Tarja Halonen, former President of Finland, narrated a delightful story at the recent Women Deliver conference at Kuala Lumpur, Malaysia. When she was elected the President of her country the second time, she got letters from thousands of little girls who cheered “yippee. I too want to be President”. But her fondest memory is of a letter sent by an eight year-old boy. “Is it true that in Finland only girls can become President?” the boy asked. Ms Halonen wrote back, reassuring him that “Little boys can also become President in Finland.” She also tossed in some sage advice: Do your homework, study hard, and then take up a job as a lorry driver, a professor or whatever else you fancy. After that, if you still want to serve your country, run for President. Ms Halonen ended the story with a knock-out punch line. “We now have a male President.”
The Finnish tale piquantly captures the compelling case for investing in women, the theme of the global conference, which brought together nearly 5,000 delegates from 149 countries, including big ticket celebs like Ms Halonen, Melinda Gates and Chelsea Clinton.
Ms Halonen, one of the star speakers at the Kuala Lumpur meet, organised by Women Deliver, an international NGO, comes from a country where women became the first in the world to have unrestricted rights both to vote (1906) and to stand for Parliament. Finns proudly say that women’s empowerment in their country has its roots in the social reform programme in the wake of the 1918 civil war. These reforms helped transform the Nordic country from a poor, underdeveloped one into a rich world democracy. The high status of women in Finland and other Nordic countries has benefited women as well as the society at large.
There are many ways to improve the status of women in a society. At the Kuala Lumpur meet, the focus was on improving maternal health and expanding a woman’s choices in reproductive health. This is an important step because, as Jill Sheffield, founder of Women Deliver, puts it “When women have access to maternal and reproductive health services, they can plan their pregnancies, contribute to the workforce and are better able to care for their children. Communities thrive, societies stabilise and economies flourish.”
While Finland and fellow Nordics are justly feted for realising that investment in the well-being of girls and women is not only an ethical issue but also smart economics, they are not the only ones. Some of the world’s poorest countries like Rwanda and Bangladesh have dramatically reduced maternal and child mortality rates by investing in girls and women.
At the high-level media forum that took place on the eve of the Women Deliver conference, Dr Kaosar Afsana director of Health, Nutrition and Population at BRAC in Bangladesh, pointed out how a sustained focus on women has helped Bangladesh improve maternal health. Maternal mortality or the number of women dying because of childbirth-related complications per 100,000 live births in Bangladesh has dropped from 574 per 100,000 live births in 1990 to just 194 in 2010, while other indicators like neonatal and under-five mortality have also fallen.
Bangladesh learnt a lesson from its own success in reducing diarrhoeal deaths among children. Women volunteers were encouraged to go from village to village, from household to household, teaching mothers how to give oral rehydration salts and zinc to children with diarrhoea. Now, the lessons in community outreach are being leveraged to boost maternal and child survival. Malaysia, the host country, was centrestage for its remarkable turn around in maternal mortality. In 1957, Malaysia’s MMR was 540 per 100,000 live births. In 2010, that dipped to 28. What did Malaysia do to turn the tide? In an article in The Lancet (May 18, 2013), Raj Karim, the Asia regional director of Women Deliver, pointed out that through the ’50s and ’60s, even before it was an economic star, Malaysia invested in critical areas like women’s education, health and rural development. By the end of the ’70s, rural Malaysians had access to a variety of health services at their door step and midwives were encouraged to work in remote areas. In 2003, Malaysia set up well-being clinics to make family planning services more accessible to women. Today, there are more than 4,000 such clinics across this Southeast Asian country. Though abortion continues to be a sensitive subject, Malaysia has taken steps to reduce maternal deaths.
Malaysia’s fortunes are to a great extent due to its natural resources. Growth has slowed down in this country in recent times, as in most parts of the world. But the sustained investment in women and in human development has created a solid base that will stand Malaysia in good stead in the future. There are two key lessons from Women Deliver 2013 that are universally relevant.
First, investment in girls and women is social justice and smart economics. A background paper from the World Bank (Closing the deadly gap between what we know and what we do) which generated much buzz at the Kuala Lumpur meet says that “a long-term study in Bangladesh found that children born to mothers who received tetanus vaccines during pregnancy received more schooling.” The paper goes on to observe that “these studies suggest that investing in routine reproductive health services, in particular antenatal care and maternal nutrition, can also have long-term benefits for future generations.” Second, even when country-level data indicates progress, it is vital to address the disparities within. This is especially true of a country as vast and diverse as India. In 1990, India’s maternal mortality ratio (MMR) was 600 women for every 1,00,000 live births, while the global figure was 400. Now, India’s MMR is down to 212 whereas the global average is 260. But there are huge differences between major states within the country. Uttar Pradesh’s MMR is 359. The corresponding figure for Rajasthan is 318 and for Kerala, it is 81. There are variations between districts too. Given this backdrop, the government’s decision to focus on 184 High Prioriy Districts in the country and allocate 30% more funds to strengthen maternal and child healthcare initiatives in these districts is a good one. Now, we wait for implementation.