Rewriting the story of birth | Marleen Temmerman & Stephan Balzer | TEDxBerlin Salon

Key Concepts

• Maternal & Newborn Health Disparities: The persistent inequities in healthcare access and outcomes for women and newborns, particularly in low-resource settings.
• Millennium Development Goals (MDGs) & Sustainable Development Goals (SDGs): International development frameworks and their impact on maternal mortality reduction.
• Intersectoral Collaboration: The necessity of cooperation between governments, UN agencies, NGOs, academia, and the private sector to achieve meaningful progress.
• Leadership & Political Will: The crucial role of strong, committed leadership at the national level in prioritizing and addressing maternal and newborn health.
• Technology & Innovation: The potential of advancements like mobile technology and AI to improve healthcare delivery and outcomes.
• Community-Based Approaches: The importance of engaging local communities and empowering them to drive change.
• The "Poverty is Sexist" Campaign: A framing of poverty that highlights its disproportionate impact on women and girls.

A Life Dedicated to Women’s and Newborn Health: Reflections and Future Directions

The interview features Dr. Mallay, a highly accomplished professional with a diverse background spanning clinical practice, research (over 600 publications, 60+ PhD supervisions), politics (serving as a Senator in Belgium), and global health policy (former Director of Women’s Health at WHO Geneva, currently at Aakhan University in Kenya). The conversation centers on her career trajectory, the challenges in maternal and newborn health, and her vision for the future.

Early Influences and Career Path

Dr. Mallay’s dedication to women’s health stemmed from a childhood desire to make a difference. Despite facing societal barriers as a woman aspiring to higher education, she persevered, initially training as a general practitioner before ultimately specializing in gynecology. Her early clinical experiences revealed stark inequities in obstetric practices – routine episiotomies and inductions of labor – fueling her commitment to change. She recounts completing her training through persistent effort, navigating a male-dominated field. The profound impact of witnessing 72 preventable maternal deaths, particularly in Africa, solidified her resolve to improve healthcare systems and outcomes. Her work in the slums of Nairobi, where she performed approximately 18,000 deliveries, underscored the urgent need for technological advancements and systemic improvements.

The MDGs, SDGs, and Shifting Priorities

Dr. Mallay highlighted the progress made during the Millennium Development Goals (MDGs), specifically Goal 5 – reducing maternal mortality – which saw a 40% reduction through unified efforts, clear accountability, and strategic use of technology. She emphasized the importance of collaboration between governments, the UN, and other stakeholders. However, she expressed concern that the Sustainable Development Goals (SDGs) have diluted the focus on maternal and newborn health, leading to a regression in progress. She noted that the SDGs’ broader agenda lacks the same prioritization, hindering continued gains.

The Gap Between Knowledge and Implementation

The core challenge, according to Dr. Mallay, lies in the gap between what works in maternal and newborn health and what is actually implemented on the ground. She identified a lack of strong national leadership as a key obstacle. While many countries have projects and programs, a lack of cohesive collaboration prevents them from achieving maximum impact. She contrasted successful nations like Rwanda and Ethiopia, where presidential-level commitment and inter-ministerial cooperation drove positive results, with Kenya, where fragmented efforts hinder progress. She specifically noted that Kenya has many programs but lacks the unified approach needed for substantial change.

The Power of Collaboration and Political Engagement

Dr. Mallay shared her experience entering politics, initially reluctantly, but ultimately recognizing its potential to effect change. She described how working with diverse constituencies – from academia to NGOs to international organizations – was essential for addressing complex issues like HIV/AIDS. She emphasized that scientific research alone is insufficient; it must be coupled with political engagement and societal involvement to translate knowledge into action. She recounted a successful campaign during the HIV/AIDS crisis where collaboration across sectors led to significant improvements. She also pointed to the recent setback in HIV/AIDS programs due to changes in US aid as a cautionary tale, highlighting the fragility of progress and the need for diversified funding and partnerships.

Recognizing and Empowering the Next Generation

Dr. Mallay attributes her success to a collaborative approach, prioritizing mentorship and creating opportunities for young researchers and practitioners. She emphasizes the importance of group work and supporting the development of the next generation of leaders. She acknowledges the support of organizations like the Gates Foundation in driving innovation and improving health systems. She was recently recognized as being in the top 2% of scientists by Stanford University, a recognition she attributes to the collective efforts of her research teams.

Future Optimism and a Call to Action

Looking ahead, Dr. Mallay expressed optimism about the potential of technology, particularly AI and mobile health solutions, to transform women’s and newborn health. She highlighted Kenya’s high mobile phone penetration rate and the potential of platforms like M-Pesa to improve access to healthcare services. However, she reiterated the need for unified leadership, clear goals, and a collaborative spirit.

Her final call to action was a plea for unity and a commitment to breaking down silos across sectors. She urged policymakers, practitioners, and citizens to work together, leveraging technology and embracing innovation to create a more equitable and sustainable future for women and newborns. She emphasized the importance of clear goals and a shared vision to avoid wasted energy and maximize impact.

Notable Quotes

• “Poverty is sexist.” – referencing the U2 Bono campaign, highlighting the disproportionate impact of poverty on women.
• “You can change…that’s what keeps me going.” – reflecting her belief in the possibility of improving maternal and newborn health outcomes.
• “We have to unite. That is clear.” – emphasizing the critical need for collaboration.
• “Science is one thing and being an obstetrician and being in medical world yes but if you don't know your other constituencies you can't really make a difference.” – highlighting the importance of intersectoral collaboration.

Technical Terms

• Episiotomy: A surgical incision made in the perineum during childbirth.
• Induction of Labor: The process of artificially starting labor.
• MDGs (Millennium Development Goals): A set of eight international development goals established in 2000.
• SDGs (Sustainable Development Goals): A set of seventeen interlinked global goals designed to be achieved by 2030.
• M-Pesa: A mobile money transfer service popular in Kenya.
• AI (Artificial Intelligence): The simulation of human intelligence processes by computer systems.
• NOS's/CBOS: Non-governmental organizations/Community-based organizations.

This interview underscores the complex interplay of factors influencing maternal and newborn health, emphasizing the critical need for strong leadership, collaborative partnerships, and a renewed commitment to prioritizing the well-being of women and children globally.