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Posts Tagged ‘midwives’

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 New York Times reports that the overall Caesarean rate in Tuba city last year was 13.5%, less than half the national average of 31.8%. This article begins with the description of one woman’s experience with childbirth in a  Tuba City Regional Health Care Corporation hospital—and goes on to highlight several lessons this small hospital could teach the rest of the U.S.A. about obstetric care. 

The New York Times

“…This week, the National Institutes of Health will hold a conference in Bethesda, Md., about the country’s dismal rates of vaginal birth after Caesarean, or VBAC (pronounced VEE-back), which have plummeted since 1996. ‘I think it’s the purpose of this conference to see if we can turn the clock back,’ said Dr. Kimberly D. Gregory, vice chairwoman of women’s health care quality and performance improvement at Cedars-Sinai Medical Center in Los Angeles.

Tuba City will not be on the agenda, but its hospital, with about 500 births a year, could probably teach the rest of the country a few things about obstetrical care. But matching its success would require sweeping, fundamental changes in medical practice, like allowing midwives to handle more deliveries and removing the profit motive for performing surgery.

Changes in malpractice insurance would also help, so that obstetricians would feel less pressure to perform Caesareans…

…The hospital serves mostly Native Americans — Navajos, Hopis and San Juan Southern Paiutes. Four other hospitals in New Mexico and Arizona, run by the Indian Health Service, also offer vaginal birth after Caesarean to some women (it is not safe for all) and have relatively low Caesarean rates without harming mothers or children, whose health in the first month after birth matches nationwide statistics…”

Read the full story and listen/watch the audio slide show here.

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Marzieh Vahid-Dastjerdi, the Iranian Health Minister, spoke to a group of people in Hendoodar, in the central province, about the state of maternal health in Iran.

Tehran Times

She described major improvements in maternal health and pointed to shortages in specialized human resources as the major challenge in eliminating maternal mortality in Iran. She also highlighted a new nursing and midwifery training program in the city—and discussed the importance of such projects.

Photo Credit: Tehran Times

Read the full story here.

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International aid groups and public hospitals are struggling to keep up with births in post-earthquake Haiti. The city still lacks adequate numbers of health workers and supplies–leaving many pregnant women without access to obstetric care services.

Miami Herald

A young Haitian doctor finishes delivering 26-year-old Joanne Desir's first baby as she's being held by her husband, Patrice Zephir, in the back of a pickup truck outside the General Hospital in Port-au-Prince. PATRICK FARRELL / MIAMI HERALD STAFF

“..There are new concerns for the 63,000 pregnant women now living in Port-au-Prince. More than 7,000 are expected to give birth this month.

`People here are giving birth under the absolute worst conditions,’ said Dr. Jonathan Evans, a pediatric gastroenterologist volunteering at the University of Miami field hospital. `They can’t find access to midwives. Little problems become big problems.’

In the sprawling camp at the city center of Champs de Mars, where the fruit flies are unrelenting and the stench of human waste inescapable, Antoine Toussaint worries about the health of her unborn child.

Toussaint, 27, is nine months into her pregnancy. She lost her last baby, a son, in childbirth two years ago. This time, Toussaint will have only the help of her family if complications arise…”

Read the full story here.

For more information on the University of Miami response to the earthquake, click here.

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The Grameen Foundation, Columbia University’s Mailman School of Public Health and the Ghana Health Service are working together on a project called Mobile Technology for Community Health (MoTeCH). This joint initiative, funded by the Gates Foundation,  is exploring how to best use mobile phones to increase quality and quantity of maternal and neonatal health services in Ghana.

MobileActive.org

“…For example, a woman might come in for a health check-up when she’s 12 or 14 weeks pregnant, at which point she would be registered into the MoTeCH system. She would then be on track to receive two kinds of messages: informative texts and action texts. The informative texts simply tell the parents what to expect (i.e., developmental stages) during a pregnancy, while the action texts encourage parents to make clinic visits based on their personal histories (such as needs for shots or follow-up appointments).

The other target audience of MoTeCH is community health workers who provide the vast majority of primary care in much of the developing world. The workers use mobile phones to enter data such as when they have seen a patient and what kind of treatment these patients received. Data is then compiled to more easily track patients.

The idea behind MoTeCH is to link the two systems so that the messages can be more specifically targeted and tailored to the needs of the individual parents; for example, if a pregnant woman misses a tetanus shot, the community health workers’ records will show how many weeks along she is and she can be easily sent a reminder. Similarly, messages can be sent to village community health workers alerting them to patients who are in need of specific services in order to locate the patient and encourage him or her to get treatment. ‘It gets community health care workers out of the clinic and seeking patients who need care a little bit more immediately,’ said Wood…”

Read the full story here.

For more info on the subject, take a look at Dying for Cell Phones (Literally).

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A NOW team from PBS recently went to Haiti to investigate high levels of maternal mortality in the country. They happened to be in the Haiti when the earthquake hit. In collaboration with the Bureau for International Reporting (BIR), a non-profit video news production company, PBS produced Saving Haiti’s Mothers, a show that examines the state of maternal health in Haiti before the earthquake and immediately following it.

NOW on PBS

“Haiti’s catastrophic earthquake, in addition to leaving lives and institutions in ruin, also exacerbated a longtime lethal risk in Haiti: Dying during childbirth. Challenges in transportation, education, and quality health care contribute to Haiti having the highest maternal mortality rate in the Western Hemisphere, a national crisis even before the earthquake struck. While great strides are being made with global health issues like HIV/AIDS, maternal mortality figures worldwide have seen virtually no improvement in 20 years. Worldwide, over 500,000 women die each year during pregnancy. This week, a NOW team that had been working in Haiti during the earthquake reports on this deadly but correctable trend. They meet members of the Haitian Health Foundation (HHF), which operates a network of health agents in more than 100 villages, engaging in pre-natal visits, education, and emergency ambulance runs for pregnant women…”

Read the full story and watch the special here.

Learn more about Haitian Health Foundation, UNFPA, and Family Care International—all organizations featured in the show.

Visit the Bureau for International Reporting (BIR) site here.

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Veil of Tears is a collection of transcribed interviews with children, women, and men in Afghanistan about loss in childbirth. These interviews are part of IRIN’s  Kabul-based radio project, which closed at the end of 2009 after six years of humanitarian radio production and journalistic capacity building in Afghanistan.

IRIN Humanitarian News and Analysis

“In Veil of Tears, a 60-page colour booklet launched today, IRIN brings you a unique collection of personal stories of loss and courage in childbirth, as told by women, men and children from different parts of Afghanistan.

The stories were originally recorded in local languages, Dari and Pashto, for IRIN Radio broadcasts. Transcribed into English in Veil of Tears, they convey the immediacy and intimacy of the interviews conducted by IRIN reporters, who travelled in some cases for several days to reach the remotest villages in Afghanistan.

The interviewees in the booklet talk about the struggle to get enough nutritious food to sustain a woman through pregnancy, and to feed their families on any given day; they describe the awesome distances and terrain that separate people living in the villages from the nearest health facility; they describe the lack of proper roads and transport that may leave a donkey cart as the only option to attempt a life-or-death journey with a pregnant wife or mother to a hospital; they explain the cultural and social rules that might mean decisions by men are made too late to save a woman and her baby…”

Read the full story here.

Click here for a PDF of the Veil of Tears.

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