Overview

Globally, about half a million women die annually from complications due to pregnancy and childbirth and virtually all take place in developing countries. Most maternal deaths are preventable, given sufficient resources, yet little has been accomplished towards reducing maternal mortality and morbidity over the last decade. The United Nations; Millennium Development Goal 5 calls for a reduction in maternal mortality ratios of 75% (from their 1990 levels) by 2015; this has raised the issue’s visibility, offering an opportunity to speed up progress.

Concerns about population pressures once led countries and international organizations to focus narrowly on incentives for the acceptance of fertility control technologies. Typical strategies today, however, reflect a comprehensive reproductive and sexual health and rights approach. This approach places women's well-being at the center of population policy and emphasizes the rights of individuals to determine and plan family size.

The Foundation's support of work on maternal mortality will increase the chances that women will have safer pregnancies and deliveries. These improved outcomes are also an indicator of the availability of services that help women make informed reproductive choices.  The focus on young people helps them make sensible choices about their sexual activities. Given the effects of population momentum and the large cohort of young people, any delay in childbearing will help reduce population growth rates.

In 2009, the grant budget for this program area is $15 million.

What MacArthur Funds

Geographic Priorities

The Population and Reproductive Health area (PRH) focuses its work in three countries - India, Mexico, and Nigeria - chosen because they represent different conditions and are influential within their respective regions.  Within each country the Foundation has selected priority states where grantmaking is concentrated.  Grants focus on the two priority themes described below. Related activities such as research and leadership development are also supported on a limited basis at the national level.

Priority Themes

• Maternal Mortality and Morbidity

  Maternal deaths and birth-related complications are problems for which little progress has been observed in the last decade. Most maternal deaths are preventable, given sufficient resources, but dramatic differences exist between richer and poorer countries.

  Reducing maternal mortality requires effective health systems, but is also dependent on educational and legal systems. Besides good care, women need a legal environment that discourages unsafe abortion, one of the major causes of maternal death and morbidity. Women's health needs must be recognized by their partners and their immediate families. Comprehensive sexuality education programs can cultivate this recognition.

  The Foundation supports civil society organizations that work for changes needed in health, education, and legal policies and help to create the political will needed for their implementation. Special attention is given to activities that focus on increased budgets for maternal health, decreased deaths from unsafe abortion, and improved access to quality emergency obstetric care.

• Young People’s Sexual and Reproductive Health and Rights

  The sexual and reproductive decisions made by today's youth will have great impact on their personal lives and on society. Indeed, the largest contribution to the size of the world population in the future comes from population momentum. An important way to diminish its effects is to increase the interval between generations - that is, by postponing the birth of the first child. From a reproductive health standpoint, adolescents are especially vulnerable. They have extremely high rates of maternal mortality, are targets of sexual assault, and have STD and HIV infection rates that are higher than among adults.

  The Foundation supports initiatives in India, Mexico, and Nigeria that increase the availability of high-quality sexuality education and confidential youth-friendly health services.  For example, the Foundation will support model sexuality programs for in- and out-of-school youth, improve young people's access to reproductive health services, and promote an enabling environmental for young people to seek those services.

International Portfolio

The Foundation also supports projects not specific to the three focus countries. The international portfolio funds selected international population and reproductive health organizations whose work stimulates innovations in policy, programs, and services. Selected research projects advancing the program’s themes are also included. Organizations funded in this portfolio make substantial contributions to reducing maternal mortality and morbidity and advancing young people's sexual health and rights, either by producing new concepts and data or by advocating new or modified policies. Alternatively, they may explore the applicability of lessons from other fields to PRH, or may shape knowledge and practice on PRH topics.

The international portfolio also includes projects on maternal health or youth reproductive health that cover more than one country. For example, a major focus has been on postpartum hemorrhage, the leading cause of maternal death. Several grants offered support for the anti-shock garment, a Neoprene and Velcro lower body suit that stabilizes the hemorrhaging woman — from research carried out in Nigeria and Egypt, to a roll-out of a continuum of care for postpartum hemorrhage (including the garment) in Nigeria and India.

Updated January 2009