Inflammation and stories on maternal health

Ethiopian maternal and child mortalitySince the year 2000, Ethiopia has halved its maternal and child mortality rate. While this statistic seems impressive on the surface, the rate of maternal and child mortality in Ethiopia remains one of the highest in the world. The child mortality rate stands at 67 deaths per 1,000 children. The Ethiopian maternal mortality rate (MMR) per 100,000 live births is 412. This number is 25 times the United States MMR.

The Global Context of Maternal and Child Mortality

The rate of maternal and child mortality in Ethiopia is best understood by examining the larger global context of maternal and child mortality. Globally, neonatal mortality remains significantly high, with 7,000 newborn deaths a day. Neonatal mortality comprises 47% of the deaths of children under 5. This number is up 7% from 1990 when it stood at 40%. Furthermore, the greatest number of neonatal deaths occur in sub-Saharan Africa.

Globally, the MMR has dropped 38% from 2000 to 2017, which is the most recent WHO estimate, but it is important to note that even though the overall global MMR has reduced, some regions still disproportionately experience very high MMR rates. The greatest number of maternal deaths occur in Africa, just as with neonatal mortality. In fact, in 2017, 66% of all maternal deaths occurred in Africa.

A key cause of maternal and newborn mortality is malnutrition. Due to COVID-19, the World Food Programme predicted that the number of food-insecure people in low- and middle-income countries (LMICs) would double to 265 million by the close of 2020. Food insecurity often links to malnutrition or undernutrition. Therefore, this fact has the potential to increase maternal deaths due to a lack of iron and other essential nutrients. The WHO estimates that, as it stands globally, 40% of pregnant women are anemic. Anemia makes these women vulnerable to fatal bleeding and infections during childbirth. Furthermore, while high-income countries have very low anemia figures for pregnant women, in certain LMICs, up to 60% of pregnant women struggle with anemia.

Global Aid Organizations Leading the Battle

Fortunately, during and despite the COVID-19 pandemic, global aid organizations have been collaborating with the Ethiopian Ministry of Health and other regional bureaus to continue to decrease the rate of maternal and child mortality in Ethiopia.

As a major player in combatting maternal and child mortality in Ethiopia, the United States Agency for International Development (USAID) focuses on providing Ethiopian women, children and families, especially those in underserved communities, access to quality healthcare. USAID works with the Ethiopian Ministry of Health and regional bureaus to institute better training so that healthcare workers can improve the care provided at various levels (facility, community and household). USAID ensures access to integrated services such as prenatal checkups, skilled care for labor and delivery, newborn care, preventative care for childhood illnesses and nutritional guidance.

Quality of Care Network

Ethiopia is a member of a 10-country Quality of Care Network created by the WHO, the United Nations Children’s Fund (UNICEF) and the United Nations Population Fund (UNFPA). The Network launched in 2017 with the aim of halving maternal and child mortality by 2022 and improving patient care. In Ethiopia, this commitment involves clinical mentoring and coaching since learning is an essential aspect. Ethiopia chose 17 districts that represent “pastoralist, urban and rural populations” to operate as “learning districts.”

Maternal Mortality Reduction

These coordinated efforts seem to be making headway according to the 2020 Gates Foundation Goalkeepers Report, which tracks progress on SDG goals. In 2019, the Ethiopian MMR was down to 205 deaths per 100,000 live births which would meet the Quality of Care Network goal of halving maternal and child mortality by 2022.

Ethiopian child mortality was down from 66 deaths per 1,000 children under 5 in 2015 to 52 deaths in 2019, which represents more modest progress. However, the Goalkeepers Report warns that COVID-19 could reverse progress made on global goals and asserts that a global collaborative response is essential in all areas.

It is critical to maintain heightened vigilance in coordinating efforts to continue to improve maternal and child mortality rates in Ethiopia despite COVID-19 challenges, so that progress is not lost.

Shelly Saltzman
Photo: Flickr

Maternal Healthcare Services in Spain
The foundations of the Spanish National Health System (SNS) are free access, equity of financing and funding from taxes. This allows the public sector to provide the most coverage. Oftentimes, this coverage is free of charge. Maternal healthcare services receive high regard in both public and private settings. However, this system faces many issues as well.

Healthcare is available to all Spanish residents for free. Social security payments guarantee almost everyone access to free healthcare. Moreover, some only need to pay a small percentage of fees. Furthermore, only non-residents with health insurance in other countries are not eligible for public healthcare in Spain.

Pros and Cons of Healthcare in Spain

The Spanish healthcare system generally offers high-quality services. There is a network of hospitals and medical centers with well-trained staff members. Additionally, the healthcare system also covers the direct family of a beneficiary. This includes dependents that are under 26 years of age and their siblings.

However, the waiting times for surgeries and treatment from specialist doctors can be extremely long. This is one of the main setbacks of public healthcare. Also, public healthcare services do not allow patients to choose their doctor or specialist. This is very troublesome for some people who wish to have a specific doctor.

Costs for Expecting Mothers

Mothers most often choose hospitals to have childbirth. However, the number of home births has been slowly increasing across Europe. In addition, the state health system does not cover home births in Spain. Moreover, less than 1% of Spanish midwives were registered to oversee home births legally in 2015.

Residents of Spain who use state healthcare can give birth for free. Yet, there may be additional costs with private insurance depending on the insurance plan. Thus, this option makes it easier to find a plan to fully cover the cost of childbirth. The cost of giving birth in Spain is about $1,950 without insurance. This is one of the lowest costs in the world.

Women must hold a private insurance policy for 6-12 months in order to have maternity costs covered. As such, the European Health Insurance Card does not include maternity care.

Maternity Leave

There is also a complicated process in receiving maternity leave. In order to have a standard maternity leave of 16 weeks, mothers must have been paying contributions for a set period of time depending on their age. Mothers are eligible for 18 weeks of maternity leave if they have twins and 20 weeks for triplets. Additionally, maternity leave can receive an extension to 18 weeks if the child has special needs or if the mother is a single parent.

Spain’s Social Security System (Seguridad Social) pays for maternal healthcare services. Mothers must receive paid contributions for at least 180 days within the last seven years to qualify.

The Spanish maternal healthcare system helps many people living in poverty. This system provides a way for people to receive care regardless of their socioeconomic status or salary. Furthermore, it provides a way for residents to choose between public and private options. These options gear towards those who want personalized treatments with a specific doctor.

Expecting mothers benefit from these affordable and accessible maternal healthcare services. Although aspects of the process are difficult and intricate, this service provides a way for Spanish women to give birth easily. This public healthcare system has made Spain a highly rated country for quality care and service.

– Miranda Kargol
Photo: Flickr

Women in NigeriaDespite the United Nations’ global commitment to improve the health of pregnant mothers and reduce maternal death, the loss of women’s lives as a result of complications during pregnancy has been on the increase in most sub-Saharan African countries. In Nigeria, there are 59,000 maternal deaths annually. Compared to those in advanced nations, women in Nigeria are 500 times more likely to lose their lives in childbirth. At 545 per 100,000 births, maternity care for women in Nigeria is the worst in all of Africa. This means that out of every 20 live births in Nigeria, there will be at least one case of maternal mortality.

Maternal Death Leads to Poverty

In Nigeria, a high percentage of pregnant women do not receive adequate healthcare. This is either because their community does not offer services or because the women cannot afford healthcare. Many pregnant women in Nigeria do not seek care because they fear that the services are not high quality. In addition, the country’s patriarchal society and suppression of females can keep a pregnant woman from receiving adequate care. Cultural issues, lack of education and poverty can influence the healthcare choices of many pregnant women.

The toll on a family is enormous if a mother dies during childbirth. A mother’s death can force a family deeper into poverty and cause the daughters to be taken out of school to care for the other children and the household. For these young girls, the death of a mother perpetuates a cycle of poverty that can be hard to escape.

The difference in maternal death rates between the wealthy and the poverty-stricken is the largest among all of the health indicators tracked by the World Health Organization. Yet, mortality can be reduced by 80% with better access to reproductive health services along with high-quality care and skilled providers.

High-Quality Maternal Care for Nigerian Women

After losing a friend during childbirth, Michael Iyanro, a social entrepreneur and healthcare development expert, wanted to do something to ensure that top-quality maternity care for women in Nigeria was accessible to all.

He and other concerned individuals founded Tomike Health to address the problem. The organization launches clinics that provide high-quality maternal healthcare at affordable rates across neighborhoods in Nigeria. Tomike Health prioritizes the low-income residential areas on the outskirts of cities. These are the fastest-growing population centers as people migrate from rural areas to seek work. Tomike Health centers serve women who are often the primary breadwinners in their families.

Clinical Innovations

Rather than relying on donations and grants, the organization’s founders wanted their operation to be self-sustainable. To meet this goal, Tomike Health has combined job training and business expertise with clinical innovations. This approach creates self-sustaining solutions for maternity care. Its partners include Easier Health Consult, the Almonsour Women Foundation and the Gender Development Initiative. The organization and its healthcare providers continue to work hard to reduce maternal mortality rates in Nigeria, saving women’s lives and keeping their children from descending into poverty.

Sarah Betuel
Photo: Flickr

Maternal Mortality LaosIt is hard to imagine how giving birth can be fatal to so many women around the world. However, even in 2021, maternal mortality remains a significant issue, especially in developing countries where modern medicine is scarce and medical facilities are not easily accessible. Fortunately, these maternal mortality rates have been dropping all over the world, especially in Laos.

Birth Complications in Laos

Laos, or Lao People’s Democratic Republic, is a landlocked nation between Thailand and Vietnam. With a population of 7.2 million, the country suffers from a declining fertility rate. In 2020, women in Laos had an average of 2.7 children, yet this rate was more than doubled just 30 years ago. In addition to infertility, women in Laos are at a greater risk for birth complications. According to the U.N., a mother’s risk of dying in Laos due to delivery and post-delivery complications is one in 150. This number is especially alarming when compared to statistics in Europe, where a woman’s risk of death is one in 3,400.

Declining Maternal Mortality Rates

Since the turn of the millennium, maternal mortality rates have dropped significantly all over the world due to the spread of modern medicine. According to the World Health Organization (WHO), the maternal mortality ratio dropped by approximately 38% worldwide in less than 20 years. Similar encouraging statistics are emerging from Laos. Eksavang Vongvichit, the nation’s former health minister, discusses Laos’s progress in tackling this issue: “We’re in third place worldwide in terms of bringing down the maternal mortality rate… We’ve brought down the number of maternal deaths from 450 out of 100,000 live births down to 220.”

The Ongoing Fight Against Maternal Mortality in Laos

Maternal mortality is a more frequent reality in developing countries. On average, women in low-to-middle-income countries more likely to die during or immediately after pregnancy than women in developed nations. This is largely because many birth-related deaths result from easily preventable causes, including severe bleeding, infections, high blood pressure, complications from delivery and unsafe abortions.

To prevent such avoidable deaths, numerous charities and NGOs are working on better educating reproductive healthcare workers in developing nations. The United Nations Population Fund (UNFPA) is a prime example of this work, being stationed in Laos and other developing nations all over the globe. In Laos, the program helped the Ministry of Health create better training programs for volunteers and midwives in reproductive care. This education includes bringing awareness to mothers about proper family planning, which covers how long to space out pregnancies and prevent undesired pregnancies. Not only will such education prevent unnecessary fatalities, but it will also aid families in properly planning for the future to break the cycle of poverty.

With the continued implementation of modern medicine and reproductive education in developing countries, there is great hope that the rate of maternal deaths will continue to decline in Laos.

– Amanda J. Godfrey
Photo: Unsplash

Maternal Mortality in Sierra Leone

Maternal mortality may not be a constant fear of yours if you think about pregnancy. However, this threat has not been eliminated in many parts of the world. Simply because developed countries have significantly decreased this issue with medical advances, many women in various regions must contend with this terrible plight. Maternal mortality in Sierra Leone, specifically, is still considered to be of high risk and something women should consider prior to pregnancy.

The Most Dangerous Place to Become a Mother

The most dangerous place in the world to become a mother, in fact, is Sierra Leone. This country has one of the highest maternal mortality rates globally. Around every one in 17 pregnancies end in the death of the mother- an overly alarming statistic. An endeavor that is supposed to be filled with joy and excitement is now clouded with fear as mothers worry about their health instead of being able to focus on their babies. This worry is not one experienced globally: Sierra Leone women are 300 to 400 times more likely to die with each pregnancy in comparison to women in Sweden, Finland, and other high-income countries.

Factors That Contribute to Higher Rates of Maternal Mortality in Sierra Leone

Postpartum hemorrhaging has accounted for 32% of deaths along with bleeding, hypertension, abortions, obstructed labor, and infections. Hemorrhaging is problematic because a blood transfusion is required immediately to resolve the issue. However, when a woman gives birth at a local clinic, it can take hours to transport her to a hospital for the procedure. Unfortunately, many women bleed to death while waiting. However, most of these conditions can be treated with the correct healthcare, but due to extreme poverty, an overwhelming percentage of families do not have access to the necessary care.  This has resulted in unnecessary deaths.

Another significant factor that contributes to higher maternal mortality rates is that women in low-income countries tend to have more children. As a result, this increases their risk of complications. On average, women in Sierra Leone have five children, which, is considerably high when looking at countries like the United States whose average is 1.73 children. More children typically mean earlier pregnancies. In a 2016 report, researchers found 20% of deaths were girls ages 15 to 19 years old; a grim statistic especially when considering a 15-year-old is three times more likely to die during childbirth than a 22-year-old.

The Good News

Although the facts appear troubling, all hope is not lost. The United Nations has recognized maternal mortality as a serious issue. Thus, it has begun to combat the risk of death during pregnancy and the six weeks that follow.

The UN agency called the United Nations Fund for Population Activities (UNFPA) has started supporting midwifery through three government-run schools that graduate 150 students each year to tackle the high mortality rates. This alone will not improve the situation, as the majority of women in Sierra Leone already have midwives. It should result in better outcomes as these midwives will be better trained and even more common.

The UNFPA also focuses on family planning which reduces mortality by 25 to 30%. This UN organization provides 90% of the country’s forms of contraception through an annual $3 million budget. They estimated that from 2015 to 2017 this service prevented 4,500 maternal deaths and 570,000 unplanned pregnancies.

Maternal mortality in Sierra Leone may be among the highest rates in the world, but the country is taking imperative steps to diminish the risks, steps that have been working thus far. By 2023, UNFPA hopes that they can reduce adolescent births to 75 per 1,000. This, in turn, will massively decrease maternal mortality.

Victoria Mangelli
Photo: Flickr

Doctors for MadagascarMore than 75% of people living in Madagascar are living under conditions of extreme poverty. Disease and natural disasters consistently fall upon the country. Madagascar faces a dangerous lack of proper healthcare provisions and a low number of medical professionals to meet the needs of all its inhabitants. The country does not lack hope of improvement though. Doctors for Madagascar carries out projects to help address the issues that Madagascar faces with appropriate medical care.

Doctors for Madagascar

Doctors for Madagascar (DfM) was founded by German doctors in 2011 after they observed the meager amount of healthcare provisions and trained professionals that were available. Its work is concentrated on providing for one of the country’s most poverty-stricken regions, being the remote south of the island.

This organization allocates immediate aid but it also wants to have a lasting impact and work toward sustainable solutions. Therefore, Doctors for Madagascar monitors its projects in the long-term to be sure that each one is reaching its maximum potential in both service and longevity. In keeping with this idea, the organization creates partnerships with doctors that are local to the south of Madagascar to base its aid on what experts in the community believe to be most necessary.

The Obstacles Madagascar Faces

  • Environmental challenges negatively affect the farming fields and threaten agricultural outputs.
  • Tropical storms have forced tens of thousands of people to evacuate their homes.
  • Hunger affects millions. In 2018, Madagascar ranked number six of nations around the world with the highest rate of malnutrition.
  • Diseases such as measles and plague affect thousands, especially due to low vaccination rates.
  • There is no universal health insurance.
  • Lack of consistent electricity.
  • Maternal health is inadequately meeting the needs of poor mothers and is especially complex during a complicated birth where proper facilities could be hours away from the mother’s village. Those who end up delivering without the assistance of medical professionals depend on the oldest women in the village.
  • Insufficient medical supplies along with difficult working conditions are some of the difficulties being faced within Centres de Santé de Base, which are facilities made of stone that provide healthcare in the countryside of Madagascar. Each one generally contains a nurse, midwife and sometimes a doctor.
  • A lack of trained medical professionals, especially in the south of the island.

 How Doctors for Madagascar Offers a Solution

Doctors for Madagascar does not discriminate against the members of the communities it helps, therefore, the organization takes care of the medical costs for those who cannot afford the treatment they need. Along with covering costs, the organization also provides cost-free maternal healthcare to women. As many women are unlikely to see a doctor throughout their entire pregnancy, DfM provides access to check-ups for women.

Transportation for pregnant women has improved as ambulances are provided and free hotlines have been made accessible for communication between ambulances and Centres de Santé de Base.

DfM builds health facilities and provides construction expertise to help carry out each project. The organization also renovates medical facilities that are necessary to the community’s health, providing medical equipment that is needed in the healthcare facilities and issuing training for its maintenance. Volunteering consists of doctors joining on aid missions. Each doctor that works with the organization must have sufficient experience and have a strong background in the french language to effectively communicate and treat Madagascans as needed. The organization also offers training to local medical professionals by experienced medical professionals that work or volunteer with DfM.

The Onset of COVID-19

As each nation confronts the global COVID-19 pandemic, Madagascar is not facing its first or only crisis. Dengue fever and malaria are killing more people in Madagascar than COVID-19, yet the pandemic is still emphasizing the urgency of improvement needed in medical care and the importance of access to healthcare. In fact, it is even shaping how some of the highest authorities in Madagascar influence this important matter through their advocacy. The Bishops’ Conference of Madagascar (CEM) stated that “The health crisis reveals the importance of an efficient health structure… we believe the time has come to look for ways to improve public health as a whole.”

The Future of Madagascar

The need for medical aid in Madagascar is a pressing issue. Doctors for Madagascar has proven that through awareness, action and understanding, impoverished communities can be helped in both the short and the long term. It is true that the country faces many recurring threats but that does not mean there has been no positive change. These changes can be seen in Madagascar today, which can provide an optimistic outlook on working to reduce poverty in other countries as well.

– Amy Schlagel
Photo: Flickr

Family Planning in ZinderZinder is a region in southern Niger with a population of more than 3.5 million as of 2012. It is one of the country’s most inhabited areas. While women in Niger give birth to an average of 7.6 children, this rate is even higher in Zinder where women have an average of 8.5 children each. Smaller families and slower population growth often correlate with a decrease in poverty. But in Zinder, where 53.8% of people live below the poverty line, large families and frequent pregnancies were associated with higher social status. Women give birth often and usually at young ages. Half of the girls in Zinder marry before the age of 15. This increases the population of a country that lacks the resources to feed, shelter and educate all of these children. Thus, there is a great need for widespread family planning in Zinder.

Global groups are implementing programs in Zinder to help normalize family planning and slow the population boom. Here are some effective programs that have been established to spread ideas and reduce the stigma surrounding family planning in Zinder.

UNFPA Schools for Husbands

Niger ranked last in matters surrounding gender equality in the 2013 Human Development Report. It is men, not women, who primarily make decisions surrounding pregnancy and childbirth. However, the United Nations Population Fund (UNFPA), an international organization that focuses on maternal and reproductive health, has dedicated itself to changing that. It has started more than 137 Schools for Husbands in the region since 2004 in order to improve family planning in Zinder.

These “schools” lack official lessons and schoolwork; rather, they are safe spaces for men to discuss possible solutions to reproductive health concerns. The men who attend them help each other understand the importance of family planning. Together they brainstorm ways to encourage “pregnant and breastfeeding women to attend Integrated Health Centers” in their area. These men, all of whom are married, also bring this information back to their wives, encouraging not only maternal health for the women in these relationships but also better communication among couples.

This program has been wildly successfulーthe use of maternal health resources has tripled in areas where these “schools” operate. Rates of prenatal doctors’ visits and safe births have increased. With these successes, the program has recently spread to several other regions in Niger.

The USAID and PSI Partnership

Population Services International (PSI), a family planning organization, has partnered with USAID to research reasons behind the lack of family planning in Zinder. It has made two important observations: the fact that Islam, the dominant religion in Niger guides many decisions around childbirth and pregnancy, and that families often fail to consider financial implications before having children.

Using this information, PSI created a series of programs in Zinder. These included a financial budgeting tool to help men calculate the cost of having multiple children. This initiative also urged religious leaders to speak with their communities about reproductive health. Another program that PSI created was a poster campaign that encourages family planning using verses from the Quran. These programs, which included more than 200 community members in nine villages, normalized family planning from both a financial and religious standpoint. They also encouraged open conversations around pregnancy prevention.

While the childbirth rate in the region remains remarkably high, many are making progress in normalizing family planning in Zinder. Organizations are working together to emphasize reproductive health in the region and slow the population growth rate.

Daryn Lenahan
Photo: Flickr

The Safe Delivery AppAcross the globe, thousands of women die every year as a result of complications during birth. A variety of organizations have been developing to combat these preventable deaths. The Safe Delivery app, a maternal healthcare app, provides one of these solutions. Below are four facts outlining the app’s purpose as well as its successes since its release in 2012.

4 Facts about the Safe Delivery App

  1. Maternal mortality is an issue around the world. Every year, more than 300,000 women die from causes related to pregnancy. Women typically die in pregnancy and childbirth for five main reasons: “severe bleeding, infections, unsafe abortion, hypertensive disorders, and medical complications like cardiac disease, diabetes, or HIV/AIDS.” There is also a greater chance of death for pregnant women who lack proper assistance. Unfortunately, in sub-Saharan Africa, less than 50% of women during birth have a trained midwife, nurse or doctor to help them through the process. Many instances of maternal mortality are 100% preventable when access to quality maternal care is provided.
  2. The Safe Delivery App educates. The University of Copenhagen, the University of Southern Denmark and the Maternity Foundation launched the app to provide skills and to assess knowledge of those assisting with births in remote areas of developing nations. The app consists of 12 modules that address numerous childbirth emergencies and the appropriate preventative procedures for each. It uses “animated instruction videos, action cards, drug lists, practical procedures, and an individualized e-learning component, MyLearning,” to guide healthcare workers. The Safe Delivery app also works offline so healthcare workers can access the modules in any place, at any time.
  3. The app’s creators collaborate. Some key partners include The Bill and Melinda Gates Foundation, Jhpiego, the Danish Emergency Relief Fund and MSD for Mothers. The app’s creators have teamed up to prep for launching the app in even more countries. For instance, Merck for Mothers is working with the Maternity Foundation to incorporate user feedback into the app’s design. They are also collecting user data through case studies and stories to help improve the app’s adoption in other countries. Additionally, the creators of the Safe Delivery App partnered with the United Nations Population Fund (UNFPA) to study the effectiveness of the app; for the study, the app trained 58 birth attendants across four different regions. After collecting feedback, the UNFPA found there was an “association between high user engagement and improvements in the health workers knowledge and competencies when handling childbirth emergencies.”
  4. The Safe Delivery app is succeeding and improving. The Safe Delivery app boasts over 17,000 downloads in 44 low- and middle-income countries. In 2019, the top five countries were Ethiopia, Sierra Leone, Ghana, Somalia and Togo. Also in 2019, a total of 10,418 users actively used the quiz functions. According to research conducted by Merck for Mothers, “Workers’ skills in handling complications increased by more than 100%” after using the app for 12 months. In 2017, a Hindi version of the app launched for users in India; this drastically increased healthcare workers’ skill sets in the region. The Maternity Foundation has also released multiple case studies that show the positive impact of the Safe Delivery app. For example, the Maternity Foundation tracked the app usage of 62 health workers across eight facilities in Congo. According to the Maternity Foundation, “The study showed a significant increase in the healthcare workers’ knowledge and confidence when handling post-partum hemorrhage and neonatal resuscitation.”

Since the launch of this maternal healthcare app, researchers have seen great improvements in healthcare knowledge. While maternal mortality is still an issue around the world, innovations like the Safe Delivery app can eradicate the dangers of childbirth.

Sara Holm
Photo: Flickr

Maternal Care in BangladeshBack in 1972, Fazlé Hasan Abed started a small organization called the Bangladesh Rehabilitation Assistance Committee (BRAC). Originally dedicated to helping refugees after Bangladesh’s war for independence against Pakistan, the organization has since grown to serve 11 countries across Asia and Africa. One of the key focuses of BRAC is poverty alleviation and includes categories such as improving maternal care in Bangladesh.

BRAC’s Strategies for Poverty Reduction

BRAC engages several strategies to combat poverty, such as social enterprises. Social enterprises are self-sustaining cause-driven business entities that create social impact by offering solutions to social challenges and reinvesting surplus to sustain and generate greater impact. Some social enterprises include those seeking to promote access to fisheries, give people access to jobs in the silk industry and businesses that give seed access to farmers.

BRAC also prioritizes social development. These initiatives refer to BRAC’s on-the-ground programs. Social development efforts aim to build communities up by attempting to foster long-term development through the promotion of microfinance and gender equality and by eradicating extreme poverty.

The third focus of BRAC is investments. BRAC seeks to invest in local companies in order to create as much social impact as possible. This includes initiatives to expand affordable internet access for all and a range of other financial support services.

Finally, the organization founded a tertiary education institution called Brac University. The University, located in Bangladesh, aims to use its liberal arts curriculum in order to try and advance human capital development and help students develop solutions to local problems.

The BRAC Manoshi Maternal Care Initiative

Founded in 2007, the Manoshi program is specifically tailored to serve mothers and newborns by providing accessible care. There are a couple of unique methods that make this maternal healthcare initiative especially effective in reaching its goals of improving maternal care in Bangladesh.

One-third of people in Bangladesh live under the poverty line and a greater part of this group live in slums, making it difficult to access and afford necessary healthcare. Manoshi focuses primarily on empowering communities, particularly women, in order to develop a system of essential healthcare interventions for mothers and babies.

Manoshi’s Focal Areas for Community Development

  • Providing basic healthcare for pregnant and lactating women, newborns and children under 5
  • Building a referral system to connect women with quality health facilities when complications arise
  • Creating women’s groups to drive community empowerment
  • Skills development and capacity building for healthcare workers and birth attendants
  • Connecting community organizations with governmental and non-governmental organizations to further their goals

The main methods used in the Manoshi project to achieve desired outcomes are social mapping, census taking and community engagement.

Manoshi’s Impact on Maternal Care in Bangladesh

BRAC projected that improvement in healthcare access would cause neonatal mortality to decline by 40-50% and the most recent data from the Manoshi program shows just that. Manoshi’s data shows that from 2008 to 2013, both the maternal and neonatal death rates dropped by more than half. From 2007 to 2011, the percentage of births at health facilities increased from 15% to 59%, while national averages only increased from 25% to 28%, suggesting that mothers served by Manoshi have more access to resources and facilities for safe deliveries. Prenatal care also increased from 27% to 52% in the same years.

With the substantial impact of organizational programs like Manoshi prioritizing the wellbeing of women and children, advancements with regard to maternal care in Bangladesh will hopefully only continue upward.

– Thomas Gill
Photo: Flickr

4 Mobile Services Reducing Maternal and Child MortalityA woman in Africa is more likely to die from pregnancy or childbirth than a woman in Western Europe. The lack of nurses and midwives in comparison to Europe can make a significant impact on pregnancy and postpartum healthcare as well as maternal mortality in Africa. However, organizations and businesses are helping improve African women’s living conditions. Here are four mobile services reducing maternal and child mortality in Africa.

Springster

This mobile platform “connects marginalized and vulnerable girls to online content designed to equip them with knowledge, confidence and connections they need to navigate the complex choices of adolescence.”

Springster’s content can be accessed through social media channels like Facebook to provide a space for girls to engage in topics like puberty, education, money management and relationships. The app is based on sharing real-life experiences, helping girls make positive choices and change their lives for the better.

A major innovation with the app is Big Sis. Big Sis is a chatbot designed to provide personalized information about questions related to sexual health. This enables girls to find advice and answers 24/7. The app has impacted many girls’ lives with the reassurance and advice from shared stories and experiences from other girls like them. As a result, they are able to provide guidance and support from each other.

Mum & Baby

This service sends free health information via SMS three times a week to mothers, caregivers and partners. When people sign up for the service, they provide their age, location and stage of parenting they need help with from early pregnancy to taking care of a five-year-old.

After giving out personal information, Mum & Baby sends out personalized messages depending on the information given. Along with the messages, there is a free mobile site that does not use data. Instead, it offers articles, videos, tutorials and tools like the immunization calendar, due date calculator and pregnancy medicine checker.

A study was conducted to see the impact Mum & Baby has on people using the service. The study found 96% of users found the information via texts helpful and 98% of users say they would take action to care for themselves or their children.

Of the mothers and pregnant women surveyed, 95% of them say the information they received influenced their decision to breastfeed. Moreover, 96% of the people surveyed were influenced to get their kids vaccinated. More than 650,000 children were immunized as a result of free text messages.

RapidSMS in Rwanda

This mobile service has a similar style to Mum & Baby in the sense that it shares information via SMS. However, with this mobile platform, community health workers are equipped with mobile devices to collect and use real-time data on key maternal, neonatal and child health indicators.

The data is collected within the first 1000 days of life from pregnancy to childbirth to up to two years. This also includes a broad range of areas of childcare such as antenatal care, delivery, postnatal care, growth monitoring and even death indicators such as maternal and child mortality.

The indicators are recorded using the mobile platform and generate reminders for appointments, delivery and postnatal care visits. There is also an emergency care platform called Red Alerts. There is also a creation of a database of clinical records on maternal care delivery.

UNICEF did a study on RapidSMS to measure its effects on maternal and child mortality. It has contributed to some changes in the use of healthcare services and maternal and child mortality but has overall made improvements on health outcomes for mothers and children in Rwanda.

M-Mama’s Ambulance Taxi

This application “uses mobile technology to connect women in rural areas of Africa to emergency transport.” The project started in 2013 to help women in rural Tanzania gain access to healthcare where almost half of the women there give birth at home without the assistance of a healthcare worker. Many mothers and children die from preventable birth complications due to the lack of health systems and delayed access to care.

The people of M-Mama intend to change that and reduce maternal mortality rates which is a challenge faced by the U.N.’s Sustainable Development Goals.

The process of M-Mama’s ambulance taxi project starts when a patient makes a call to a 24-hour dispatch center. A call handler will then access the condition of the patient using the app, which would indicate whether the patient needs a transfer to a health facility. If healthcare is required, the nearest taxi will be notified and identified through the app, requesting the taxi driver to take the patient to the hospital. This way, taxis act as a cost-effective ambulance for the patient. The driver will then be paid after safely escorting the patient to the hospital.

Since M-Mama’s start, there has been a reduction in maternal mortality of 27% in the Lake Zone regions of Tanzania.

Conclusion

These mobile apps are reducing maternal and child mortality rates in Africa. Through the mobile services’ resources and aid, young girls can make better decisions and expecting mothers can get the help they need, despite their remote locations. Reducing maternal and child mortality by 1% can increase GDP by about 4.6% in African countries.

However, one issue that stands in the way is the lack of access to mobile phones and the internet. Women in Sub-Saharan Africa are 13% less likely to own a phone and 37% less likely to access the internet on mobile.

The more investment there is to reduce maternal and child mortality in Africa, the more it will generate social and economic benefits for Sub-Saharan Africa. To do that, governments and non-profit organizations need to work to close the gender gap and develop mobile health services. These efforts will help women be informed and make healthier decisions.

– Jackson Lebedun
Photo: Flickr