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Database - Alliance francophone pour l'accouchement respecté (AFAR)

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Created on : 18 Dec 2009
Modified on : 18 Dec 2009

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Bibliographical entry (without author) :

Systematic Underfunding of Research and Development in Maternal and Perinatal Health. Special Report to the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN). Published simultaneously in Journal of Midwifery and Women’s Health 2009;54(5)

Author(s) :

R. Rima Jolivet

Year of publication :


URL(s) :…

Résumé (français)  :

Cet article révèle une déficience systématique du financement de la recherche (publique et privée) dans le domaine de la santé maternelle et périnatale. Il couvre le Royaume-Uni, l’Union européenne, les USA, le Canada, l’Australie, l’Inde, et l’Afrique du Sud.

Bien que les problèmes de santé maternelle et périnatale soient au premier plan des problèmes de santé en général, la proportion du financement qui leur est accordé est dans une fourchette de moins de 1% à 4% dans les pays couverts par l’étude.

Abstract (English)  :

Several recent publications point to evidence of
systematic underfunding of research and development
in maternal and perinatal health. This gross
underrepresentation on research budgets persists
worldwide despite the push for greater focus on
health improvements for mothers and babies in
public health goals from major national and
international organizations, including the United
Nations Millennium Development Goals and
Healthy People 2010.

Fisk and Atun (2009) conducted a systematic review
of funding for maternal and perinatal clinical
research in the United Kingdom, the European Union,
the United States, Canada, Australia, India and
South Africa, looking at both governmental and
philanthropic funding. They report that although
maternal and perinatal conditions are the single
largest contributor by category to the global disease
burden, the proportion of total spending
allocated to maternal and perinatal research in the
countries studied ranged from < 1% to 4% of all
health research funding.

These findings are mirrored in the same authors’
earlier analysis of funding by the global pharmaceutical
industry for research and development of
new drugs for use in pregnancy (Fisk & Atun,
2008). Here, the authors found that despite the fact
that 3/4 of the world’s 4500,000 maternal deaths
are attributable to preventable or treatable conditions,
only one new class of drug licensed in the
last 20 years was primarily for obstetric use, and
only 17 drugs were under active development for
maternal health indications at the time of their

Lyerly, Little and Faden (2008) point out that in the
United States, two-thirds of women take 4 to 5 medications
during pregnancy, and of the over 4 million
pregnancies each year in this country, 1% are complicated
by hypertension or diabetes, and > 10% by
psychiatric illness. Virtually all medications taken
during pregnancy are prescribed ‘‘off-label’’, i.e.,
without approval by the Food and Drug Administration
for use in pregnancy. This means that there are
no data on their safety or e/cacy or information to
guide dosing regimens in pregnancy.

The Institute of
Medicine 1994 report, Women and Health Research:
Ethical and Legal Implications of Including
Women in Clinical Studies, strongly recommended
clinical research to advance the medical management
of diseases of pregnancy, and conditions that
threaten the outcomes of pregnancy. However, 15
years after the release of that report, the health
and safety of pregnant women and their infants remain
poorly addressed and sorely neglected on the
health research agenda. The recent heightened
focus on comparative electiveness research presents
an opportunity to address some of the
established research gaps relating to maternal and
newborn health.

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Argument (français) :

Bien que les problèmes de santé maternelle et périnatale soient au premier plan des problèmes de santé en général, la proportion du financement qui leur est accordé est dans une fourchette de moins de 1% à 4%

Argument (English):

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Keywords :

➡ public health

Author of this record :

Bernard Bel — 18 Dec 2009

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