Greater than one third of all women experience mistreatment during facility-based childbirth. Mistreatment, particularly in humanitarian settings, may include verbal or physical abuse, poor patient-provider rapport, a lack of information about maternal and newborn health (MNH) services for both pregnant women and providers, lack of privacy within facilities, challenges with receiving informed consent from women for medical procedures due to language and cultural barriers, and denied or delayed care. Such mistreatment can stem from historical tensions between populations seeking care and health workers (both foreign and local) as well as systemic mistreatment of providers who are burned out and possibly carry their own biases. Evidence shows that some women delay seeking care, or avoid care entirely because of social fears stemming from negative stigma or negative perceptions of their situation. 

“The COVID-19 pandemic has amplified pre-existing inequalities and vulnerabilities,” writes the United Nations Population Fund (UNFPA) in a recent report on the impact of COVID-19 on sex workers in East and Southern Africa. The pandemic has had an impact on people in marginalized communities around the world, but for sex workers globally, “the impact on livelihoods, human rights and health has been devastating, leaving many struggling to survive,” states the report.

Evidence shows that in low- and middle-income countries, the expansion of health coverage or access to care has not always reduced overall mortality, said Dr. Patricia Jodrey, Child Health Team Lead in the Office of Maternal and Child Health and Nutrition at the U.S. Agency for International Development (USAID). “However, the analysis also showed that when countries have progressed in improving the quality of their health systems, the survival rate tends to improve,” she said.

“The pandemic and related global economic recession are severe setbacks to already insufficient progress towards meeting the global nutrition targets set for 2025 for stunting, wasting, maternal anemia and breastfeeding,” write the authors of a 2021 study examining the effects of COVID-19 on child and maternal health and nutrition. Adequate nutrition in the perinatal period is essential for healthy mothers and babies, and COVID-19-induced poverty and disruptions to global supply chains have compromised the food security of people around the world, mostly in low-to-middle-income countries (LMICs).

With a high burden of cervical cancer in Tanzania, we are advocating for the government’s parliament to prioritize cervical cancer prevention in its annual budget, said Dr. Safina Yuma, a Reproductive Cancer Coordinator at the Ministry of Health, Tanzania, at a recent event hosted by TogetHER for Health on cervical cancer leadership in recognition of cervical cancer awareness month. At least 270,000 women die globally from cervical cancer each year and in Tanzania, it is a leading cause of death, taking the lives of approximately 4,200 women annually. However, cervical cancer is 90 percent preventable with appropriate prevention strategies such as human papillomavirus (HPV) vaccinations and screenings. Expert leaders from NJIA, a leadership development program for practitioners working in cervical cancer research and prevention, discussed strategies for improving collaboration and leadership within the medical profession to reduce avoidable deaths.

Since its onset, the impact of the COVID-19 pandemic on maternal mortality has been a question of great concern. And yet, few empirical attempts have been made to capture the potentially profound impact of the pandemic on maternal deaths, particularly in resource-limited settings.

“Regardless of income level, regardless of education level, Black women, Native women, women who live in rural areas are more likely to die or be left scared or scarred from an experience that should be safe and should be a joyful one; and we know a primary reason why this is true – systemic inequities,” said Vice President Kamala Harris during her opening remarks at the first-ever White House Maternal Health Call to Action Summit on December 7, 2021. Members of Congress and maternal health advocates gathered to discuss the importance of addressing racial disparities and systemic challenges in maternal health through national policy.