It depends on the country. We sometimes forget that one of the reasons we can play a leadership role is that we share similar geographies with many of these countries. Some of the technologies we've developed in telemedicine are an example, and how we deal with rural communities or northern communities provides valuable lessons on how we can contribute as well.
Your question is very well taken, because in addition to that, there's very little infrastructure in terms of roads. One of the realities is that you need to have skilled attendants in the community, because they can then make a decision that this person is going to have trouble with her delivery, and if there is no facility in the village or the town, where most of the women will be, she will have to go away. That, in and of itself, is okay, except that if you have to pay when you get there, and you have to be buried in your village, you're not going to go, if in fact you have to pay.
When we talk of being integrated and putting everything together, it's because the issues are so large, but we know how to deal with them at the local level. Maybe you can enlighten us from your own personal experience, but I really do think it's absolutely essential to realize that each country is different. Some countries use the lakes as a method of transportation, or women will be on the backs of bicycles for 30 miles, in labour, trying to get somewhere. It's a bit late then.
Why don't they go earlier? Perhaps it's because they have no money or perhaps they have no one to babysit their kids. Perhaps their husband says “No, you're not allowed to leave the village”, or “I'm not going to pay”, or “I'm not going to get rid of my best cow”, or “I'll marry somebody else”.
These are all elements of their decision-making. That's why an integrated approach, as opposed to a one-off, is so important.