STRATEGIES Policy Change

Politicians and officials make key decisions regarding budget allocations,
infrastructure and staffing patterns. Advocacy can play an important role in
gathering support for maternal and neonatal health. Key target groups may
include leaders at the national, regional and local levels, religious leaders,
and professional associations (e.g., medical, nursing and midwifery).
Religious leaders can be strong change agents and influence community attitudes,
especially where men are the primary decision-makers, about the use
of health services. These leaders need to understand the: 1) magnitude of the
problem; 2) interventions that can address the problem; 3) actions that can
be taken by the community and families to have favorable maternal and
neonatal outcomes; 4) impact of a maternal death on the community and
family; and 5) importance of women participating in the decision-making
processes about health seeking practices.
Advocacy is important; however, it is difficult to make persuasive arguments
without good data. Improvements in the information systems and
use of the data, in the hands of decision-makers, can go a long way to
increase the awareness of the policy-makers and program planners on the
importance of the issues. Without this knowledge and subsequent “political
commitment” to the issues, other efforts such as changing laws or
budget allocations will be virtually impossible.
Although a Safe Motherhood policy may exist, it may not have been implemented
at the local level for a variety of reasons. Policies are not very useful
unless they are disseminated, their contents understood, and they are incorporated
into daily practice. Health workers, through in-service training,
need to be educated on the protocols and standards that are embodied in
the policy. They need to embrace these protocols and incorporate them into
their daily practice. These protocols and practices need to be reinforced
through supportive supervision and refresher training to bring about sustained
improvements in the quality of maternal health services.