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Posts Tagged ‘skilled birth attendants’

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 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 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 fifth event of the series on Advancing Policy Dialogue on Maternal Health: Improving Transportation and Referral for Maternal Health. The event will be held on May 20th from 3-5pm in Washington, D.C.

The MHTF Blog

“…Access to skilled birth attendants and emergency obstetric care are key solutions to improving maternal morality, yet functioning referral systems and poor road infrastructure delay efficient care. Increased research, funding, knowledge sharing, and coordination between private and public sectors are necessary to make transportation and referral a global health priority.

Today’s discussion will highlight the lessons and knowledge gaps identified at a Wilson Center workshop in Washington DC with 25 experts from the transportation and maternal health communities, as well as representatives from the private sector and donor community.

Víctor Conde Altamirano, obstetric nets manager, CARE-Bolivia will discuss how transportation and referral data is being incorporated into Bolivia’s health system to improve maternal health. John Koku Awoonor-Williams, east regional director, Ghana Health Service, will address the utilization and maintenance of ambulances in rural Ghana. Subodh Satyawadi, chief operating officer, GVK Emergency Management Institute will discuss the lessons learned and challenges faced through India’s “Emergency 108” call system. Strategies and recommendations identified at the Wilson Center workshop in Washington DC will be provided by Patricia Bailey, public health specialist, Family Health International…”

Click here for event details, information on how to RSVP or watch the live/archived webcast, and additional info on the series!

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