The Safe Motherhood Initiative in Latin America and the Caribbean

Background: Despite the progress made over the past 20 years in reducing maternal mortality in the Region of the Americas, the figures remain high in many countries, and access to reproductive health is still limited and problematic. In 2010, the Pan American Health Organization (PAHO) estimated that: 9,200 women in the Region die in pregnancy and childbirth; 3,240,000 pregnant women in the Region do not have access to modern contraceptive methods; 748,000 do not receive medical care in a health institution during pregnancy; and 1,122,000 do not have access to care in childbirth from skilled health personnel. One year ago, PAHO and several other institutions launched the Safe Motherhood Initiative (SMI) – a call to the countries of the Americas to redouble their efforts to meet Millennium Development Goal 5. One of the many components of the SMI is a “Best Practices” contest which aims to decrease maternal mortality through the effective translation of knowledge into interventions that result in a reduction in maternal mortality. Methods: By examining the data, information, and descriptions of the best practices, I will assess lessons learned from the Initiative and describe some of the limitations and kinds of resistance encountered throughout the course of the project. Results: The best practices contest has come across some challenges not in the overall outcome of the contest, but in the inconsistent participation of various countries, especially in the Caribbean. This is partly due to PAHO’s efforts to maintain legitimacy and neutrality, while encourage cooperation between member states. Conclusion: This case study offers insight to the capacities and limitations of a global organization for intervening in a complex public health dilemma. The Initiative depicts the challenges of encouraging continuous participation from the Region to promote safe motherhood.