Universal Access to Maternal Health and Sexual and Reproductive Health and Rights in Europe

Some of the best discussions are often held around the dinner table. A combination of a convivial atmosphere and a good guest list can make all the difference. A working dinner on maternal health hosted by the Alliance for Maternal Health Equality in partnership with the International Planned Parenthood Federation European Network (IPPF EN) and the European Parliamentary Forum on Population and Development (EPF), had exactly those ingredients. The result was energising.

Held during Women Deliver 2016, and in a residence formerly owned by the Royal Copenhagen Shooting Society (the Solyst), the setting was by no means typical! The evening turned out to be a very special moment where stakeholders , from policy makers, to CSOs and industry came together to make a commitment for the greater wellbeing of women in Europe. The evening was made even more special with the presence of Her Royal Highness Princess Sarah Zeid of Jordan who is a maternal and newborn health advocate.

The objective of event was to generate discussion on how to improve maternal health in Europe and implement the SDGs from a European perspective, with a view to generating concrete policy commitment. When it comes to maternal health, the divide between global North and South no longer exists. All women matter and deserve to have proper access to high quality maternal healthcare – including women in Europe.
Jacqueline Bowman-Busato is policy lead for the AMHE and set the context for the dinner discussions; “The level of discrepancy in Europe in relation to maternal health and Sexual and Reproductive Health and Rights (SRHR) is especially within the context of the Sustainable Development Goals and their enshrined universality: whatever is being implemented at the global level must also reach Europe. This is particularly valid in light of the different healthcare systems and standards that women have to access in each country in Europe.”

The outcomes of the dinner fed into the European Caucus held during Women Deliver and into a series of national-level events, currently being planned by the AMHE and its partners. Following the break-out groups during the Caucus, a more detailed commitment document is to be produced, with the inclusion of the Alliance points as well.

Dinner Discussion

A list of 6 questions were provided to guests in advance of the evening, and discussed during the dinner.

1. What are the most important ways in which evidence based policies can level the playing field for maternal health and SRHR in Europe?
2. What are the most important long-term benefits of putting in place harmonized indicators on a European scale, for access to maternal health and SRHR?
3. How can we ensure that particularly vulnerable groups (migrants, minorities, disabled, underage mothers) are provided with equitable access to maternal health and SRHR in European health systems?
4. How can we ensure universal access with 28 different healthcare systems in Europe?
5. How can personalised care (continuity of care) help to achieve more equitable access to maternal healthcare before, during and after pregnancy?
6. What are the most successful ways digital tools can facilitate access to high-quality maternal healthcare and SRHR?

There was general consensus during the dinner that to improve maternal health in Europe, there is a need for both data (indicators) and a register of experiences. Together they can be used to create truly efficient long-term policies that will be of benefit to women. It’s clear that discussions around indicators and standards are complex, but by using them to kick-start the political discussion, progress can be made.

In terms of caring for vulnerable minorities, monitoring is required to fully understand the obstacles that these groups are facing when trying to access services linked to maternal health. This needs to be considered within the context of Europe, where health remains a national competence.

Reference was made to the Safe Motherhood Week Survey on Pregnancy Perceptions launched earlier that same day which reveals significant access, care and information deficiencies in Europe. A vast majority of respondents experienced some sort of difficulty during their pregnancy ranging from perceived barriers to doctors or midwives, perceived impact on relationships (personal and professional), perceived discrimination in the workplace^[1], and perceived appropriate access to information.

Ultimately, empowerment is key. Women need to be equipped and informed so that they can make the right choices and receive the right care. Giving women a central role in the decision making process will support universal and equitable access to high quality maternal healthcare and SRHR, as it was frequently mentioned during the conference itself.

Moving Forward

Safe Motherhood Week 2016 (26/09 - 03/10) is a major initiative on the maternal health calendar. Conclusions from the dinner discussion will feed into the agenda.

The European Health Forum Gastein will take place during Safe Motherhood Week 928/09 - 30/09). A session dedicated to maternal health entitled “Crossing borders: Maternal healthcare in Europe - Making it a Reality” will have 3 objectives;

• Contribute to a roadmap to ensure equitable and universal access to maternal healthcare along the wellbeing continuum
• Health systems performance measurement
• The cross-border dimension – how access to maternal healthcare and health systems performance affects migrant and marginalised populations

The AMHE will be present at Gastein and will be contributing to the debate.