After scaling the near impossible hurdle of travelling on a Nigerian passport to a high risk country, I was thrilled to be attending the International Conference on Maternal and Reproductive Health, held between the 20th and 21st of September and co-organised by The Arab-German Young Academy of Sciences and Humanities (AGYA), the Global Health Next Generation Network (GHNGN) and Saint Joseph University of Beirut (USJ). In attendance were a mix of about 40 participants, including Maternal and Reproductive Health (MRH) students, young global health professionals and seasoned experts. It is not very often that I attend such an interesting conference without getting lost in a sea of faces, and being able to interact with almost everyone was certainly efficient for networking.
During the two days of the conference, we engaged in MRH-related discussions in the 4 plenary sessions and 6 workshops, all the while, trying to make lessons local and stimulating reflections on MRH-related challenges and opportunities in Arab societies. The key themes included gender equity, challenges to meeting the SDG goals for maternal health, and the financing of MRH services. Particularly gratifying for me was the fact that panel presentations were followed by at least 30 minutes of questions and reflections – a precious interlude for digestion that is often missed out or not allocated sufficient time in many conferences these days.
For a region that is mostly associated with conflict and an escalating migration crisis, it was worth assessing the unique challenges that countries in the Middle East (ME) face in attaining universal access to Sexual and Reproductive Health and Rights (SRHR). The complexities of the region makes one wonder if the targets of the SDGs are equitable in themselves. Come 2030, will we commence superficial discussions on why regions grappling protracted humanitarian and political emergencies fell short of expectations? Prof. Jocelyn De Jong from the American University of Beirut highlighted the inequities resulting from the migration crises with respect to SRHR- there is more evidence on refugees than on internally displaced persons, although the proportion of the latter is significantly higher. It was therefore worth reflecting on how although reaching conflict-affected populations is included in the preamble of the SDGs, no goals are dedicated to addressing its intersectionality with health and other social determinants. Are we somehow avoiding the elephant in the room?
We learnt that challenges to evidence and action in the ME are generally also linked to the fact that data is politically sensitive and as such not readily open to academic scrutiny – a frustrating scenario for researchers who feel like their hands are tied. What is the point of identifying the problem if the buck stops there? Presenters from academic institutions like the American University of Beirut and USJ also revealed that the majority of discussions on MRH in Arab states are confined to mainstream academia. To rectify this, we need to better promote knowledge translation and embedded research practices, with a continued focus on capacity building, mentorship of the next generation and advocacy for actionable data collection and reporting.
In addition to speaking as a panelist on: ‘Digital Technology and the Quality Gap: is mHealth the future?’, I attended a creative workshop on the Gender and Poverty dimensions of maternal morbidity and mortality by Dr. Viveka Guzman from Trinity College, Dublin, where in small groups, we traced the complex dimensions of the three delays in accessing maternal care. The plenary session on financing for MRH explored the Global Financing Facility and challenge of attaining equitable financing for UHC and MRH for vulnerable populations, based on principles of social justice. The post-presentation discussions on this were quite intense, as we discussed the key factors that drive donor decisions to invest in other countries and what the ‘win’ for donors and recipients amounts to, thereby alluding to the Trojan nature of foreign aid. The conversations carried on well into dinner, reminding me of Dambisa Moyo’s critique of the aid model, and making me curious about the existence of any research that has successfully reported the per capita economic gain for donor countries on every dollar of aid investment. It also brought to light the dearth of humanitarian economists in global health. The last panel explored lessons learnt 20 years after the 1994 ICPD conference in Cairo, the normalisation of over-medicalization i.e. too-much-too-soon in many Arab states and the INSPIRES strategy for child protection which is argued to reflect a dyad approach to care involving both paediatricians and obstetricians.
While in Beirut, I had the opportunity to reconnect with old friends and establish new connections. I also enjoyed exploring Beirut at night through the eyes of locals, ending my stay on a high note, with the movie ‘Capharnaum‘ which I believe should be added to the global health must-watch list (assuming such a list exists). Laced with humor, the movie highlighted some of the painful but pertinent social issues of our time including migration, modern slavery, reproductive health and child rights, and stimulated critical reflection.
With funding from the German Federal Ministry of Education and Research, AGYA is clearly making strategic impact via its various working groups as the first bilateral young academy globally. Based on the successful feedback of participants, organizers seem to have started discussing the focus and location of the next conference. Hopefully, we can report some progress in the domain and region between Beirut 2018 and destination X. It would be great if organizers can maintain an excellent program, a manageable number of participants and sufficient time to actually talk about the interesting issues of concern. If there are not too many hurdles to overcome, I look forward to being there!