Maternal, Newborn, & Child Health: Our Impact

A woman from the Positive Deviance Hearth program educates women on good nutrition practices. {Photo credit: Tadeo Atuhura/MSH.}

Living in a wobbly shack with mud walls and a grass roof has not deterred Tushemerirwe Esparanza from becoming a change agent in the fight against child malnutrition in her village of Nantungo, in Lwebitakuli Sub County Uganda. Tushemerirwe has helped teach her home village that balanced nutrition is important for children’s health and development—malnutrition is responsible for nearly 60 percent of infant deaths in Uganda. But spreading that message was not easy for her at first.“When I was starting out, many women despised me.

Momotaung holds Sabelo. {Photo credit: J. Mavudze/MSH.}Photo credit: J. Mavudze/MSH.

In rural Lesotho, Momotaung wakes up early to prepare for a trip to the hospital for her checkup, a hospital two hours away from her home. On her way, she stops to pick up an elderly neighbor’s child, a three-year-old orphan named Sabelo---one of 12 siblings and cousins being cared for by their grandmother. She collects three other children from the village also needing care at the hospital.

Baby Victor and his mother. {Photo credit: Y. Otieno, MSH/Kenya}Photo credit: Y. Otieno, MSH/Kenya

Around 11 in the morning, mothers start streaming into the health facility. Baby Victor’s mother has brought him today for a routine immunization, but she’s also concerned about his lack of appetite and high fever. The nurses recommend that one-year-old Victor be tested for malaria.Thanks to a malaria rapid diagnostic test (RDT) kit, Victor’s test results come back in just half an hour.

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.

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