the good news on maternal mortality, and the politics of aid

A good discussion in the Columbia Journalism Review on science versus advocacy, on the heels of The Lancet’s piece on declining Maternal Mortality Rates (MMR) worldwide (using new, more rigorous modeling on countries with estimates available):

On Wednesday, The New York Times gave its lead front-page slot to a study published in the medical journal The Lancet, where, “For the first time in decades, researchers are reporting a significant drop worldwide in the number women dying each year from pregnancy and childbirth, to about 342,900 in 2008 from 526,300 in 1980 … The study cited a number of reasons for the improvement: lower pregnancy rates in some countries; higher income, which improves nutrition and access to health care; more education for women; and the increasing availability of “skilled attendants” — people with some medical training — to help women give birth.”

…most articles took a pass on [The Lancet editor] Horton’s comments about pressure from advocacy groups. One exception was the Associated Press, which mentioned it right in the lede (although, curiously, a headline on an early version of the story that read “Politics of aid seen in clash over maternal deaths” was later changed to “Lancet: Sharp drop in maternal deaths worldwide”).

Unfortunately, the AP had nothing to add on the extent to which advocates are actually concerned about the political (read: financial support) ramifications of the statistics presented in The Lancet. What the article, by Maria Cheng, does mention is that “A separate report by a group headed by the United Nations reached a very different conclusion on maternal mortality, saying the figure remains steady at about 500,000 deaths a year.”

…Ultimately, Horton concluded, “given the dramatic difference” between the results of the Lancet study and those reported by the U.N. in 2008 (pdf), which found that little progress had been made toward reducing maternal mortality, “a process needs to be put in place urgently to discuss these figures, their implications, and the actions, global and in country, that should follow.”

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