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Dr. Jonathan Quick, President and CEO of MSH, tours with Dr. Christian Nzitimira, director of Kibagabaga Hospital in Rwanda. {Photo credit: Jon Jay/MSH.}Photo credit: Jon Jay/MSH.

In a postoperative ward of Kibagabaga Hospital, the district hospital serving Rwanda’s capital city of Kigali, Eric Bizimana sits up in bed. Bizimana, 25, had sought care after severe pain in his right leg forced him to stop work as a barber. He was diagnosed with a bone infection called osteomyelitis. Antibiotics alone couldn’t clear the infection. Without an operation to remove the diseased bone, Eric faced the possibility of losing his leg.

Eric was one of the 40 patients who enter Kibagabaga for surgery every day. In Rwanda’s tiered healthcare delivery system, patients are referred from local health centers up to the district hospital when their conditions require more complex care. Most babies are delivered at health centers, for example, but a woman suffering complications or who was expected to need a C-section would be referred to the district level.

Jane Briggs of the USAID-funded SIAPS program at MSH gives examples from Rwanda and Kenya during the Improving Access to Essential Maternal Health Medicines session on the first day of the conference. {Photo credit: C. Lander / MSH.}Photo credit: C. Lander / MSH.

Cross-posted from the SIAPS website.

“Respectful maternal care was said to be more than just a means to an end, and can be framed as several issues: human rights, quality of care, equity and public health,” Jocalyn Clark, senior editor of PLoS Medicine, noted about the final day of the 2013 Global Maternal Health Conference (GMHC).

The conference brought together scientists, researchers, practitioners, and policymakers to share knowledge, ideas, innovations, research, programs and policies on maternal health quality and access, among several other topics. Participants also worked on building progress towards reducing and eliminating preventable maternal mortality and morbidity.

Quality of maternal care was a consistent theme throughout the conference.

Attendees of the Global Maternal Health Conference 2013. {Photo credit: MSH.}Photo credit: MSH.

Management Sciences for Health (MSH) staff presenting at the Global Maternal Health Conference in Arusha, Tanzania, January 15-17, 2013. (Photo credits: C. Lander & J. Briggs / MSH)

Dr. Agnes Binagwaho is a pediatrician and serves as the Minister of Health of Rwanda. {Photo credit: dr-agnes.blogspot.com/}Photo credit: dr-agnes.blogspot.com/

The second Global Maternal Health Conference began yesterday in Arusha, Tanzania, as an intentional dialogue between scientists, researchers, implementers, advocates, policymakers, and media. More than 700 people (from about 2000 abstracts) were selected to attend and share knowledge on how to improve the quality of care and eliminate maternal deaths.

This is my first global maternal health conference --- but not my first maternal health conference. I keep wondering: how will this one be different?

As I went through the first day of sessions and informal exchanges, I couldn't help feeling like one person "stole the show". At lunch and dinner, the conversations kept coming back to the dynamic Dr. Agnes Binagwaho, the Minister of Health from Rwanda. She served as the keynote speaker in the opening plenary and a panelist for another session.

When you hear Dr. Agnes speak, you know she is smart and accomplished. And, talking with other attendees, it is clear that, regardless if participants agreed with her specific recommendations, Dr. Agnes' commitment, knowledge, logic, and candor are appreciated and needed in the conference conversation.

Women visit the SDSH-supported Marmont clinic in Haiti’s Central Plateau. {Photo credit: C. Gilmartin/MSH.}Photo credit: C. Gilmartin/MSH.

Late one April night in 2012, 19-year-old Ilionelle was struggling to give birth at her home in rural northwest Haiti. After several hours, she began having seizures, a clear indication of eclampsia, a severe medical disorder that can lead to the death of the mother and/or baby.

Ilionelle’s situation is not uncommon in Haiti, which has the highest maternal mortality rate in the Western hemisphere with 630 deaths per 100,000 live births. Fortunately, Tilma, the traditional birth attendant helping Ilionelle, quickly identified these life-threatening symptoms and arranged for her transport to Beraca Hospital for emergency obstetric care. After being carried on a stretcher for four hours along a steep and treacherous road, Ilionelle arrived at Beraca Hospital where she safely delivered a healthy baby boy. “If it wasn’t for Tilma, both my son and I could have died,” Ilionelle said.

Tilma is among thousands of Haitians working to improve their nation’s health after recent years of misfortune.

When I worked in Smallpox eradication in the mid-1970s, I traveled all over northern India and Bangladesh. I never took malaria prophylaxis, because malaria had been cleared from those areas. Likewise, I did not take malaria prophylaxis when I worked in the Brazilian Amazon in the late-1970s. At that time, malaria was found only in gold miners in isolated tributaries of the Amazon. Now, due to our financial inability to continue high levels of malaria eradication activities worldwide in that time period, emergence of both anti-malarial and insecticide resistance, and spread of the mosquito vectors, all of these are heavily malaria endemic areas with a high mortality rate for pregnant women and children.

The World Health Organization (WHO) recently released the World Malaria Report 2012, summarizing 2011 data from 104 malaria-endemic countries and citing progress and challenges toward the eradication of malaria.

Tanzanian woman (Photo credit: MSH)Tanzanian woman (Photo credit: MSH)

Management Sciences for Health (MSH) invites you to attend the following sessions and poster presentations at the Global Maternal Health Conference in Arusha, Tanzania --- whether in person at the Arusha International Conference Center, or watching via archived videos online. (All times are listed in Eastern Africa Time: UTC/GMT +3 hours. Sessions will be recorded and available within 24 hours.)

Sessions: Tuesday, January 15

Improving access to essential maternal health medicines (Track 3): 13:30–15:00 · Simba

Moderator: Deborah Armbruster, USAID

Immaculée, seated, holding her twin boys. Thanks to the intervention of the center’s midwife, at left, both of these babies are now in good health. {Photo credit: IRC.}Photo credit: IRC.

Thirteen newborns die every hour in Democratic Republic of the Congo (DRC). So on July 23, when 25-year old Immaculée went into labor with twins at the Monvu Reference Health Center in the Idjwi Health Zone, and her first twin was born without signs of life, the chances of survival were not in his favor.

The odds are stacked against newborns in the DRC: neonatal mortality hovers around 97 deaths for every 1,000 live births, and has done so for years, explaining the acute need for intervention in this area.

Recognizing this need, the USAID-funded DRC-Integrated Health Project (DRC-IHP), in conjunction with the Church of Latter Day Saints and the Ministry of Public Health, organized a “Helping Babies Breathe” training in Kinshasa in April 2012, to build the capacity of health providers who oversee labor and delivery.

Helping Babies Breathe is an evidence-based neonatal resuscitation approach designed for resource-limited areas, which teaches health workers how to handle newborns’ breathing in their first minute of life, a critical period known as the “Golden Minute.”

MSH: Saving lives and improving health in 2013.{Image credit: MSH.}Image credit: MSH.

We have seen some remarkable gains in global health in 2012. Yet millions of women, children, and men still die from preventable causes. As we pause and reflect on 2012 and look ahead to the new year, I invite you to read and share some of our favorite blog posts from the year.

Democratic Republic of the Congo {Photo credit: MSH.}Photo credit: MSH.

Last night, while in the Democratic Republic of the Congo (DRC) visiting our programs, I attended a US election-eve gathering of mostly Congolese people in Kinshasa. The DRC is one of those “distant nations” President Obama was referring to in his early morning acceptance speech today, where people are, “risking their lives just for… the chance to cast their ballots like we did today.”

Fragile, conflict-ridden nations, such as the DRC, struggle with leadership and governance. Its people have been victims of horrific violence, stunning gender inequality, and some of the worst health conditions in the world. They deserve better.

The United States reelected President Barack Obama to lead not only our country, but also to lead on addressing global health and other global development challenges such as those faced by the DRC.

Management Sciences for Health (MSH), a global non-profit organization dedicated to saving lives and improving health for the poorest and most vulnerable in the world, has long been a partner with the US government, foundations, and other donors, working in more than 140 countries to build stronger and more sustainable health care systems.

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