 26 countries from five continents.
SMNLW participant Maria Fernandez Elorriaga is the principal investigator and technical coordinator of a study investigating the use of the World Health Organization (WHO) Safe Childbirth Checklist to improve the quality of institutional delivery in Mexico. Maria is also co-investigator on two more studies of implementation science in maternal and perinatal care. In addition, Maria has worked as a primary and community care nurse in Spain, as a regional nutrition coordinator in Malawi and as child health and nutrition coordinator in the Sahrawi refugee camps in Tindouf, Algeria.
K: Tell me about yourself and the work that you do.
M: I work in the National Institute of Public Health in Mexico, in the Center for Evaluation Research and Surveys (CIEE). My group is working on quality of care. I am the principal investigator working on the WHO’s Safe Childbirth Checklist project in Mexico. We are working on a pilot project all over the world to determine whether use of the checklist will be an international recommendation.
K: What is the biggest challenge in maternal and newborn health in your country and what is being done to address that challenge?
M: I think there are two main challenges. One is the information system, not only for maternal child health, but in general. It is really difficult to get reliable data, especially for newborn health. I think we need to improve data collection. The other challenge is quality and the right to have proper service available. Now, coverage of service isn’t the big problem, it’s the type of attention that women receive when they arrive. The main problem is the process; we need to follow more of the international guidelines and evidence-based recommendations to improve practices.
One of the things we are working on with the checklist is to ensure that basic and evidence-based actions and interventions are taken. We have adapted the checklist to Mexican guidelines and context. We started implementation a few months ago, but we expect to see a change in good practices – for example, more professionals administering oxytocin in the first minute and other evidence-based practices. What we want is to improve practices that reduce the three principal causes of maternal mortality: hemorrhage, infection and high blood pressure (pre-eclampsia/eclampsia) and two of the three main causes of neonatal mortality: asphyxia and infection.
K: What kind of leader do you aspire to be? How can quality leadership in maternal newborn health help us achieve the Sustainable Development Goals (SDGs)?
M: An effective leader is someone who understands or has the capacity to empathize with problems, someone who is trustworthy and focuses on important topics. For me, it’s really important to focus on family planning, quality and safe abortion. We need to talk about these topics.
In terms of the SDGs, in many places, the problem is related to rights and equity. We need to make this visible. As Nosa Orobaton said during his SMNLW talk, the power is distributed, in the sense that populations have power. I think what we have to tackle is showing the evidence we already have.
K: What would you like MHTF readers to know?
M: Mexico has improved its maternal mortality rate, but there is a long way to go, especially in terms of quality of care and rights. I think women (and their newborns) should know that they have the right to be attended and have good care and be safe. Individuals do not all have the same literacy or education levels – we have to show people that they are part of the community and help them demand their rights. At the same time, health providers should have the commitment to offer the highest quality care, and I would like to help to lead this improvement process.
Read our latest post on best practices for implementing the WHO Safe Childbirth Checklist.