Tag Archives: maternal health

USAID Tackles Respectful Maternity Care, Better Working Conditions for Midwives

This week USAID released its follow-up to Ending Preventable Maternal Mortality: USAID Maternal Health
Vision for Action (June 2014) with its new report of the same name with the addition of evidence for strategic approaches. These approaches seek to lower the world’s maternal mortality rate. Right now 289,000 women die per year from complications during child birth.

While it is widely known that MDG 5 will fall short of its overall global goal, USAID has partnered with other leading organizations including the World Health Organization, Maternal Health Task Force, United Nations Population Fund, and the Maternal Child Health Integrated Fund along with representatives from 30 countries  to work on a new set of maternal health goals. Set in April 2014, these organizations are now working towards a global maternal mortality rate (MMR) of 70/100,000 with no country having above a 140 MMR by 2030.

Continue reading USAID Tackles Respectful Maternity Care, Better Working Conditions for Midwives

Ethiopian Health Workers Receive Influx of Family Planning Training

In sub-Saharan Africa, 49 million women use traditional methods of family of no family planning methods at all. In Ethiopia, 39.1 percent of women use modern contraceptives up from 15 percent in 2005. The current low rate of contraceptive use in Ethiopia is a result of a combination of factors: cultural biases as well as a lack of trained health workers that can reach every woman in the country. Ethiopia is Africa’s second-most populated country behind Nigeria with 90 million people and only has a few hundred OBGYNs. There is currently only one obstetrician for 1.8 million women in Ethiopia.

That said, Ethiopia’s federal government has done an exceptional job training health workers since its Health Extension Workers program officially launched in 2003. Now 34,000 women strong, Ethiopians are afforded access to skilled health workers in their villages and cities, but there is still an unmet need for reproductive health and family planning services from health professionals.

The University of Michigan was recently gifted an anonymous $25 million dollar grant to train Ethiopian doctors in reproductive health services.  University of Michigan’s new Center for International Reproductive Health Training will train incoming doctors, nurses and midwives in comprehensive family planning services at seven medical schools across Ethiopia. The first phase of the grant will be used to build upon the work the University of Michigan is already doing at St. Paul Hospital Millennium Medical College in Addis Ababa.

Thomas Mekuria, third-year resident in OB/GYN at St. Paul's Hospital Millennium Medical College in Addis Ababa, Ethiopia.
Thomas Mekuria, third-year resident in OB/GYN at St. Paul’s Hospital Millennium Medical College in Addis Ababa, Ethiopia.

“Every day, women across the globe are dying and suffering from poor health outcomes because they don’t have access to high quality, comprehensive reproductive health care,” says Senait Fisseha, M.D., J.D., the center’s director in a statement.  Fisseha, who was born in Ethiopia, is a reproductive endocrinology and infertility specialist at the U-M Health System.

“We are overwhelmingly grateful for this extraordinary grant that allows us to build on our strong foundation of global reproductive health programs and continue to pursue a longtime dream to provide all women a full scope of high quality reproductive health care when and where they need it.”

With a maternal mortality ratio of 420 per 100,000 live births in Ethiopia, family planning services are essential to keep more mothers alive, especially teenage mothers who are not prepared physically to bear children. The average Ethiopian woman has 5.5 children according to the most recent demographic data.

“Our center will help empower women to make their own decisions about their own reproductive health, thereby choosing whether and when to start a family,” Dr. Fisseha continued. “Our ultimate goal is to help train future generations of capable and competent health care providers in many parts of Africa and South Asia who can deliver comprehensive reproductive health services, and also be advocates for the safest and best health care possible at every stage of a woman’s life.”

Uganda Moves Closer to Using Misoprostol to Curb Postpartum Hemorrhage

In low- and middle-income countries women continue to die each day during and immediately after childbirth mainly due to postpartum hemorrhaging (PPH). In fact, most maternal deaths in sub-Saharan Africa (440 every day) are caused by PPH.

The World Health Organization’s strong recommendation to save mothers who experience PPH is to administer oxytocin, the most effective drug to stop hemorrhaging. The problem, however, is oxytocin must be kept refrigerated. Most health centers and hospitals in low resource areas lack electricity or have spotting service making the use of oxytocin improbable to impossible. Oxytocin must also be injected by a skilled health worker which causes another barrier to its universal use. For African women, who likely live great distances from their closest health center, the chances of delivering their baby with a skilled health professional are increasingly low.

Scientists in Uganda recently conducted a double-blind, randomized trial where they compared the use of oxytocin and misoprostol, an oral drug that also stops postpartum hemorrhaging. They found that misoprostol can effectively be used against PPH because it can be taken as a pill and does not need to be refrigerated. In cases where oxytocin  and health workers are not available the World Health Organization has also recommended the use of misoprostol. This recommendation has stood since 2011.

Although misoprostol has been used and distributed to health centers in Uganda since 2010 the researchers acknowledge that the drug has been illegally abused because it can also be used for abortions. Researchers also admit that oxytocin is a superior drug to reduce PPH because misoprostol often causes shivering and fevers in addition to stopping hemorrhages.

While misoprostol seems to be the likely alternative to oxytocin in resource-poor settings, researchers in Australia at Monash University as well as their global partners Glaxo Smith Kline, McCall MacBain Foundation, Grand Challenges Canada and Planet Wheeler Foundation are currently collaborating on an inhaled oxytocin product that does not require refrigeration while still saving mothers’ lives.

Photo: United Nations

 

 

5 Global Health Stories We’re Following This Year

2015 will be an interesting year in global health primarily because this is the year when the Millennium Development Goals should ideally be reached. Global health experts admit that many of the goals, for example MDG5, will not be reached globally even though some of them have already been reached on a country level.

Ethiopia effectively reached MDG4 along with Bangladesh, Liberia, Malawi, Nepal, and Tanzania according to a 2013 report in the Guardian and UN data. Globally, the proportion of people having access to safe drinking water was reached in 2012. That is cause for celebration.

The overarching theme this year will be how the global health community will save more lives in low and middle-income countries in the best ways possible. This does not necessarily mean substantive goals, target dates, and data measurements will be scaled back. Rather, improved approaches to global health will be devised to streamline processes and programs.

While there are many global health stories that deserve following in great detail here are our top five picks for 2015.

1. The Effect of Ebola on Maternal Health: While Ebola is being fought in Sierra Leone, Guinea, and Liberia there must also be an enhanced emphasis on women who are pregnant and need to deliver their babies in a hospital setting. As it is, with low resources and crippled health systems in these three countries, women still need to be afforded quality care during pregnancy and delivery while health workers also care for those stricken with Ebola.

As the year goes on it is probable that key data will emerge from lessons learned during the Ebola response. According to Scientific American, the WHO, UNICEF, and Save the Children have already devised best practices and protocols for safe delivery.

2. Global Immunizations: This year we will watch the increase in rotavirus vaccine roll-outs across poor countries. Why? Diarrhea is one of the top three leading causes of deaths for children under five, and yet the rotavirus vaccine isn’t accessible in the volume of some the other vaccines. That said, rotavirus roll-outs have increased substantially since 2011. There is more good news. With increased GAVI funding, the rotavirus vaccine will be introduced in 30 countries this year.

rotavirus

We will also look at the progress of the Ebola vaccine. GAVI has announced that it is ready to purchase a million doses of the vaccine as soon as the World Health Organization approves its use. Today, Johnson & Johnson announced that they have already begun clinical Ebola vaccine trials with volunteers in Africa.

3. Country Commitments to the Every Newborn Action Plan (ENAP): Last year saw the official adoption of the plan during last year’s World Health Assembly and the launch of the Every Newborn Action Plan in Johannesburg during the Partners Forum. Upon its launch there were already 40 commitments (PDF) to save more newborns globally. That said, this year we will also look for increased commitments, particularly country commitments, to the ENAP especially since 2.9 million newborns die every year due to largely preventable causes.

4. Scaling Up of Frontline Health Workers: Did you know there is a global shortage of 7.2 million frontline health workers? That key data has been widely shown by the lack of health workers in  Ebola stricken countries. It’s the lack of health workers that has made fighting Ebola harder than it should be and why many health workers outside of Africa have had to pick up the slack.

Scaling up health workers is a large expense, but it bears repeating that in order for countries to provide quality health care to their citizens there must first be enough health workers. Ethiopia is touted time and again as an excellent example of a poor country that effectively scaled health worker coverage across the country through a government-led effort. Other countries’ health ministers have traveled to Ethiopia to see best practices for scaling up their own frontline health force. The second step after key learnings, however, is making sure actions are taken besides pure lip service. In 2015 we will look at evidence from other low- and middle-income countries, particularly in sub-Saharan Africa, that will introduce better national health worker programs.

5. Food Security in Conflict Areas: At the end of 2014, the World Food Programme said that it had suspended food aid to 1.7 million refugees in Syria due to a lack of donor funding. And previous to that, the WFP split vouchers in half to stretch funds according to the New York Times. Even though the World Food Programme received an emergency influx of funds after their voucher suspension announcement last month, it is never a good sign to see that there are not enough donor dollars to feed the world especially those who are living in conflict areas. Food security in not only conflict zones, but also in West Africa will be on our must-follow list this year.

Which global health stories are you following this year?

 UN Photo/Martine Perret

Our Top 10 Most Read Posts of 2014

Over the course of this year we have shared a great deal of global health news and information, reports from the field in Ethiopia, Nicaragua, Tanzania, and the Phillipines, and have broken down some of the most pressing global health documents. That said, some of our posts received many more reads than others. Here is the countdown of our top 10 most read posts in 2014. Not surprisingly, maternal health, issues facing women and girls and health workers were some of the most read topics this year.

10. How Ethiopia is Scaling Midwifery to Save More Newborns:


In Ethiopia there are 4.9 million pregnancies each year of which 84% take place in rural areas. Here in Ethiopia, where the vast majority of women deliver at home, only 32% of maternal, newborn and child health needs are being met by midwives according to the newly released State of Midwifery Report. That is troubling for a country that is making noticeable strides to save its women and children, including reaching Millennium Development Goal 4 last year. There is still scalable work to be done to save more Ethiopian mothers and their newborns. Read more.

9. Photos: B&W Historic Photos of Public Breastfeeding in the United States

Historic Breastfeeding
Long ago in Internet years (about seven years ago) I was a staunch breastfeeding advocate and researcher (still am!). Back then I wanted to get to the bottom of why nursing in public was such a big issue in the United States. So, I started digging in the photo archives of the Library of Congress for hundreds and hundreds and hundreds of hours and discovered through black and white, historic photos that breastfeeding in public hasn’t always been a problem in the United States. Read more.

8. 5 Maternal Health Organizations to Support Now

Peacekeeping - UNMIL
Every day 800 women die due to largely preventable causes during childbirth. That number is mentioned everywhere maternal health is mentioned and championed, but it always bears repeating. Until the drastic maternal mortality numbers decline the data must remain front and center. Mothers’ lives depend on us knowing the facts. Read more.

7. How  One Philanthropist Is Changing Lives for Indian’s Women and Girls

It’s been just over a week since philanthropist and advocate Indrani Goradia landed in India. She’s been many times before, her husband’s family is Indian and she is from Trinidad and Tobago, of Indian descent. But this is a different trip and fifty-plus years in the making.

Not long ago, gender-based violence was viewed as a private, domestic affair. Even in the United States, legal protections against violence toward women were not enacted until 20 years ago in 1994. Read more.

6. Traveling to Tanzania With PSI, IntraHealth, and Mandy Moore
Over the years I have had the distinct privilege of meeting health workers around the world from Ethiopia and Kenya to Tanzania and South Africa to India and Brazil. Health workers, particularly in low- and middle-income countries, are the unequivocal backbone of health systems that can oftentimes be severely taxed due to the overwhelming number of people who rely on them for care to the disarray of health systems’ frameworks coupled with a dismal lack of financial allocations to national health care. Read more.

5. Maternal Mortality in the United States: The Numbers May Surprise You

When we talk about sky-high maternal mortality rates we tend to look more closely at low-income countries like Afghanistan, Chad and Somalia that have the world’s highest maternal mortality rates in the world according to the World Bank. And, of course, sub-Saharan African countries need to desperately bring their numbers down. But when you look at rich, developed countries the United States has the highest maternal mortality rates among them and the rates are not declining. In fact, maternal mortality rates in the United States have doubled over the past 25 years. Read more.

4. Book Review: Consuming the Congo: War and Conflict in the World’s Deadliest Place

There has increasingly been more attention paid to conflict minerals – the minerals that are extracted from mainly developing countries – that are used to power the technology we all cannot live without. These minerals cause problems for a great many of us. We cannot go a day or even a few hours without our cell phones, tablets, and laptops even though we realize that the minerals inside of them most likely caused suffering for some African miner working to earn very little wages. Read more.

3. A Day in the Life of a Family Planning Health Worker

It took over an hour in notoriously congested Dar es Salaam traffic and gingerly moving through winding, narrow, dirt roads to visit Blandina Mpacha. Mama Blandina, as her community affectionately calls her, is a PSI health worker who teaches women, men, and whole families about the importance of family planning. This isn’t something new to her. Mama Blandina has been a family planning health worker for over twenty years and has seen the slow-going, but eventual change in attitudes toward spacing births. Read more.

2. How  One Philanthropist Is Changing Lives for Indian’s Women and Girls – Part II

Laxmi strode confidently into the hotel ballroom where we were holding the launch of Wajood – a project developed in partnership between Indrani’s Light Foundation and PSI India to stem gender based violence in Delhi.

She’s slight, dressed in skinny jeans and unmistakable in her confidence, her beauty and for the scars covering her face and arms. Read more.

And, the most read post is..

1. Why Don’t We Spend More Money at Home? Breaking Down False Notions About US Foreign Aid

foreignaid101-thumbnail_1_orig_c (1)Whenever I go to the Hill to advocate for continued and, more importantly, increased funding for foreign aid I always hear from staffers that their constituents perpetually call their congressperson’s or senator’s office telling them to stop spending money in other countries and use that money at home. What these concerned citizens and so many in the United States, do not understand is that the United States’ federal budget is so unimaginably huge, we spend less that 1 percent on foreign aid (from budget.house.gov). Read more.

Join Ashley Judd In Supporting Health Workers in Haiti

unnamed (1)By Ashley Judd, PSI Global Ambassador

Virgila is more charismatic and animated than most actors I know.

She’s a PSI-trained health worker on the outskirts of Port Au Prince, Haiti. And she’s passionate about her work. She goes door-to-door educating women about the benefits of reversible contraception like the IUD.

Giving birth is dangerous business for Haiti’s poor, who suffer the highest maternal mortality rate in the western hemisphere. To save the lives of mothers, we must ensure that we prevent unintended pregnancies from occurring.

Please make a tax-deductible donation to fund the efforts of PSI-trained health workers like Virgila. For a short time, your donation will be matched through a generous $200,000 challenge gift from PSI’s board of directors.

Virgila says, “I reach women wherever they are. I go door-to-door. I go to hospitals. I go to mother’s associations. I go to community meetings.”

She waves her arms, “There is so much need. It’s never ok to stop working. I want women to be able to have the number of children they want.”

Roslyne, a woman who arrived at the clinic today to get an IUD says, “Ms. Virgila knocked on my door one day. That’s why I’m here.” Roslyne — who ekes out a living for her family by selling spinach she grows — has five children, ages 13, ten, six, two and one. She didn’t know about the IUD before Virgila told her about it.

The work Virgila does changes people’s lives — plain and simple. Please join me and support the effective work of community health workers. For a short time, your donation will go twice as far through this generous challenge match.

Thank you.

Sincerely,

Ashley Judd

P.S. Peter Singer says, “I recommend PSI because they focus on interventions with proven impact that help children survive the most serious health challenges they face — like a lack of family planning, HIV and AIDS.” Donate now.

Ashley Judd is a celebrated American actress and humanitarian. She became an ambassador for PSI in 2002 and served as a board member from 2004 to 2013.

Why This 21-Year-Old Filipino Mother Dropped Out of School in 6th Grade

I met Jasmine and her son, Kent John, 7-months-old, on a sunny day at a free health clinic in Ormoc, a busy port city on Leyte island in the Philippines. At just 21-year-old Jasmine came to the clinic because Kent John had been experiencing a cough and fever for two weeks.

Luckily located very close to the clinic, Jasmine takes her son to the clinic for his regular immunizations and goes anytime Kent John is ill. Sometimes she has to wait for two hours before being seen by Glenda B. Serato, the health clinic’s nurse.

“I am confident with my baby’s health because I can access free immunizations and medicine,” Jasmine says through translation.

The mothers I spoke to including Jasmine mention always coming to the clinic for their children’s  immunizations even though many live deep in the rural areas where rice and sugar fields are abundant and access to health services are not.

“The mothers are educated now,” Serato confirms. “It is very rare that mothers don’t get their children vaccinated.”

During Typhoon Haiyan that devastated much of Leyte island, Jasmine was five months pregnant, but was able to deliver her first child, Kent John, via C-section at a public hospital. Now, she is taking oral contraceptives to space her children with her husband, who drives a motorcycle for a living.

Continue reading Why This 21-Year-Old Filipino Mother Dropped Out of School in 6th Grade

5 Maternal Health Organizations to Support Now

Every day 800 women die due to largely preventable causes during childbirth. That number is mentioned everywhere maternal health is mentioned and championed, but it always bears repeating. Until the drastic maternal mortality numbers decline the data must remain front and center. Mothers’ lives depend on us knowing the facts.

Over the past few decades maternal health numbers have effectively decreased by 47 percent, but we still have a long way to go especially in sub-Saharan Africa where most maternal deaths occur.

Large, international NGOs and governments have put their influence and resources behind saving more mothers’ lives. But, this is a big world in which we live where there are many women who still do not have access to quality prenatal health care and who must resort to delivering their babies at home which can often be fatal for them and their newborns. Some expecting mothers, especially in the poorest sub-Saharan African countries, do not have any other choice but to deliver at home due to a lack of access to health workers and proximity to a health facility.

There are countless organizations that are working diligently to ease the burden on expecting mothers in low-resource settings and are striving to save more lives. While decreasing the number of maternal deaths may seem like a Sisyphean task in the short term, there are organizations that save mothers’ lives every day! Every life matters even if the data points don’t show significant change quickly enough.

Here are five organizations we think are doing phenomenal maternal health care work and that deserve to be supported especially during this giving season.

  1. [This campaign has ended] The Safe Delivery App is a groundbreaking mobile training tool, which can save mothers and newborns in Africa during pregnancy and childbirth. The app is developed by Maternity Foundation in cooperation with leading scientists from University of Copenhagen and University of Southern Denmark.The app aims to improve the quality of maternal and neonatal care in developing countries by teaching birth attendants in hard-to-reach areas how to manage normal and complicated deliveries through animated clinical instruction films.They are raising $100,000 to scale the app. Donate to their campaign at www.indiegogo.com/projects/the-safe-delivery-app-a-life-saving-mobile-app.
  2. Jacaranda Health is a social enterprise and operates as a 501(c)3 in the US.  Their mission is to transform maternal health care in East Africa and make pregnancy and childbirth safer for women and newborns. “Jacaranda Health aims to provide respectful, patient-centered, kind and high-quality care during pregnancy and childbirth,” says Amie Newman, Jacaranda Health’s Director of Communication and Development.That’s why we love their work! Donate at jacarandahealth.org/our-approach/jacarandas-model/donate.
  3. Every Mother Counts has teamed up with CrowdRise to raise essential funds to save more mothers’ lives in the seven countries, including the United States, where they work on maternal health care and prevention of maternal deaths.
    Every Mother Counts was launched with the intention to make pregnancy and childbirth safe for every mother. Donate at www.crowdrise.com/EveryMotherCounts-Tower.
  4. Midwives for Haiti: When we hear about mothers who die during childbirth they most likely succumb to hemorrhaging (bleeding to death). This is particularly sad because hemorrhaging, in most cases, is preventable. In low-resource settings, however, hemorrhaging takes the lives of countless women and it doesn’t have to happen. Midwives for Haiti has put together a program that specifically addresses postnatal care. Many women who delivered at Hospital Ste. Therese in Haiti where they work, either received no postnatal care or were sent home four hours after delivery. That is highly unacceptable and deadly.Donate at midwivesforhaiti.org/projectpostnatal.html.
  5. [This campaign has ended] Zero Mothers Die is a global partnership initiative that is equipping pregnant women in developing countries with unique mobile phones to give them access to healthy pregnancy information and healthcare that could be just a phone call away during emergencies. Their aim is to bring mobile technology solutions to pregnant women to empower them with information and enable them to seek care when they need it most.Donate at www.indiegogo.com/projects/zero-mothers-die-mobile-phones-for-pregnant-women.

We know there are countless organizations that are working with mothers to keep them alive before, during, and after childbirth, but we can’t mention them all. Please list other maternal health organizations in the comments.

Photo: UN Photo/Eric Kanalstein

How Mother’s Loving Support Encourages Breastfeeding in Zambia

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Mutinta Roni Maimbo

Mother’s Loving Support is a non-profit volunteer organisation borne out of the founder’s desire to encourage and support women as they breast feed their babies while continuing to work outside the home.

In Zambia, breastfeeding a child is a socially accepted and encouraged step with the coming of a child, but many women in urban areas slowly transition to formula or other substitutes as the child grows or as they end their maternity leave to go back to work. Typically this happens at three months postpartum, though some women are able to extend their maternity leave in order to spend more time with their babies and nurse them for longer. When the time comes, many difficult decisions are made, one of them being how a mother can continue nursing while she goes to work?

Employment law does not have a specific allowance for nursing mothers, but at the discretion of the employers, mothers can take an hour each day to breastfeed their children, with many women able to go home during lunch hour to nurse. However, others face challenges in taking this time to nurse and this prevents them from providing breast milk for their children, thus transitioning them to substitutes earlier than is recommended. In addition, if women have not had an easy time breastfeeding, they are likely to stop at this stage.

Continue reading How Mother’s Loving Support Encourages Breastfeeding in Zambia

7 Facts About Premature Births You Might Not Have Known

Photo: A premature baby is shown in the postnatal ward at Cama Hospital, a major hospital for women and children, in Mumbai, India. UN Photo/Mark Garten

Premature births are now the number one killer of babies globally. Of the 6.3 million children under five who died last year, 1.1 million of them died due to complications from premature births. Most of these deaths occured within the first month of life, according to new research published in The Lancet.

“This marks a turning of the tide, a transition from infections to neonatal conditions, especially those related to premature births, and this will require entirely different medical and public health approaches,” says Joy Lawn, M.D., Ph.D., of the London School of Hygiene & Tropical Medicine, a member of the research team and a long-term advisor to Save the Children. “The success we’ve seen in the ongoing fight against infectious diseases demonstrates that we can also be successful if we invest in prevention and care for preterm birth.”

Today is the the fourth World Prematurity Day, a global awareness campaign that focuses on the number of newborns that die every year and ways in which we can help those numbers decline. With heightened attention on premature births it is only a matter of time before global prematurity rates improve just as the overall child mortality statistics have improved steadily since 1990.

Continue reading 7 Facts About Premature Births You Might Not Have Known