October 16, 2015
Written by Dr. Emmanuel Otolorin, MCSP Nigeria Project Director and Katrin DeCamp, MCSP Senior Communications Specialist
This post originally appeared on the Maternal and Child Survival Program’s website. Reposted with permission.
Globally, 15% of pregnant women will experience life-threatening complications during pregnancy or childbirth, as will many of their babies. But did you know that the majority of maternal and newborn deaths – approximately 60% and 75%, respectively – happen after childbirth?
Few of these deaths will occur in the developed world; they are largely confined to low and middle income countries. In fact, nearly 800 women still die every day from treatable complications of pregnancy and childbirth, 99% of them in developing countries.
The reason for this disparity is two-fold: differences in emergency responsiveness and quality of care.
Many factors conspire to prevent prompt and adequate emergency responsiveness:
We must increase investments in these structural inputs, and build the capacity and equitable distribution of frontline health workers (FHWs).
At USAID’s flagship Maternal and Child Survival Program (MCSP), we recognize the tremendous contributions FHWs have made to improving health, particularly in remote and very poor communities. And we know that developing and strengthening community health worker cadres is key to increasing access to the low-cost, high impact interventions that have proven to save lives.
Beyond FHWs, we must think in new and creative ways to address the global shortage of skilled birth attendants. Here, the concept of task shifting comes into play: midwives and nurses are often the frontline service providers for women during childbirth, but in many settings they lack the training and authorization to perform the same duties as physicians.
For those women who don’t patronize health facilities for antenatal or delivery care, community health workers must be trained to meet them where they are – in the community – for care and referral, if needed. These services should be followed by introduction to postpartum family planning for healthy timing and spacing of pregnancies.
By training lower level health care workers in needed skills—and gaining stakeholder buy-in for their expanded scope of work—we greatly extend our reach to those most in need.
But how will we know if we’re achieving effective coverage of these low cost solutions? We need reliable record-keeping and data tracking to guide our decisions.
For example, a monthly dashboard—used to track of the proportion of women delivering in health facilities or at home who receive a uterotonic—can be used for a quality improvement program. Low compliance should trigger root cause analysis to identify barriers and find appropriate solutions to correct the problem.
As the first-ever Global Maternal Newborn Health Conference gets under way, the global community must elevate the evidence and share our lessons learned scaling up effective interventions in countries.
This care must include access to uterotonic drugs, magnesium sulphate and parenteral antibiotics. Health care workers must be trained to use the partograph, vacuum extractors, and manual vacuum aspiration kits. And we must scale up chlorhexidine use for cord care in both home and facility settings, as well as use of Ambu bags and masks for neonatal resuscitation.
Because we know what’s at stake: more than 3 million newborns and women could be saved each year through high-quality care around the time of birth.
There have been significant improvements in maternal and newborn health during the last decade. However, due to the poor quality of the services offered, health indicators in many countries don’t reflect an increased utilization of institutional care. MCSP is working to change these facts, meeting women and their families where they are — in the community and the facility — to ensure equitable access to these evidence-based, high impact health care services.
During this week’s conference, we encourage you to add your voice to the global conversation – use the official conference hashtag (#GlobalMNH) and “virtually” attend via conference webcasts. You’ll be joining technical implementers, policymakers, researchers and practitioners from more than 50 countries, all strategizing on the best ways to eliminate preventable maternal and newborn mortality globally.