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Posts Tagged ‘maternal mortality’

The Safe Motherhood Program at UCSF is looking for interns to work in the Copperbelt of Zambia from August – October, 2011.

Interested? Check out the details below!

This internship is based in the Copperbelt Region of Zambia.  The intern will work on a study which aims to reduce maternal mortality and morbidities in Zambia and Zimbabwe caused by obstetric hemorrhage.  This is a cluster randomized control study which compares outcomes based on evidence from intervention and control clinics.  The intervention clinics in this study are the clinics that are using the NASG (Non-pneumatic Anti-Shock Garment) as a first aid device for patients suffering from hypovolemic shock caused by bleeding during pregnancy.

Some of the duties of the intern are:

  • Providing logistic support for the local Zambian team – distributing supplies, copies
  • Reviewing data collection forms
  • Encouraging protocol adherence
  • Conducting training with local hospital and clinic staff
  • Visiting the study clinics
  • Following up on cases
  • Liaising with the San Francisco office and the in-country staff

Desired qualifications:  Experience in international settings, interest in maternal health, research experience, familiarity with clinical environments.  Must be highly detail- oriented, be well-organized and have excellent follow-through skills.

Note: This internship is unpaid. Intern must provide their own airfare and living expenses.

To apply, send cover letter and cv to:

Elizabeth Butrick

NASG Project Director

ebutrick@globalhealth.ucsf.edu

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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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On May 27th, Sarah Boseley reported on her Global Health Blog that the families of two women who died in childbirth have taken legal action against the Ugandan government, asserting that the women’s rights to life and health were violated.

Sarah Boseley’s Global Health Blog, The Guardian

“…The case is unprecedented in Uganda. Aid agencies and medical charities and donor governments can condemn the death toll in pregnancy and childbirth, but the most powerful argument is the devastating testimony of those who suffer.

Sylvia Nalubowa died in Mityana hospital on 10 August 2009 from the complications of obstructed labour. She was carrying twins, one of whom was delivered. The second died with her. Jennifer Anguko died in Arua regional referral hospital on 10 December 2010 when her uterus finally ruptured after 15 hours of obstructed labour. Her status as a district councillor brought her no favours – she was said to be the fourth woman to die in that hospital that day…”

Read the full story here.

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On Monday, I traveled with my colleague, Anupam Sarkar, a nutrition and newborn health expert and Project Advisor for the Maternal and Newborn Survival Initiative (MANSI), to Hudu, a small, hard-to-reach village amidst forest, steel plants, and roaming wild elephants. It took us nearly 2 hours from Jamshedpur, weaving around and cutting through steel plants and villages along bumpy and muddy roads–the same roads that pregnant women must travel on if they opt for institutional delivery. We were heading to Hudu to observe a Seraikela Chhau peformance.

Seraikela Chhau is a traditional form of dance that originates in the Seraikela block of Jharkhand, part of the eastern steel belt of India. Over the past six months, I have been working as a Clinton Fellow with the Maternal and Newborn Survival Initiative in the Seraikela block. MANSI is a partnership between the American India Foundation, Tata Steel Rural Development Society, and the local government—with technical support from SEARCH. As part of our project activities, our team has recently coordinated a series of Seraikela Chhau performances that will combine the native dance form with key maternal and newborn health messages throughout the 174 villages of our project area.

When Anupam and I arrived in Hudu, we learned that a pair of twins had recently passed away in the village and we decided to visit the family before the performance began. We are conducting similar home visits for every maternal and newborn death that has been reported in our project area (spanning 174 villages) since the baseline survey was completed in 2009. The goal of the home visits is to gain a better understanding of the ground realities and knowledge gaps so that we can shape and inform the messages of the MANSI health communication campaigns in a way that meets the needs of the communities.

The local health worker guided us to the home where the twins had passed away. The parents were not at home–but we were able to meet with the paternal grandparents, Asha and Ganesh Sardar.

 

They shared their story…

The mother of the twins, Vilasi, is 28 years old. She and her husband, Ragdu, already had four children, all girls, and the family was  eager to have a boy. Soon they became pregnant with twins, one girl and one boy. All four of the previous children were delivered at home without complication–and the family assumed that this delivery would also be free of complications. They explained that they were unaware of the benefits of institutional delivery. When the twins were born, they seemed very small. Immediately following delivery, the mother put the babies to her breasts to feed them. They were weak and unable to suckle. Initially the family thought about giving them goat’s milk–but eventually decided to give sugar water (locally called Misri Pani). When it became clear that the babies were extremely weak and in critical condition, the family wanted to take the infants to the hospital but they had not anticipated the emergency. They were not prepared. They did not have a transportation plan or money set aside. One baby died the very same day–and the other died the following day.

We thanked the grandparents for sharing their story and asked them if it would be OK if we also shared their story with other communities. The grandparents agreed and the grandfather said, “After losing the twins, I have come to know about the importance of institutional delivery. Why not share our story and let others also come to know?”

It is tough to know precisely what led to the death of the twins—and if giving birth in a facility would have made a difference. But it is clear that many factors were stacked against them. The family was faced with poor roads, long distances to health centers, limited resources, combined with a lack of information at the community level about birth spacing and planning, care of low birth weight babies, danger signs, institutional delivery, and information on how to tap into government schemes that offer cash incentives for institutional delivery—all potential topics for future Chhau performances.

With the story of the twins on our minds, we returned to the center of the village to observe the performance.

With no electricity in the village, the performers rigged their loud speaker system to their vehicle battery. They began beating their drums and singing loudly, calling on community members to gather in the village center.

It did not take long for community members to gather, all curious to know what the commotion was about. They formed a crowd of boys and girls, and men and women of all ages. Soon the drumming and singing picked up pace, a performer dressed in a traditional colorful costume with a big mask jumped out from behind the vehicle, and the show began!

The performers acted out various situations, using dance and drama to cover several critical maternal and newborn health topics—with a focus on the importance of institutional delivery, birth planning/preparedness, and the five cleans of safe delivery. The audience watched with great enthusiasm.

As we traveled the bumpy roads away from Hudu, a jagged rock punctured our tire–delaying our return to Jamshedpur and reminding me of the numerous barriers that women face in accessing care. While we waited for the tire to get repaired, I thought of the twins and the grandparents who we interviewed. I also thought of the Chhau dance and all of the community members in attendance. That day, I witnessed the consequences of the various factors that were stacked against the twins. I also witnessed one strategy for building community awareness of critical maternal and newborn health information. I left feeling confident that the Chhau performance that we observed will help to equip the community of Hudu with key information about maternal and newborn health—and will serve as one of many important steps toward the overall goal of protecting the health of women and infants in the Seraikela block.

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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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In April, the Lancet published new maternal mortality estimates (out of the Institute for Health Metrics and Evaluation) that showed a significant reduction in global maternal deaths, shaking up the global health community’s understanding of the global burden of the issue–and providing new hope. The report also illustrated the important links between HIV/AIDS and maternal mortality.

In the wake of the Lancet report, maternal health professionals from various organizations engaged in robust dialogue (like this one) about measurement methodologies–and raised questions about when the World Health Organization would release their estimates and how they might differ from the IHME estimates.

On September 15th, WHO, UNICEF, UNFPA, and the World Bank released their new maternal mortality estimates in a report, Trends in maternal mortality. Their report also showed a significant drop in maternal deaths—a 34% decrease between 1990 and 2008.

Excerpt from the WHO press release:

“The new estimates show that it is possible to prevent many more women from dying. Countries need to invest in their health systems and in the quality of care.

‘Every birth should be safe and every pregnancy wanted,’ says Thoraya Ahmed Obaid, the Executive Director of UNFPA. ‘The lack of maternal health care violates women’s rights to life, health, equality, and non-discrimination. MDG5 can be achieved,’ she adds, ‘but we urgently need to address the shortage of health workers and step up funding for reproductive health services’…”

More highlights from the report:

  • Ten out of 87 countries with maternal mortality ratios equal to or over 100 in 1990, are on track with an annual decline of 5.5% between 1990 and 2008. At the other extreme, 30 made insufficient or no progress since 1990.
  • The study shows progress in sub-Saharan Africa where maternal mortality decreased by 26%.
  • In Asia, the number of maternal deaths is estimated to have dropped from 315 000 to 139 000 between 1990 and 2008, a 52% decrease.
  • 99% of all maternal deaths in 2008 occurred in developing regions, with sub-Saharan Africa and South Asia accounting for 57% and 30% of all deaths respectively.

Click here to read the press release and here to read the full report.

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In my last few weeks at the Maternal Health Task Force, I have been working with Raji Mohanam, Knowledge Management Specialist at the MHTF, Matthew Meschery, Director of Digital Initiatives at ITVS, and Lisa Russell, Filmmaker and Co-Founder of MDGFive.com, and an incredible team of presenters, to coordinate a panel presentation on digital tools for maternal health for the Global Maternal Health Conference in Delhi. Take a look below for a post I wrote for the MHTF Blog about the upcoming panel session–with info on how to participate remotely.

I am off to India tomorrow! Check back next week for posts from the conference.

The upcoming Global Maternal Health Conference in Delhi (August 30th-September 1st) will focus on lessons learned, neglected issues, and innovative approaches to reducing maternal mortality and morbidity. The anticipated outcome of the conference is increased consensus around the evidence, programs and advocacy needed to reduce preventable maternal mortality and morbidity.

One session, Maternal Health Digital, will showcase a number of digital communication tools being applied to maternal health. Matthew Meschery, Director of Digital Initiatives at the Independent Television Service, will moderate the session—and will guide panelists and participants through a lively discussion that will explore the potential of digital tools to improve the health of women around the world. Panelists will also address questions about how to measure the impact of such projects.

Throughout the session, conference participants will learn about an email help desk that is aiming to increase access to misoprostol and mifepristine, a mobile phone and radio initiative that is aiming to improve delivery of maternal and neonatal health services, an online media “mash-up” tool that is enabling users to make their own advocacy videos, a crowd-sourcing project that is tapping into the knowledge of front-line maternal health care providers in 9 languages, and more.

This exciting session will include presentations from Google.orgWomen on WebZMQ Software SystemsHealth ChildMDGFive.com, the Social Media Research Foundation, the Pulitzer Center for Crisis ReportingUniversity of Oxford, the Maternal Health Task Force, and the Independent Television Service.

Take a look at the session summary:

In recent years, the health, technology, and communication sectors have come together to innovate health communications through the use of digital media. Advances in tools for cross-media storytelling, social networking, digital games, real-time messaging, and mobile and location-aware technologies are being adapted to fit the needs of the maternal health community—and are helping to fuel the increased momentum around the issue. In this interactive session, conference participants will learn about a diverse range of innovative projects that are aiming to identify challenges and solutions for providing care to pregnant women, build stronger connections among maternal health organizations, create new ways to collect and use data, foster increased collaboration through engaging communities, and continue to drive attention toward the issue. As well as highlighting the promise of these new tools, we will also look at some specific challenges such as measuring impact, working in areas with limited connectivity, and merging online and offline strategies. There will be a series of mini-presentations on crowd-sourcing, interactive mapping, a media mash-up tool, an online reporting hub, mobile health campaigns, and more. Participants will not only get an over-view of a wide variety of strategies and recent developments in digital health communications—but they will also learn tips for applying many of these new tools to their own work and engage in a dialogue around how to maximize the utility of these technologies in order to significantly improve the health of women around the world.

This session will be live streamed! Click here for the live stream schedule.

Join the discussion via Twitter! Conference hashtag: #GMHC2010, Session hashtag: #GMHC2010Digital


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Final preparations are underway for the Global Maternal Health Conference in Delhi! With only a couple of weeks until the conference, things have been very busy at the Maternal Health Task Force! Take a look below for the recently finalized live stream schedule. We will be streaming (open-access, no registration necessary) all plenary sessions as well as a number of parallel and panel sessions. In addition, ALL sessions will be archived for future viewing.

If you are interested in guest blogging about the conference sessions, click here for more info.

Cross-posted from the MHTF Blog.

In just a couple of weeks, the Maternal Health Task Force (MHTF) and the Public Health Foundation of India (PHFI) will convene an unprecedented gathering of over 600 maternal health experts and their allies in a global technical and programmatic meeting. The Global Maternal Health Conference 2010 aims to build on the existing momentum around MDG5.  The conference will focus on lessons learned, neglected issues, and innovative approaches to reducing maternal mortality and morbidity. The anticipated outcome is increased consensus around the evidence, programs and advocacy needed to reduce preventable maternal mortality and morbidity.

In an effort to engage and inform a broader audience, the plenaries and several sessions will be live streamed.

For information on each of the sessions that will be live streamed–including speakers and abstracts, click on the session title below.

This schedule is in India Standard Time. Click here for a time zone converter!

ACCESS LIVE STREAM FOR ALL SESSIONS HERE.

August 30th, 2010

9:00-10:00 Inaugural

11:00-12:30 Plenary Session:
Global Progress on Maternal Health: The Numbers and Their Implications

13:30- 15:00 Parallel Session:
Human Resources for Maternal and Newborn Health: The Key Element

15:30- 17:00 Parallel Session:
Extremely Affordable Technologies for Maternal and Newborn Survival

August 31st, 2010

9:00-10:30 Plenary:
Community and Facility Interventions: Reframing the Discussion

10:45-12:15 Parallel Session:
Task-Shifting to Expand Access to EmOC: Developing a Deeper Understanding of What it Takes

13:45-15:15 Parallel Session:
Prevention and Treatment of Postpartum Hemorrhage

15:30-17:15 Panel Session:
The Next Generation of Maternal Health Solutions from the Young Champions of Maternal Health

September 1st, 2010

9:00-10:00 Plenary Session:

Maternal Health Accountability: Successes, Failures and New Approaches

10:45-12:15 Parallel Session:
Indian Models of Public-Private Partnerships

13:45-15:15 Parallel Session:
Informatics to Improve Systems

15:30-17:15 Panel Session:
Maternal Health Digital

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Health officials in the state of Bihar, India have decided to develop a computer software/database that will track expecting mothers, new mothers, and newborns at the village level. The goal of the project is to keep a close eye on maternal and infant mortality in each and every village in Bihar–as well as share important health information via SMS.

iGovernment

“In a bid to minimise maternal and infant mortality in the state, the Bihar government has decided to create a database of each pregnant woman and newborn babies at village level to track their health conditions and provide prenatal and postpartum care to mothers.

The data base would offer unique named-based searches on mother and children.

The data will include date of vaccination and expected date of delivery of pregnant woman. If the family of the expecting mother has any cell phone, they would be informed through SMS. In all 80,797 anganwadi sevikas across the state have been involved to make the campaign a success.

The decision to create software to track the health conditions of expecting women and infants was taken at a meeting of senior officials of the Health Department…”

Read the full story. For more on this story from FIGO, click here.

More on maternal health in Bihar:

  1. Click here to read about a recent agreement between the state government of Bihar and the Bill and Melinda Gates Foundation in an effort to boost the public health of the state.
  2. Click here to read about PRACHAR, a Pathfinder International project that aims to disseminate family planning and reproductive health behavior change communications messages throughout 700 villages in Bihar.
  3. Click here for a recent post on conditional cash transfers to increase in-facility births in many states, including Bihar.

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Cross-posted from the MHTF Blog.

The World Health Organization (WHO) invites you to join the WHO Guidance Global Discussion Forum on Prevention of Maternal and Perinatal Mortality and Morbidity.

The online forum will be held from July 26th – August 6th, 2010.

The 2 week virtual discussion forum is designed to provide an opportunity for people to share their ideas, experience and opinions about the type of evidence-based guidance WHO should produce in order to support the reduction of maternal and perinatal mortality and morbidity.

Over the two-week forum participants will receive one to two emails per day: one email to introduce the day’s questions, and one daily digest of the contributions. Five questions will be addressed, and each discussed over two consecutive days. All contributions received will be acknowledged.

For any questions on this Virtual Global Discussion Forum please contact the forum facilitator: Cordelia Coltart at coltartc@who.int.

Click here for official announcement and invitation to the discussion forum.

REGISTER NOW!

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A recent study in the Lancet took a close look at a conditional cash transfer scheme to entice women to deliver in health facilities. The scheme, Janani Suraksha Yojana (JSY), aims to reduce maternal, perinatal, and neonatal mortality.

Published along side the study was a commentary by Vinod K. Paul that summarizes several of the key findings of the study–pointing out successes and challenges with the scheme.

“…In just 4 years, its beneficiaries multiplied 11-fold, from 0·74 million in 2005—06 to 8·43 million in 2008—09 (thus covering nearly a third of the 26 million women who deliver in the country annually). Budgetary allocation for the JSY increased from a mere US$8·5 million to $275 million in the same period. Surely, it is time to ask the question about what health outcomes are achieved by this massive and expensive investment and effort. On the face of it, by promoting a strategy of deliveries in the facilities, attended by skilled providers, JSY should lead to a reduction of maternal, perinatal, and neonatal mortality…”

Click here to read the full commentary. You will need to register (free) with the Lancet to access this article.

Excerpt from a Washington Post story on the study:

“…The payment program seems to be working, according to Indian health workers and researchers who conducted the study for the Lancet.

‘The cash payments mean that India is really starting to invest in women. That trickles out to the rest of the family and the rest of society,’ said Marie-Claire Mutanda, a health specialist with UNICEF, which is supporting the program.

In two of the poorest states in India — Bihar and Uttar Pradesh — the number of women giving birth in medical facilities soared from less than 20 percent in 2005 to nearly 50 percent in 2008, according to the most recent data available.

Doctors here attribute that to the payment program, whose Hindi name translates to ‘women protection scheme’…”

Click here to read the full story in the Washington Post.

Click here to read the study, India’s Janani Suraksha Yojana, a conditional cash transfer programme to increase births in health facilities: an impact evaluation, in the Lancet. You will need to register (free) with the Lancet to access this article.

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The Woodrow Wilson Center’s Global Health Initiative, the Maternal Health Task Force, and the United Nations Population Fund (UNFPA) invite you to attend (or watch online) the sixth event of the series, Advancing Policy Dialogue on Maternal Health: The Impact of Maternal Mortality and Morbidity on Economic Development. The event will take place on July 29th from 3-5pm in Washington, D.C.

Woodrow Wilson International Center for Scholars

Event Details:

Investing in women and girls health is smart economics. According to the United Nations Population Fund (UNFPA) women contribute to a majority of small businesses in the developing world and their unpaid work on the farm and at home account for one-third of the world’s GDP. The U.S. Agency for International Development (USAID) estimates that maternal and newborn deaths cost the world $15 billion in lost productivity.

Mayra Buvinic, sector director of the gender and development group of the World Bank, will address the economic impact of maternal deaths and the role of education and gender equality on economic development. Dr. Nomonde Xundu, health attaché at the Embassy of South Africa in Washington DC will discuss the policy implications of maternal health and share lessons learned in empowering women and girl’s economic status in South Africa. Mary Ellen Stanton, senior maternal health advisor of USAID, will present the foreign policy and economic case for increased donor investment in maternal health.”

For more info and to RSVP, click here.

For info on future events and links to videos of previous events in the maternal health policy dialogue series, click here.

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On July 1st, the Women Deliver team announced the top five highlights from the 2010 conference (June 7-9). See below for a summary of the conference highlights–with links to publications, videos, photos, and additional information that came out of the conference.

This post was originally posted on the Women Deliver website and is reposted on MMD with permission from Women Deliver.
conference-participants.jpg

Women Deliver 2010 Conference participants

Thank you to everyone who contributed to the success of the second Women Deliver global conference. To put world leaders on notice that the time for action on maternal health is now, 3,400 advocates, policymakers, development leaders, health care professionals, youth, and media from 146 countries converged on Washington, DC on June 7-9 at Women Deliver 2010. More than 800 speeches and presentations were given at the six plenaries and 120 breakout sessions.  The heads of five UN agencies, plus the Secretary-General of the United Nations, attended. Thirty countries, UN agencies, the World Bank, corporations, and foundations helped support Women Deliver. Please see below for highlights and recaps of the conference.

1. Key Statements. Read the outcome statements from the:

2. Webcasts. Watch the videos from our plenary sessions and our press conferences, and watch Hillary Clinton’s address to the Women Deliver 2010 attendees.

3. Photos. Take a look at photos from the plenary sessions, breakout sessions and other conference events, and download them at no cost.

4. Programme. Review the plenary and breakout sessions that were held at Women Deliver 2010.

5. Publications and Advocacy Tools. Visit our Knowledge Center to download publications and advocacy tools, including:

Stay tuned for our summary report on breakout sessions by theme.

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The application process is now closed for this position. (7/22/10)

The Safe Motherhood Program at UCSF is accepting applications for an upcoming internship opportunity in the Copper-belt of Zambia. The intern(s) (2 or more interns are needed) will support the start-up of a randomized control trial of the Non-pneumatic Anti-Shock Garment (NASG) in 24 midwifery-led clinics as a low-tech and low-cost life-saving method for treating shock, resuscitating, stabilizing and preventing further bleeding in women with obstetric hemorrhage.

See below for background information on the Safe Motherhood Program and the use of the NASG–as well as details on the internship including expected deliverables, qualifications, timeline, and information on how to apply.

Background

The mission of Safe Motherhood Program at the University of California, San Francisco, is to prevent maternal deaths by promoting women’s health and human rights.   This international research program is part of the UCSF Bixby Center for Global Reproductive Health, which engages in the advancement of new reproductive health technologies and development of innovative programs to improve reproductive health.  The Safe Motherhood Program is also a member of the Women’s Health and Empowerment Center of Expertise (COE), one of three centers within the University of California Global Health Institute.  The primary goals of the Safe Motherhood Program are to:

  1. Conduct rigorous, relevant and timely research resulting in new and applicable knowledge
  2. Reduce pregnancy related death and disability
  3. Ensure maternal survival through principles of respect, dignity and equality
  4. Create direct and practical links from research to policy to implementation
  5. Train health care workers in low-resource settings
  6. Raise community awareness of maternal health
  7. Disseminate information and innovations globally

Working with distinguished colleagues in a variety of countries, the Safe Motherhood Program has the knowledge, skills, vision, technology, and energy to make a real difference in the advancement of women’s reproductive health throughout the world.

Non-pneumatic Anti-Shock Garment (NASG)

In many poor countries women deliver at home, often without skilled attendants or at clinics with limited services available.  If complications arise and a woman bleeds heavily, one, two or all of the “three delays” (Thaddeus and Maine, 1994) may impede her ability to access timely treatment.  Many women do not survive these delays.  In recognition of the direct and indirect root causes of maternal death and disability, the Safe Motherhood Program works to ensure all women have an equitable opportunity to survive childbirth.

A major research effort of the Safe Motherhood Program, the NASG is a low-technology and low cost life-saving device used to treat shock, resuscitate, stabilize and prevent further bleeding in women with obstetric hemorrhage (www.lifewraps.org).  Use of the NASG as part of standard management of shock and hemorrhage has demonstrated promising outcomes for women in low-resource settings, where appropriate health care providers and technologies are limited or non-existent.  To date, NASG use has reduced maternal mortality and morbidity by over 50%.

Internship Opportunity

To build upon the early and promising data, a randomized cluster trial is underway in Zambia and Zimbabwe.  Specifically, the trial addresses the question of whether the early application of the NASG at midwife-led maternity clinics, before transport to a Referral Hospital, will decrease maternal mortality and morbidity.

The internship will take place in the Copper-belt of Zambia and support the start-up of the randomized control trial of the NASG in 24 midwifery-led maternity clinics.  The intern(s) (2 or more interns are needed) will work with the clinics during their transition from Phase 2 study (women with obstetrical complications transported to referral facility) to Phase 3 of the research study (women with obstetrical complications transported to referral facility in the NASG).  Specific activities will include: Observing clinical procedures at the clinics and supporting clinical protocol adherence, observing data collection and supporting research protocol adherence, helping/training data collectors become familiar with data collection forms, matching data collection forms begun at the clinic with data collection forms completed at the referral facilities, supervising cleaning and completion of data collection forms, and training new providers (midwives, residents, medical officers) in the addition of the NASG to emergency response for hemorrhage.

The intern(s) will receive mentorship and supervision from the Safe Motherhood team members both in Zambia and in the US during the field experience.

Deliverables

Weekly reports on progress, participation in weekly calls/Skype with Project Coordinator are expected.

Qualifications

  • Professional degree, graduate student or junior faculty in the health or social sciences (such as medicine, nursing, public health, anthropology, sociology, etc.)
  • Previous experience in health or social science research
  • Knowledge of global sexual and reproductive health, maternal health preferred
  • Ability to work well with partners
  • Flexibility and willingness to travel
  • Highest preference for those with some midwifery/obstetric experience or those who have worked on field-based research projects

Timeline

The internship requires a minimum eight-week commitment (Fall 2010 – Winter 2011) to live and work in Zambia.  Preference will be given to applicants who can remain in Zambia longer than 8-weeks.

Expression of Interest

To apply for the internship, please send a current resume and cover letter to Ms. Elizabeth Butrick (ebutrick@globalhealth.ucsf.edu) with copy to Ms. Jennifer Clark (JClark@globalhealth.ucsf.edu) by August 15, 2010.

For more information on the use of the NASG (specifically the LifeWrap), check out a recent guest post from the Director of the Safe Motherhood Project, Suellen Miller, on the Maternal Health Task Force‘s new MedScape blog, GlobalMama. (You will need to register with MedScape. Registration is free.)

Also, take a look at www.lifewrap.org for additional information about LifeWraps.

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The controversial research reporting unexpected gains in maternal health, published April 12 in the Lancet, has triggered rigorous debate about the measurement tools used to count maternal deaths globally and at a country level. The paper, Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5, was written by Chris Murray and his team of researchers at the Institute for Health Metrics and Evaluation. The study found a dramatic reduction in the number of women dying from pregnancy complications between 1980 and 2008–and these findings have triggered both celebration and skepticism within the global health community. Some global health leaders are cheering the global progress toward MDG5 indicated by the research. Some are expressing cautious optimism. Others are challenging the paper’s methodology, asking whether it really signals big gains in the struggle against global maternal mortality or just flawed means of estimating how many women are dying.

On June 5th, the Lancet published a reply from Chris Murray in which he addresses some of the concerns voiced by his fellow global health researchers regarding the methodology of the study.

“We appreciate the rich set of letters in response to our paper on maternal mortality. The authors of the letters raise many important points, but we focus our short response on four larger themes that have been raised.

The country graphs in the webappendix to our paper show all the available data points for each country and our best estimates based on these data and the modelling strategy. In the case of the Philippines, Indonesia, Burkina Faso, and Peru, the correspondents have noted that our data-points derived from the analysis of sibling histories in household surveys are different from published figures from the same surveys. The differences stem from two sources. First, we correct for problems of survivor bias in sibling histories, following the published methods of Gakidou and Kingand Obermeyer and colleagues...”

Read the full reply by Chris Murray on the Lancet Online. Be sure to take a look at some of the critiques of the study–linked on the right panel next to Murray’s reply.

For more on this topic, take a look at a recent post, New Maternal Mortality Estimates Published in the Lancet: What’s the Buzz?, on the Maternal Health Task Force’s new MedScape Blog, GlobalMama.


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