Advocacy for maternal health: Insights from 20 years of crying out for the world's mothers

In the past two decades, advocacy for safe motherhood has been an essential component of directing global attention to the long tolerated tragedy of maternal/newborn deaths in the majority (developing) world. It has led to an increase in: interventions, measurement of impact, and financial/human resources targeted toward maternal/newborn health around the world. Models to evaluate the nature and impact of this advocacy have been developed including the four-factor approach of Shiffman. Advocates are trans-disciplinary, represent high, low and middle income countries, and include cultural leaders (such as actors and musicians). Important global traction has been achieved through policy windows such as the Millennium Development Goals (and the post-2015 Development Agenda). Initiatives such as Mother Baby Friendly Hospitals from Save the Mothers and the Federation of International Gynecologists and Obstetricians are working toward ensuring access to quality care and safe, dignified deliveries at health facilities. Stakeholders need to continue to advocate for: a) improved accountability from governments and non-government organizations b) increased access to quality maternal health services c) increased funding for maternal health, with a significant deployment of more midwives, and d) increased understanding among the general public, media and policy makers regarding the vital role of global maternal health.