What does it take to keep more mothers alive?

On Tuesday evening, four countries-Nepal, Benin, Botswana, and Ethiopia-shared  insights from their recent strong progress in reducing maternal mortality. They presented to a packed auditorium at UNICEF in New York.

"Human resources have been the foundation of Nepal's health successes in general, and especially of maternal health successes," said Dr Sudha Sharma, Secretary of Health of Nepal-a country that recently won an "MDG award"  for progress on reducing maternal mortality.

Ethiopia's Director General for Health Promotion and Disease Prevention, Dr Kessetebrehan Admasu also focused on the importance of trained health extension workers, noting that 34,000 such workers have been trained to date in Ethiopia, two for each kebele, or village.

Benin's Minister of Health, Prof Issifou Takpara described three  challenges to maternal health in Africa that must be addressed- identifying the person in a village who decides whether a pregnant women should be taken to a health center for delivery; solving transport problems; and providing good quality care quickly at health centers.

Finally, Dr KCS Malefho, Permanent Secretary, Health, Botswana, spoke of the importance of integrated programs, saying "We made our Prevention of Mother-to-Child Transmission (PMTCT) Program talk to other programs we already had, so it became much more cost-effective and sustainable."

More than one country appealed for fresh money to scale up programs that have proven effective. Dr Margaret Chan, Director-General, WHO, stressed the importance of both donors and countries keeping their promises on aid and on country budget allocations to health.

Tamar Manuelyan Atinc, the World Bank's VP for Human Development, answered the call, announcing that the Bank would expand its support for results-based health programs, in which cash or in-kind incentives are given to both service providers to provide pre-agreed services and to people to make use of them.

"We will expand our results-based support to health by more than 600 million over the next 5 years for 35 countries, largely Africa and Asia," she said. "We will assist countries to scale up essential health and nutrition services and strengthen health systems."