Globalization and Inequity in Global Maternal Mortality Essay

Globalization tends to put a visible pressure on global health, despite it also brings a number of benefits. Inequity in global maternal mortality remains a critical issue that is being affected by its processes. This paper aims to investigate the problem through the lens of globalization. Moreover, in the framework of inequity in maternal deaths, a number of changes to the current international governance of healthcare will be suggested.

Impact of Globalization

The emergence of cooperation between different countries in the field of healthcare took place due to the need to coordinate measures for sanitary protection because of occurring epidemics and pandemics worldwide. Globalization has led to the transition of existing threats to collective and individual health to a new qualitative level and to the emergence of new threats. It resulted in the need for joint action by the efforts of the entire world community. These threats are associated both with changes in the very nature of diseases and with the occurrence of new diseases and in the ways of their spread. Changes in the kind of these diseases are caused by transformations in the economic, political, and environmental spheres at the local, regional, and global levels. Thus, globalization creates problems of a specific nature, the solution of which is possible exclusively on the international scale.

The main priority of current politics is that all people should have a health level that provides them with an active working and social life. This 21st-century health-for-all policy should be implemented through appropriate regional and national strategies. Hence, issues related to healthcare become the cornerstone for the entire world community. They go beyond the borders of one state and need to be regulated within three dimensions: global, regional, and bilateral. With the freedoms of the contemporary world, humanity has found new threats that pose a danger to both individual and collective health.

Currently, globalization processes cause a negative influence within the scope of this collective health. As a result, the spatial scale of measures to ensure and protect the right to health is significantly increasing. The link between global mobility and the spread of various healthcare issues is among the most famous effects of globalization. Over time, the processes of this phenomenon have intensified the negative impact on the planetary ecosystem. They have led to a change in biogeochemical processes and global climate change, which undoubtedly affects collective and individual health.

Then, globalization has a substantial and visible impact on health systems. On the one hand, from the end of the 20th century, the globalization of trade, tourism, and migration erased the traditional differences between national and global prevention of maternal mortality. On the other hand, it resulted in deepening global inequality, pursuing a policy of trade liberalization in third world countries, and complicating access to health services and medicines. In this era, the world has become unequal in the framework of the right to health. The gap between developed and developing countries, not only in terms of social and economic development but also in the level of healthcare systems, significantly affects the quality of the latter. Given the fact that more than a billion people live in poverty that degrades human dignity, their access to minimal medical care is very limited.

The processes of globalization that should lead to the provision of sustainable health cannot be solely founded on the national interests of a state. It requires considering the needs of both a particular country and the international community. However, it is necessary to take into account the mentioned national interests, and this is the essence of the problem of unity and contradiction between the national and the global. This issue needs to be approached through the prism of health protection that is a vital value nowadays. Therefore, maintaining human health in the context of globalization is a more complex and broader problem than a particular public health issue, which determines the priority of universal international cooperation.

It should also be noticed that globalization contributes to the monopolization of transnational companies of the global pharmaceutical market due to economies of scale, legislation, and judicial practice in the field of intellectual property rights. The growth of the industry and the gaining of superprofits by pharmaceutical giants became possible due to huge investments in innovation and the development of new drugs. Moreover, aggressive international marketing based on the asymmetry of information contributes to such a state of affairs. The use of Internet resources to accelerate communication between participants in the promotion of goods, including doctors, is another essential characteristic of today.

At this point, it seems reasonable to emphasize that the above characteristics of globalization lead to a number of issues regarding inequity and inequality in global maternal mortality. The resistance to the problem might be considered as an indicator of universal healthcare system efficiency as all the issues related to bringing a new life to this world are to be resolved (Callaghan, 2020). Substantial differences between developed and developing countries in this issue’s framework seem to be deepening. 94% of the maternal deaths take place in developing states; moreover, plenty of them were preventable (WHO, 2019). It allows assuming that contemporary health gains are delivered unfairly.

Contemporary System that Tackles the Problem

It might be assumed that there are four primary international actors that design a global policy within the scope of reducing maternal mortality – WHO, the World Bank, UNFPA, and UNICEF. Due to the processes of globalization, almost all governments have restricted their powers in favor of several international organizations. It means that these organizations have a number of mandatory authorities that legally affect the policies of member-states to an exact extent.

The leading actor in the prevention of maternal mortality is the World Health Organization. Member States must submit annual reports to WHO on measures taken and achievements in improving the health of their populations. In practice, the Secretariat works closely with the related ministries of the Member States. The Assembly develops and adopts international conventions open for ratification by member states. Each of them undertakes to give a positive or negative answer within six months; in the latter case, it must justify its refusal. In particular, WHO’s functions to reduce maternal mortality are “increasing research evidence, providing evidence-based clinical and programmatic guidance, setting global standards, and providing technical support to Member States” (WHO, 2019, para. 22). Thus, despite its ability to set international health standards, WHO seem to be an advisory organization.

The World Bank might be considered as a primary financial source that maintains the struggle against high rates of maternal mortality. The Bank “launched the Global Financing Facility … , a multi-stakeholder partnership that supports country-led efforts to improve the health and well-being of women, children, and adolescents” (The World Bank, 2019, para. 2). The institution emphasizes the importance of dealing with the gap between developed and developing countries. According to The World Bank, “a milestone replenishment of US$1 billion in 2018 have enabled the GFF to expand from four to 36 countries with the world’s highest maternal and child mortality burden” (para. 2). Then, through its approved programs, UNFPA may be perceived as a secondary financial source – governed by the UN – to decrease maternal mortality. It promotes “universal access to sexual and reproductive health care and rights, including by promoting international maternal health standards and providing guidance and support to health systems” (UNFPA, 2019, para. 16). The two latter organizations leverage pecuniary help to the ones who need it.

Finally, UNICEF contributes to the development of an appropriate system to assess rates and scale of maternal mortality. “This includes leading methodological work, developing international standards, and establishing mechanisms for the compilation and verification of national data, and maintaining global databases” (UNICEF, no date, para. 1). Hence, the organization might be understood as a foundation for the accurate evaluation of the issue. With its solid reputation, it may also affect public opinion to a significant extent.

Given the above characteristics, the underlying architecture of international means regarding overcoming global inequity in maternal mortality might be formulated as follows. WHO is a primary organization that coordinates and regulates states’ policy in the problem’s framework. It founds its rulings, standards, and recommendations on the findings and assessments of such institutions as UNICEF. The World Bank is the main financial foundation that provides assistance in reducing maternal mortality. UNFPA has a similar role but mostly aims to utilize the reputational power of the UN to have an effect on countries’ affairs. It should be noted that the listed organizations act in the framework of and in accordance with the UN Sustainable Development Goals (Department, 2015; The UN, no date). The described actors cooperate with each other and give transparent and consistent reports on their joint activities.

Proposed System to Handle the Issue

It seems apparent that the primary disadvantage of the described global system is that WHO does not have an absolute mandate to oblige Member States to act in an appropriate way. They may refuse to adhere to its standards in the case of provision some convincing arguments. It may be even assumed that the World Bank has more influence on overcoming the inequity in global maternal deaths as it could leverage countries’ policies due to the capability to provide financial help. It might be rational to delegate all the necessary functions to WHO. It is suggested to give a mandate to WHO so that it could distribute this financial help to beneficiaries. Nevertheless, WHO will take into account recommendations, opinions, and assessments of the Member States and partner organizations. Such an approach will create a system in which the competent and influential institution will govern countries’ policies in decreasing maternal death. It will take measures to spread the contemporary gains of healthcare on an equal basis.

The distribution of these gains will be founded on specific plans provided by the Member States and evaluations of such organizations like UNICEF. These plans should cover human resources, financing, and monitoring of a comprehensive package of actions to decrease maternal deaths. States are to ensure that women and children have access to a complete package of guaranteed services, including information and family planning services, antenatal and postnatal care, and skilled childbirth care in appropriate facilities. Services for safe abortion (when abortion is not prohibited by law) and the prevention of HIV and other sexually transmitted infections are also a necessity. The measures taken should include vaccination, immunization, and nutritional supplements (such as vitamin A). Comprehensive care contributes to the improvement of health and helps to prevent and treat illnesses related to maternal mortality. The link between disease-specific programs and services for women and children needs to be strengthened.

States should be mdeeply aware of their dual role in our global world. Besides the responsibility that each government independently bears before its society, it has provide citizens of all countries with a dignity life. The time has come to unite the efforts of the world community for joint action under the qualified and significant guidance of WHO. This means scaling up and prioritizing a number of highly effective interventions aimed at strengthening health systems and integrating efforts to combat global inequity in maternal mortality. It also implies respect for human rights, gender equality, and poverty alleviation. The current situation requires a comprehensive strategy based on obligatory international standards and commitments.

Conclusion

In conclusion, it seems rational to state that the processes of globalization have both positive and negative impacts on global health in general, and on maternal mortality in particular. The above investigation shows that despite the relatively developed international system aimed to overcome the issue of inequity in maternal deaths, this problem remains unsolved. It was suggested to delegate a considerable number of powers to WHO so that it could provide a legal, high-quality, and competent governance in the framework of the problem.

Reference List

Callaghan, W. (2020). ‘Maternal Mortality’, Obstetrics & Gynecology, 135(2), pp. 274–275.

Department of Economic & Social Affairs (2015) Transitioning from the MDGs to the SDGs: accountability for the post-2015 era. Web.

The UN (no date) About the Sustainable Development Goals. Web.

The World Bank (2019) Reproductive, maternal, newborn, child and adolescent health. Web.

UNFPA (no date) Maternal health. Web.

UNICEF (2019) Global goals. Web.

WHO (2019) Maternal mortality. Web.