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Posts Tagged ‘EngenderHealth’

This post is the first in a series on maternal health in the Seraikela block of Jharkhand, India. 

In 2009, Sarah Blake and I worked together at the Maternal Health Task Force, a Gates Foundation funded maternal health initiative based at EngenderHealth in New York City. Since then, Sarah went on to work as a consultant with several non-profit organizations, including UNFPA and Women Deliver.  I took off for India as a Clinton Fellow with the American India Foundation where I have been working for the past nine months on a maternal and newborn health project in Jharkhand, a state with high levels of maternal and newborn deaths.

A new mom holds her newborn in a small community called Sini, in the Seraikela block, as community members look on.

Sarah and I recently teamed up again (this time, in India) to explore our common interest in maternal health. Over the past two weeks, we have visited hospitals, health centers, government offices, rural villages, and homes in the Seraikela block, a rural area with rugged terrain and limited infrastructure outside the industrial city of Jamshedpur, in the state of Jharkhand.  We conducted a series of interviews with women, families, health workers, and government health officials. We asked questions about pregnancy, childbirth and the postpartum period. We learned about the women’s experiences with home and institutional deliveries–and the factors that influence their decision to deliver at home or in an institution. We explored the implementation of and attitudes toward Janani Suraksha Yojana, a conditional cash transfer program that aims to increase institutional deliveries across India.

A collapsed road on the way from Jamshedpur to the Seraikela Block of Jharkhand.

Conditional cash transfers are trendy. Various governments, non-governmental organizations, and private enterprises across the globe are supporting cash transfer initiatives in efforts to improve school attendance, reduce child under-nutrition, improve maternal and newborn health, and to address other development goals.

What is a conditional cash transfer program? According to the World Bank, “conditional cash transfer programs provide cash payments to poor households that meet certain behavioral requirements, generally related to children’s health care and education”.

Janani Suraksha Yojana (JSY) is a widely discussed (mostly within the global health community but to some extent in mainstream media) and frequently praised cash transfer program. JSY was launched by the Indian government as part of the National Rural Health Mission in 2005, in an effort to reduce maternal and newborn deaths by increasing institutional deliveries.

JSY provides cash incentives to women who deliver in government health institutions as well as accredited private health centers. The program also provides a cash incentive to the health worker who supports the woman throughout her pregnancy and accompanies her to the facility. (For details and FAQs on JSY, click here.)

A community health worker accompanies a pregnant woman to Mahatma Gandhi Memorial Hospital in Jamshedpur, the main referral hospital for the surrounding rural communities.

Maternal and newborn death rates have gradually been declining across India (and the world), but the problem has yet to be resolved. Both maternal and newborn deaths in India continue to make up an extremely large percentage of the overall global burden. According to a study published in the Lancet last year, 20% of global maternal deaths and 31% of global newborn deaths in 2005 occurred in India.

JSY is a big program (the biggest of its kind in the world) that aims to deal with a big problem. The lessons that are drawn from it have the potential to influence global health policy in a big way. The 2010 evaluation of JSY published in the Lancet suggested that the program is having a significant impact on perinatal and neonatal health, but the paper asserted that the verdict was still out in terms of any impact on maternal mortality.

The lesson that has emerged from JSY for newborn health is that giving women money increases institutional deliveries and reduces perinatal and neonatal mortality.  It is likely that the same message will emerge in terms of reducing maternal mortality—and there is a good chance that this approach will be picked up in national health programs in numerous other countries that also have high levels of maternal and newborn mortality.

Our concern is that JSY is far more complex than providing women with money—and reducing maternal mortality is far more complex than increasing institutional delivery.

Given the scope, cost, and potential of JSY; it is incredibly important that we ask questions about the nuances of JSY—the role of money as an incentive for women, families and health workers; the readiness of institutions;  the challenges with transportation; the human rights implications of the program; and a variety of other related factors.

Over the next week (or couple of weeks), Sarah and I will share our experiences and insights from our time with the women, families, health workers, and government health officials of the Seraikela block of Jharkhand, a focus state for JSY. We will highlight stories from the people most impacted by and involved in Janani Suraksha Yojana.

We believe that we have scratched the surface of some interesting issues related to JSY, but our time in Seraikela certainly left us with more questions than answers, and we will be sharing those questions in upcoming posts.

We will also be asking our colleagues working in maternal and newborn health to share their thoughts through guest blog posts. If you are interested in submitting a guest post, contact us at katemitch@gmail.com and sarahcblake@gmail.com.

Tata Steel Rural Development Society, my host organization for my fellowship, provided us with transportation and interpreter services. Many thanks to Shabnam Khaled for her help with translation. 

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I am back to blogging after a few weeks break to get settled in India!

I arrived in Jharkhand, India  just over a month ago. I am here as a William J. Clinton Fellow with the American India Foundation. I transitioned out of my previous role at the Maternal Health Task Force at EngenderHealth just after the Global Maternal Health Conference in Delhi. (Click here to view archived videos of the conference sessions.)  I was craving on-the-ground experience in program implementation and I was looking forward to working at the community level—to put to action the knowledge I gained during my time at the MHTF as well as the program planning skills I learned while completing my MPH in International Health at Boston University.

Mother and Baby, Jharkhand, India--Photo by Kate Mitchell

The people of India face some of the highest levels of maternal and newborn mortality and morbidity in the world.  Jharkhand, a newly formed state in India, faces higher maternal and newborn mortality ratios than India as a whole. And the villages of the Seraikela block, a region of Jharkhand with difficult geographic terrain and low levels of literacy, experience even higher ratios than the state.

My fellowship placement has already offered me some remarkable experiences (I’ll be writing about those experiences in upcoming posts)–and mentors who are working together to improve maternal and newborn health in Seraikela from a number of different angles and organizations.

My assignment is with a new public-private partnership that aims to improve maternal and newborn health in Seraikela at the community and facility level. (Click here to read about recent conversations at the Global Maternal Health Conference focused around striking the right balance between community and facility based interventions.)  MANSI, the Maternal and Newborn Survival Initiative, is being implemented by Tata Steel Rural Development Society, a division of Tata Steel’s corporate social responsibility wing, and the American India Foundation in partnership with the local government. (Click here for a recent post by Alanna Shaikh on corporate players getting involved in global health.) 



MANSI is a replication of the Home Based Newborn Care (HBNC) project that was originally (and very successfully) implemented by SEARCH in Gadchiroli, Maharashtra, India. The MANSI team is working closely with SEARCH to train community health workers from 174 villages within the Seraikela block on the HBNC curriculum, a set of modules that prepares community health workers to address the leading causes of newborn mortality and morbidity in India.  The team will also be training the health workers on a number of interventions that will target the health of the mother–as well as upgrading several sub-centers within the Seraikela block to be equipped to handle normal deliveries and improving referral systems for complicated deliveries.

Mother and Infant Wait to be Seen at a MNCH Clinic Under A Banyan Tree, Jharkhand, India---Photo by Kate Mitchell

Much of what I will be doing over the next ten months is helping to develop training modules for the maternal health interventions that will be added onto the HBNC model–as well as helping to conduct the training. 

I am really excited to be a part of the MANSI team.  It is going to be an exciting and challenging ten months–and I promise to keep you posted:)

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I was recently selected as a Clinton Fellow in maternal health with the American India Foundation which means I will be moving to India in September to work on the ground on a maternal and neonatal health project! This also means that my position with the Maternal Health Task Force at EngenderHealth will be open as of September.*

So…if you have a background in public health, gender studies, or a related field, are interested in using web-based communications tools, and are passionate about improving global maternal health–take a look at this job at the Maternal Health Task Force at EngenderHealth in New York City!

Job Summary:

“The Knowledge Management (KM) unit of the Maternal Health Task Force (MHTF) requires a highly motivated KM Assistant to help coordinate and implement the MHTF KM strategy and tactics. The KM Assistant will work closely with the KM Specialist in making its online knowledge portal robust, relevant, engaging, and user-friendly. The KM Assistant will proactively identify ways to engage current members and expand our audience.  This position provides a unique opportunity for those who are interested in how technology can help advance MDG5 goals.”

For more information about the job and to apply, click here.

Please feel free to contact me with questions about the position.

*While, I will be leaving my position with the Maternal Health Task Force, I will continue to maintain Maternal Mortality Daily throughout my fellowship in India—in fact, I have  exciting plans for adding new features to the blog over the next few months so stay tuned!

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If you are interested in and skilled at using various forms of social media to increase the visibility of an organization or raise awareness for a cause–and also have a solid understanding of global sexual and reproductive health issues, you might want to take a look at this newly created job at EngenderHealth in New York City!
Excerpt from Job Description:

“…Working with the entire Communications and Marketing (C & M) Team, the Copywriter/Social Media Associate is responsible for conceptualizing and writing an array of communications and promotional materials, and growing EngenderHealth’s presence in the blogosphere and social media. The Copywriter/Social Media Associate is responsible for translating technical information into understandable and compelling language that will inform, appeal to and inspire multiple audiences (e.g., donors, professional audiences, media, and the general public). The Copywriter/Social Media Associate undertakes research to develop story ideas, and produces well-researched, lucid content for a variety of communications vehicles, such as brochures, newsletters, and online platforms.

The Copywriter/Social Media Associate will work closely with the Director and Manager of the Communications and Marketing Department to develop promotional and communication dissemination plans, and assist in the implementation of communications and marketing campaigns. The Copywriter/Social Media Associate will spend up to 40% of his/her time managing social media efforts to grow EngenderHealth’s online presence in this area. He/she will report directly to the Manager of Communications & Marketing…”

Learn more about the job and apply here.

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I attended a press conference yesterday (6/17) where Ashoka and the Maternal Health Task Force at EngenderHealth announced the 16 winners of the Young Champions for Maternal Health competition. The 16 Young Champions come from 13 different countries and will be placed with Ashoka Fellows around the world for a 9-month mentorship.

Excerpt from my post on the MHTF Blog:

“…Tim Thomas explained that improving global maternal health is a persistent challenge—and one that will need to be tackled via multiple sectors. Tim pointed out that the Young Champions have big and innovative ideas for improving maternal health—and that the Ashoka Fellows will play a crucial role in teaching the Champions about social entrepreneurship, building sustainable infrastructure, and how to ‘scale-up’ global health projects—so that their big ideas can result in real and lasting impact.

A big idea is precisely what Yeabsira Mehari has—and she looks forward to tapping into Glory Alexander’s wisdom to develop the idea. Yeabsira aspires to set up a fistula care center in Ethiopia that will address both the health needs of the women affected by fistula as well as the economic and socio-cultural effects of fistula. Her dream is to establish a fistula care center that will prepare women to be social entrepreneurs themselves–by providing them with midwifery training and/or small business development training as well as offering micro-loans to get their businesses off the ground.

Ashoka India Fellow Glory Alexander works to end stigma and discrimination associated with HIV/AIDS in India. Her organization, ASHA Foundation, focuses on prevention of mother-to-child transmission of HIV/AIDS and primary prevention for vulnerable women.   Aside from learning about social entrepreneurship, sustainability, and ‘scale-up’, Yeabsira is excited to work with Glory to develop expertise in engaging with and helping to empower stigmatized populations. She anticipates that many of the lessons she will learn from working with HIV/AIDS patients in India will be transferable to working with fistula patients in Ethiopia…”

Read my full post on the MHTF Blog.

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Tuesday (6/8) marked day two of Women Deliver 2010. Day two was all about innovation and (high and low) technology to improve the health of women and infants worldwide–in fact, the conference organizers marketed Tuesday’s sessions as a stand-alone symposium called Technology as a Catalyst for Social Transformation.

Take a look at two examples of technologies that were discussed at the conference on Tuesday…

Microbicide Vaginal Rings (High Tech)

“The nonprofit International Partnership for Microbicides (IPM) today announced the initiation of the first trial among women in Africa testing a vaginal ring containing an antiretroviral drug (ARV) that could one day be used to prevent HIV transmission during sex. The clinical trial, known as IPM 015, tests the safety and acceptability of an innovative approach that adapts a successful technology from the reproductive health field to give women around the world a tool to protect themselves from HIV infection…”

Read the full press release here.

Clean Delivery Kits (Low Tech)

Clean Birth Kits–Potential to Deliver?, a publication supported by Save the Children/Saving Newborn Lives, Norwegian Ministry of Foreign Affairs, Immpact (University of Aberdeen), and the Maternal Health Task Force at EngenderHealth, was released at a session at Women Deliver yesterday. The session was chaired by Claudia Morrissey of Save the Children; moderated by Richard Horton, Editor of the Lancet; and presenters included Wendy Graham of University of Aberdeen, and Haris Ahmed of PAIMAN. The goal of the session was to summarise the evidence base for clean delivery kits, discuss practical implementation experiences from the field, and to have a lively debate on the “risks” associated with promoting birth kits. The report will be available online soon.

Subscribe to the MHTF Blog for updates on this project/report–as well as updates on other MHTF projects and commentary on a variety of maternal health issues.

Check out a recent blog post, A Good Idea or an Expensive Diversion: Workshop on the Evidence Base for Clean Birth Kits, by Ann Blanc, Director of the Maternal Health Task Force, on a workshop leading up to the new report on delivery kits.

Click here for the webcast of a session at Women Deliver 2010 that explores “What’s on the Horizon” for new technologies in contraception.

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The University of Oxford, with support from the Maternal Health Task Force at EngenderHealth, will be launching a maternal health crowd-sourcing project on June 7th, 2010. The project, Global Voices for Maternal Health, will launch at the Women Deliver conference. The idea is to give health care providers a “direct global voice in identifying and solving the barriers to providing evidence-based maternal health care.”

The MHTF Blog

The crowd-sourcing initiative consists of two main components: an online survey, available in 9 languages, for maternal health care providers in developing countries on the barriers to providing evidence-based care, and an online discussion forum for health care providers, program managers, and policy makers—to discuss innovative solutions for barriers to providing evidence-based care.

“The website will give new weight and force to the views of people who are actually delivering medical care, providing them with a stronger voice to determine where the global community’s future efforts should be focused.”

Click here to read the full post on the MHTF blog.

Visit www.globalvoices.org.uk for more info on the project–and ways to get involved.

If you have information about people working on the ground in maternal health who might like to participate, please contact global.voices@obs-gyn.ox.ac.uk.

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