Maternal, Newborn, & Child Health: Our Impact

Using RapidSMS, a community health worker requested an ambulance to transport Dorcelle to the Musanze Health Center, where she delivered a healthy baby. {Photo credit: Candide Tran Ngoc/MSH.}Photo credit: Candide Tran Ngoc/MSH.

In 2011, Drocelle gave birth to her fourth child, and, for the first time, delivered at a health center. Throughout her pregnancy, Drocelle had been monitored by a community health worker, Elizabeth, who regularly visited her at home and encouraged her to go to the Musanze Health Center for antenatal care. When Drocelle went into labor, she contacted Elizabeth, who sent a RapidSMS text message to the Musanze Health Center requesting an ambulance. Without the ambulance, it would have taken Drocelle three hours to walk to Musanze Health Center.

Juan-Carlos Alegre

Monitoring and evaluation (M&E) systems have played a critical role in advancing the field of global health, from applying quantitative and qualitative methods in collecting and using health data, to informing decision making, applying rigorous evaluations in assessing program effectiveness, and designing and conducting operational research that address implementation challenges.

 {Photo credit: Candide Tran Ngoc/MSH}A Rwandan nurse immunizes a child.Photo credit: Candide Tran Ngoc/MSH

Until recently, nurses and midwives in Rwanda had varying degrees of knowledge, training, and capacity. Some had received inadequate instruction abroad and others had even bought counterfeit diplomas. Because there was no system in place to ensure nurses were adequately prepared, many Rwandans were subjected to inconsistent care and unreliable service quality.

Photo credit: C. T. Ngoc/MSH.

Eugénie is a widow and farmer living in the southern province of Rwanda, who struggles to provide for her three children. For many years, Eugénie suffered from a renal tumor. Although she had community-based health insurance (CBHI) that covered 90 percent of her medical fees, Eugénie was unable to pay the remaining 10 percent. Her health deteriorated.

Dativa is a mother of two living in eastern Rwanda. Her first baby was born at home; she felt that the health center was too far away. During her second pregnancy, a community health worker encouraged Dativa to deliver at the health center. When Dativa went into labor, she took the advice. The community health worker helped her to take a motorcycle taxi to the nearest health center at Nzige, which would normally be a 90-minute walk.Dativa was examined by an experienced nurse who quickly detected a fetal malposition, which required urgent transfer to the district hospital.

Dr. Eliud Wandwalo. {Photo credit: MSH.}Photo credit: MSH.

MSH works with international, national, and local partners to strengthen the capacity of health systems, national tuberculosis (TB) programs, and health managers to improve the lives of those affected by TB and prevent the spread of the disease. MSH participates in several global TB initiatives, including USAID’s Tuberculosis CARE I Program (following the TB CAP program); the STOP TB Partnership; and the Global Fund to Fight AIDS, Tuberculosis, and Malaria.

Erik Schouten presents data on Option B+ in Malawi. {Photo credit: Sara Holtz/MSH.}Photo credit: Sara Holtz/MSH.

A Conversation with Dr Erik SchoutenWhen considering which public health intervention is best for a country or region for prevention of mother-to-child transmission (PMTCT) of HIV, the World Health Organization (WHO) provides a set of guidelines that provide options for various settings.

{Photo credit: C. Tran Ngoc/MSH.}Photo credit: C. Tran Ngoc/MSH.

Before RapidSMS, a cell phone-based technology designed to support maternal and child health at the community level, was in place people in remote areas of Rwanda couldn’t access health care easily. Extremely ill patients were brought to facilities using hand-carried stretchers.

As the international community gathered for the XIX International AIDS Conference last week, HIV & AIDS experts and key organizations voiced their support for a new approach to preventing mother-to-child transmission of HIV: Option B+. Option B+ calls for antiretroviral therapy (ART) for life for all HIV-positive pregnant women, regardless of CD4 levels.The government of Malawi, with the support of MSH, adapted the World Health Organization (WHO) guidelines on preventing mother-to-child transmission, to the needs of Malawi.

The millions of children orphaned and made vulnerable by the AIDS pandemic face particular challenges, including loss of their primary care givers, increasing poverty and a greater risk of dropping out of school. When the President’s Emergency Plan for AIDS Relief (PEPFAR) was launched nearly 10 years ago, interventions were put in place to address the specific needs of orphans and vulnerable children. Over the past decade, research regarding the effectiveness of these strategies has identified successful program interventions and potentially fruitful new directions.

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