maternal health

{Photo Credit: Francies Hajong/MSH}Photo Credit: Francies Hajong/MSH

This is the third in a series of four stories about how strong health systems improve the health of women and children. 

Every day, approximately 830 women die from preventable causes related to pregnancy and childbirth, and 99 percent of them live in developing countries, according to the World Health Organization. Many of these women – and their babies – could be saved with medicines. However, access to these medicines is often limited in the countries where they are most needed. Sheena Patel, a technical advisor for the MSH-led, USAID-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) project, talks about the program's work in helping to improve access to essential medicines. This story was originally published on the SIAPS website February 23. 

MSH: The health of women and children is critical to the overall health and prosperity of a country—and the world. Can you talk a bit about why?

MSH representatives at the launch meeting of the Quality of Care Network (L-R): Zipporah Kpamor, MSH Nigeria Country Representative; Erik Schouten, Country Lead, MSH Malawi; Grace Mlava, Technical Clinical Director, ONSE Health in Malawi; Rudi Thetard, Project Director of ONSE Health in Malawi; Catharine Taylor, Vice President of the Health Programs Group, and Antoine Ndiaye, Country Lead, Cote D’Ivoire.

This is the second in a series of four stories about how strong health systems improve the health of women and children.

Nine countries, with support from the World Health Organization (WHO), the United Nations International Children’s Fund (UNICEF), and other partners, launched the Network for Improving Quality of Care for Maternal, Newborn and Child Health last week.

The new Network aims to improve the quality of care that mothers and babies receive in health facilities while supporting countries in achieving their targets agreed under the Sustainable Development Goals to end preventable maternal and newborn deaths. 

Despite remarkable progress in improving access to health services proven to reduce maternal and newborn deaths, every year worldwide, 303,000 women die during pregnancy and childbirth, 2.7 million babies die during the first 28 days of life, and 2.6 million babies are stillborn. Most of these deaths could be prevented with quality care during pregnancy and childbirth.

However, the provision of care is uneven within and between countries, and often fails to respect the rights and dignity of those who seek it.

Nurses at health clinic Virgen del Lourdes in Lima, Peru (Photo Credit: Leslie Alsheimer)

This is the first in a series of four stories about how strong health systems improve the health of women and children.

Last year, we shared with you stories of the people we work alongside all over the world. We introduced you to Aster Amanuel Desalegn, a 70 year-old woman from Ethiopia who relies on her town's public hospital for her diabetes medication. You met Linvell Nkhoma, a midwife manager in Malawi who lives on the hospital premises so she can be on call 24 hours per day. And you heard from Animata Bassama, a representative from a community in Mali that worked with MSH to open a center providing a safe space for gender-based violence survivors to seek medical and psychosocial care.

 {Photo credit: Cindy Shiner/MSH}A mother waits for the nurse to vaccinate her baby during an immunization clinic at Phebe Hospital in central Liberia.Photo credit: Cindy Shiner/MSH

Stronger health systems are critical to preventing outbreaks from becoming epidemics. In fragile states, systems already weakened by conflict, disaster, or instability can crumble under the weight of an outbreak -- devastating access, availability, and quality of basic health for women and their families.

{Photo credit: Mark Tuschman}Photo credit: Mark Tuschman

A woman. A newborn. A child. In many countries, their basic health and rights are tenuous. These women, newborns, and children are the health system.

A woman is ostracized: abandoned by her husband, her family, and her community. She suffered a fistula after giving birth to her son. After 20-plus years, an operation repairs her fistula; now, she is teaching again, and a part of the community.

{Photo credit: Mark Tuschman}Photo credit: Mark Tuschman

Impact. Scale. Sustainability. As public health professionals, we are dedicated to high-impact and high-coverage interventions that significantly improve the health of large human populations. We also hope that the benefits become part of the timeless fabric of their families, communities, and the health system.

This triple expectation—impact, scale, and sustainability—has accompanied global health for decades and especially during the last  generation. In 1990, Dr. Thomas Bossert reported that, among five US government-funded health programs in Africa and Central America, a project’s capacity to show results was the most important factor to ensure the sustainability of its benefits.

 {Photo credit: MSH staff}Several MSH delegates gather at the Global MNH conference.Photo credit: MSH staff

The Global Maternal and Newborn Health Conference held last week in Mexico City was an action-packed three days of presentations and conversations about state-of-the-art strategies to improve maternal and newborn health. Throughout it all, the following key themes stood out as critical for the post-2015 development agenda, particularly in the context of pursuing universal health coverage (UHC).

 {Photo Credit: Joan Marshall-Missiye/MSH}A break-out session at the first ECOWAS Forum on Good Practices in Health, held July 29-31 in Ouagadougou, Burkina Faso.Photo Credit: Joan Marshall-Missiye/MSH

“If you want to go fast, go alone. If you want to go far, go together.”

This ubiquitous African proverb became the unofficial motto of the first ECOWAS Forum on Good Practices in Health, held July 29-31 in Ouagadougou, Burkina Faso. More than 300 health professionals, researchers, donors, implementing partners, and stakeholders gathered at the conference, hosted by the West African Health Organization (WAHO), a partner of Management Sciences for Health.

In his opening speech, USAID West Africa Regional Mission Director Alex Deprez reminded the assembly that most maternal and child health indicators in West Africa are “unflattering.” The average fertility rate remains the highest in the world at 5.7, while the contraceptive prevalence rate, at 10 percent, is the lowest. West Africa loses thousands of mothers and young children daily to preventable complications and diseases. More than 100 children in West Africa die per 1,000 live births, and there are between 438 and 888 maternal deaths per 100,000 live births.

 {Photo credit: Matthieu Koy Matili/MSH}Elene O. and her baby, Omedji village, Benadibele health zone.Photo credit: Matthieu Koy Matili/MSH

Breastfeeding is a human right, and critical for the health of both newborn and mother. Newborns benefit from early skin-to-skin contact and the antibodies in the mother’s first milk, plus factors that protect against later obesity and chronic diseases such as diabetes and asthma. Mothers benefit because early breastfeeding assists in uterine shrinkage and helps prevent postpartum bleeding. In addition, frequent, exclusive, breastfeeding reduces the likelihood of an immediate new pregnancy.

Optimal breastfeeding is most advantageous when started within an hour of birth and continued exclusively for six months; research shows that it could save 800,00 children’s lives. Yet, globally, only 38 percent of infants are breastfed exclusively.

World Breastfeeding Week 2015 (August 1-7) focuses on supporting women breastfeeding at the workplace (“Let’s make it work”).

For many women, especially in the developing world, barriers to breastfeeding start in the home or even the health facility -- before returning to work in her household, community, or workplace.

{Photo credit: Todd Shapera, Rwanda}Photo credit: Todd Shapera, Rwanda

Rwanda is one of the "biggest success stories" of countries improving child survival since 2000, the BBC World News reported April 29, 2015, linking to a podcast on BBC's The Inquiry.  

Randy Wilson, Principal Technical Advisor, Management Sciences for Health (MSH), spoke with BBC The Inquiry's Helena Merriman about MSH's role supporting Rwanda's efforts, including training community health workers with RapidSMS to saves lives. Said Wilson:

We helped to introduce RapidSMS within the districts, training 45,000 community health workers, many of whom who had never touched a cell phone in their life.

Wilson continued: "If there's even the slightest evidence" of a health concern, RapidSMS "encourages the community health worker not only to refer, but also to accompany, the mother to a facility where they get proper care."

{Screenshot, BBC, April 29, 2015}Screenshot, BBC, April 29, 2015According to the BBC:

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