Ahead of the publishing of a timely article on the threat of antimicrobial resistance (AMR) to maternity units in low-and-middle income countries, GHA spoke with one of the authors, Professor Wendy Graham of the London School of Hygiene and Tropical Medicine. Professor Graham has been researching maternal health in LMICs for more than three decades, and is the original architect of the widely-used Sisterhood Method for estimating maternal mortality.
The topic of her recently published article is being addressed at a High Level Forum on AMR linked with the 71st United Nations General Assembly, taking place this month in New York.
GHA: Why is the publishing of this research so important right now?
WG: The world is changing; the burden of disease is changing. While there are many threats and risks, one in particular that is of growing concern is the threat of antibiotic resistance. At the same time, within new SDG3 – there is a sub-target of reducing maternal mortality, and infections continue to play a major role in these deaths in low-and-middle-income countries.
As a point of historical reference, when maternal deaths in the UK fell by 80% between 1935 and 1950, it was due to many developments including the use of antibiotics to prevent infection-related mortality.
GHA: What do you see as the key areas of opportunity for reducing maternal deaths due to infection in LMICs?
WG: First: prevention, and second, infection management through rational use of antibiotics. There’s been very little work on AMR in maternity and birth settings in LMICs and the evidence base is weak. We know though that the circumstances in which many births take place are not hygienic. And a great many infections that occur before, during and after delivery can be avoided.
For instance, more women in LMICs are going to maternity units to deliver their babies, and many of these institutions are not well prepared. In many cases, the facilities pose increased risk for contracting an infection, which may not appear until later.
GHA: Quality, then, at these institutions must be a significant issue.
It is. And it’s one we continue to grapple with. How to measure it, to figure out what exactly needs to change? And how do we address it while being cognizant of cultural sensitivities. While the definition of a quality birth varies greatly throughout the world, it is what every woman wants regardless of where she lives. It is the universal pact.
With the amount of global attention AMR is getting, we have an opportunity to make the reduction of infections in relation to maternal health a real priority.
Read Professor Graham’s full commentary in Global Health Action: What are the threats from antimicrobial resistance for maternity units in low- and middle- income countries?
Tags: AMR, antimicrobial resistance, maternal health