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Posts Tagged ‘health systems strengthening’

On April 13th 2010, the New York Times published an article,  Maternal Deaths Decline Sharply Across the Globe, about the recent findings published in the Lancet that suggest a dramatic reduction in global maternal mortality. Since then, the paper has published a series of Letters to the Editor. These letters come  from leaders of organizations working on reproductive and maternal health and from health professionals working on maternal health on the ground in countries where maternal mortality continues to be a major problem.

The New York Times

A variety of opinions and sentiments are expressed in these letters that certainly add depth to the initial story published in the Times. Two themes pound through the letters: a new sense of hope that improvements in maternal health are possible and a sense of urgency that this battle has not yet been won–that now, more than ever, is the time for the maternal health community to stick together (despite squabbles among advocates over whether or not the Lancet should have published the paper when they did) and engage in concerted efforts (that include emergency obstetric care, HIV services, and expanded access to family planning) to achieve MDG5.

A careful look at these letters will stimulate a much more robust understanding of the myriad of factors contibuting to global maternal mortality—as well as the potential implications of the findings of the Lancet paper and necessary next steps towards achieving MDG5.

Some authors express cautious excitment that investments are (or might be depending on the author) paying off while simultaneously declaring that it is not yet time to celebrate; far too many women are still dying of pregnancy-related causes!  Joanne Jorissen Chiwaula, director of the African Mothers Health Initiative describes her frustration with Chris Murray (one of the authors of the Lancet paper) for downplaying the importance of emergency obstetric care services in favor of playing up the importance of HIV services, when a comprehensive approach is really what is needed. Mary Robinson, president of Realizing Rights: The Ethical Globalization Initiative, calls attention to the relationship between maternal health and discimination against women, lack of reproductive choices for women, child marriage, sexual violence, unsafe abortions and inability to own property. She emphasizes the importance of considering maternal health in the context of human rights—and also points out the need to focus on strengthening entire health systems. 

Take a look at a group of Letters to the Editor published on April 18th, and more on April 19th.

For readers comments on the initial story in the Times, click here.

And for Nicholas Kristof’s take on the new maternal mortality estimates, click here.

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Last week, Dr. Blanc, Director of the Maternal Health Task Force, attended a workshop on the evidence base for clean birth kits in London–and this week, she blogs about it on the MHTF Blog.   

MHTF Blog

“…Many questions were raised by participants about whether clean birth kits represent a good investment for maternal and newborn health. There was some concern expressed about the potential for birth kits to be an ‘expensive diversion’ away from much needed work on strengthening health systems, although some could also imagine ways in which birth kits could be used as a strategy for improving the quality of care in health facilities…”

Read the full post, A Good Idea or an Expensive Diversion? Workshop on the Evidence Base for Clean Birth Kits.

The workshop was organized by Immpact/University of Aberdeen and Saving Newborn Lives/Save the Children.

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Immpact is looking for a researcher to conduct a scientific literature review of the quality of international maternal health care—and prepare proposals/implementation of formative research studies to improve quality of maternal health services in developing countries.

Immpact

Screenshot from Immpact website.

About Immpact and their current research activities

Immpact is a research unit at the University of Aberdeen with a focus on knowledge generation, knowledge management and knowledge transfer dedicated to reducing maternal and newborn mortality and morbidity in developing countries. This is a global research initiative whose aim is to promote better health and is closely linked with global efforts to meet the UN Millennium Development Goals for 2015, especially those related to maternal mortality reduction.

Immpact has recently been awarded funding by the Norwegian Government to conduct multiple research activities related to improving the quality of maternal care in developing countries, including systematic literature reviews, formative research and developing a large-scale international field trial testing package of quality of delivery care interventions including birth kits.    The current focus of the research project is India and a few selected African countries.

This initiative will contribute to the better conceptual understanding of quality of care available via maternal health services and will generate evidence on the means improving maternal care in the context of developing countries.

The study will improve the quality of delivery care and strengthen health systems, and thus impact upon maternal mortality. The key potential outputs will be:

  • Scientific literature reviews to describe status of quality of maternal care and to identify the effective health systems interventions in developing countries.
  • Prioritisation and pre-testing of promising targeted interventions through series of formative research activities
  • Robust evaluation of the quality of a delivery care intervention package in target developing countries”

Download the full job description here.

See the online posting here.

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WATCH THE LIVE WEBCAST TODAY AT THIS LINK.


The Woodrow Wilson Center’s Global Health Initiative, the Maternal Health Task Force (MHTF) at EngenderHealth, and the United Nations Population Fund (UNFPA) have announced the third event, Maternal and Newborn Health as a Priority for Strengthening Health Systems, in their series, Advancing Policy Dialogue on Maternal Health.

MHTF Blog
The event will be held on March 8th, 2010 from 3-5pm at the Woodrow Wilson International Center for Scholars in Washington, DC.

About the Event
“Increasing investments for strengthening health systems requires improved donor coordination and additional research to help guide decisions about where investments will have the greatest return. The inclusion of key maternal health indicators such as access to emergency obstetric care is an important strategy to improving health systems and encourages the implementation of priority evidence-based interventions.”

Presenters
Julio Frenk, Dean of the Harvard University School of Public Health; Helen de Pinho, Assistant Professor of Clinical Population and Family Health at Columbia University; and Agnes Soucat, Senior Health Economist & Lead Advisor for Health, Nutrition and Population with the World Bank, will be presenting.

Visit the MHTF Blog for more information, including a PDF invitation, RSVP information–and info on how to watch live or archived videos of this event.

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Five recent stories published on the site have raised various issues impacting maternal health—including leadership and innovation, maternal death audits, access to primary health care and safe delivery, human rights, and even a proposal for a separate maternal health ministry.

allAfrica.com

Namibia: Leadership Development, Social Innovation and Improved System Performance

The Maternal Health Initiative Team,  an offshoot of the African Public Health Leadership and Systems Innovation Initiative, funded by the Bill and Melinda Gates Foundation, is “developing a model for improving public health leadership and system performance.”

“…The project is underpinned by three principles: local leadership development, social innovation and improved system performance.

The initiative applies a business-consulting approach called the Innovation Lab. Through the Innovation Lab, multi-stakeholder teams are guided through an intensive leadership development and problem-based learning experience. The aim is to tackle a complex social and system problem through a multi-stakeholder and innovation response.

When deciding on a priority health problem to tackle as a pilot, it wasn’t hard for Namibian health leaders to choose maternal health. Between 2000 and 2006, maternal mortality jumped to 449 deaths per 100 000 births, an increase of 178 deaths…”

Read the full article,  Namibia:Health Authorities Tackle Maternal Mortality.

Rwanda: A Call for Maternal Death Audits

“…As a strategic move to curb the maternal death rate further and achieve millennium development goal 5, the government recently extended the fight to the village level.

This was announced recently by the Minister of Health, Dr. Richard Sezibera, during a meeting that was held with a visiting US medical team to discuss Rwanda’s health progress.

During the discussions, Sezibera noted that it was imperative to engage the community in fighting maternal death rates so that leaders at the village level can identify the causes of these deaths in bid to find a lasting solution.

‘This year we started maternal death audits in villages because we believe that social audits on death causes will enable authorities identify answers to this problem,’ the minister said…”

Read the full article, Rwanda: Maternal Mortality Control Extends to Village Level.

Nigeria: Improving Access to Primary Health Care and Safe Delivery

“Health System Development Project II, a World Bank assisted project has commissioned two Comprehensive Primary Health Centres at Dagiri community in Gwagwalada and Dabi village at Kwali.

The Health Centres are to address the high rate of maternal and child mortality cases in the country, said Mrs Anne Okigbo-fisher, World Bank task team leader during the hand over ceremony of the centres. She said Nigeria records 10 percent of the world’s maternal mortality rates out of the 524,000 women that die yearly during child birth, adding that approximately 99 percent of the mortality rate is due to child birth complications in developing countries.

According to her the objective of HSDP II is to reduce such complications and improve safe delivery in the country…”

Read the full article, Nigeria: World Bank Commissions N104 Million Hospitals in Abuja.

Kenya: Human Rights Impacting Maternal Health

Amnesty International calls on Kenya’s Parliament to ensure that the draft Constitution of Kenya upholds respect for, the protection and fulfilment of all human rights. The draft Constitution should retain social and economic rights as enforceable rights. In addition, the organization also calls on Parliament to remove the provision stipulating that the right to life begins at conception and if the article on abortion access is retained, provide for abortion for rape victims…

…If the Constitution explicitly limits women’s access to abortion services, it must, at least ensure women’s access to safe and timely abortion services in cases of risk to the life or health of the woman or pregnancy resulting from rape or incest. Such an exemption is required by international law and is required by the Protocol to the African Charter on Human and People’s Rights on the Rights of Women in Africa, which Kenya signed in 2003. In view of the high number of maternal deaths resulting from abortion complications, the State should protect women’s right to life by ensuring meaningful access to sexual and reproductive health services including information and contraception and commit to address sexual violence and coercion…”

Read the full article, Kenya: New Constitution Must Ensure Rights for All.

Uganda: A Call for an Independent Maternal Health Ministry

“An independent ministry should be set up to handle maternal health, the deputy Speaker of Parliament, Rebecca Kadaga, has said.

‘Who is planning for women’s health in this country? Basic things like antibiotics, oxytocins (drugs that help manage bleeding) which cost sh300 and manual vacuum aspirators to remove retained products from the womb are not there,’ she told journalists at a briefing on the state of maternal health on Friday…”

Read the full story, Uganda: Kadaga Wants Independent Maternal Health Ministry.

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The Woodrow Wilson Center’s Global Health Initiative, the Maternal Health Task Force (MHTF) at EngenderHealth, and the United Nations Population Fund (UNFPA) have announced the third event, Maternal and Newborn Health as a Priority for Strengthening Health Systems, in their series, Advancing Policy Dialogue on Maternal Health.

MHTF Blog
The event will be held on March 8th, 2010 from 3-5pm at the Woodrow Wilson International Center for Scholars.

About the Event
“Increasing investments for strengthening health systems requires improved donor coordination and additional research to help guide decisions about where investments will have the greatest return. The inclusion of key maternal health indicators such as access to emergency obstetric care is an important strategy to improving health systems and encourages the implementation of priority evidence-based interventions.”

Presenters
Julio Frenk, Dean of the Harvard University School of Public Health; Helen de Pinho, Assistant Professor of Clinical Population and Family Health at Columbia University; and Agnes Soucat, Senior Health Economist & Lead Advisor for Health, Nutrition and Population with the World Bank, will be presenting.

Visit the MHTF Blog for more information, including a PDF invitation, RSVP information–and info on how to watch live or archived videos of this event.

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Brain-drain, a poorly funded public health system, professional negligence, poor communication and  supply shortages all seem to be factoring into this spike in maternal mortality

Relief Web

“Figures showing a rise in the number of women dying in childbirth have only confirmed the multiple challenges facing maternity provision in Kyrgyzstan, which is short of qualified hospital staff, medical supplies and equipment. From January to the end of August, the latest period for which national data are available, 58 deaths were recorded among mothers during pregnancy, childbirth and the post-delivery period. The figure for eight months was ten more than for the whole of 2008. The figures were announced at a national congress of Kyrgyzstan midwives, paediatricians and paediatric surgeons held in the capital Bishkek on October 29-30. As the meeting took place, investigations were continuing into the deaths of four women at Bishkek’s perinatal centre between July 1 and August 18…”

Read the full story here.

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Women Deliver is holding a conference, Delivering Solutions for Girls and Women

The conference will be held in Washington DC from June 7-9 and will have two main messages:

1.) The MDGs will not be achieved without investing in women.

2.) There is just enough time, if the world commits funding now, to achieve MDG5 — additional US$10 billion annually by 2010 and US$20 billion by 2015.

Other themes to be discussed include family planning, reproductive health, maternal health, HIV/AIDS, gender, health systems strengthening, women in conflict situations, human rights and more.

Women Deliver is committed to making the conference accessible to all and is offering full scholarships—that include conference registration, roundtrip airfare, visa fees, hotel stay, and a stipend for incidentals and meals.  The deadline to apply for the scholarship is December 15th, 2009.

Click here to apply for a scholarship.

Click here for information on the conference.

Click here to visit Women Deliver’s website—and here for their blog!

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