Drones Protect Botswana's MothersChildbirth in Botswana carries high risks, especially because remoteness threatens safe deliveries for women. If complications arise, it can take hours to transport patients to adequate medical facilities. The lengthy travel time to get medical assistance can prove lethal. In response, the U.N. devised a solution involving drone technology. Drones protect Botswana’s mothers by delivering essential medical supplies. Excessive bleeding is a primary cause of maternal mortality and medical drones can now deliver blood to women who need it. In May 2021, Botswana became the third African nation to implement the Drones For Health project in order to improve maternal health.

Botswana’s Maternal Mortality Rate

Prior to Botswana’s independence from the United Kingdom in 1966, the country had one of the highest poverty rates in the world. Since then, abundant resources and an adept government significantly reduced poverty. Botswana is now considered an upper-middle-income country. However, childbirth risks remain high. Botswana’s 2019 maternal mortality rate was 166 deaths per 100,000 births.

While the worldwide maternal mortality rate dropped by nearly half from 1990 to 2010, progress has been slower in many sub-Saharan African countries. Through projects like Drones For Health, Botswana works toward a 2025 goal of reducing its maternal mortality rate to 71 deaths per 100,000 births.

How Maternal Mortality Impacts Poverty

Maternal mortality harshly impacts poverty as a mother is often a central figure in a household and in society, taking on multiple functions and responsibilities. Surviving children often drop out of school in order to fulfill household obligations or take on employment to compensate for lost household income due to a mother’s death. Children without mothers often have deficient health outcomes because they are less likely to be immunized and often do not receive adequate healthcare when sick. Furthermore, due to the severe economic challenges of losing a mother, some young girls are forced to marry early.

The Drones For Health Initiative

Botswanan academics and government officials worked with the United Nations Population Fund (UNFPA) to put the Drones For Health initiative in motion. The medical drones have launch pads in four locations across the country, all situated next to healthcare facilities. The drones protect Botswana’s mothers by completing quick deliveries of blood. As long as the cargo is less than two kilograms, the drones can also carry medications and other medical supplies. Medical drones are also able to bypass infrastructure limitations such as uneven roads or missing bridges. These barriers prevent land-based vehicles from delivering blood to remote areas. In addition to providing a life-saving service, the battery-powered drones cause much less pollution than a land vehicle making the same trip.

Poverty is the main predictor of women’s endangerment during deliveries. Without traveling to medical facilities or hiring a midwife, childbirth becomes exponentially more difficult and risky. Botswana’s medical drone project exemplifies the benefits of creative and tech-savvy strategies to reduce maternal mortality.

– Lucy Gentry
Photo: Unsplash

LMIC MidwivesAccording to the World Health Organization (WHO), utilizing well-trained midwives could be a game-changer. Globally, midwives could decrease maternal, newborn and stillborn mortality by 83%. This is why WHO advocates for a midwife or other skilled health professional at every birth globally. Midwives are health professionals trained to manage uncomplicated pregnancies and deliveries and guide the family through the immediate post-natal period. More low-to-middle-income country (LMIC) midwives are needed to reduce maternal mortality rates.

Midwifery

Midwives can deliver 87% of the maternal health service need. However, only 42% of skilled midwives work in the 73 countries with 90% of the maternal, newborn and stillborn deaths. Further, a 2020 University of Dundee study found that midwifery is less effective in low-to-middle-income countries (LMICs). Where it does exist, there is a lack of standardization in education, training and regulation. Fortunately, organizations are focusing on increasing the number of LMIC midwives, midwifery education options and midwifery regulation.

Role of the Midwife

Not only do midwives deliver babies but they also play several other key roles. As members of their communities, they are culturally sensitive. Because they have community trust, they effectively promote strong health measures. Midwives help patients with family planning and breast and cervical screenings. They advocate for female rights and the elimination of genital mutilation practices. Midwives counsel teens on sexual and reproductive health and counsel victims of gender-based violence.

The midwife-led model of care is one in which the midwife is the lead medical provider for childbirth. According to a 2020 study, the holistic midwife-led model leads to more patient satisfaction and fewer unnecessary procedures. The study, however, suggests that the model needs stronger implementation in LMICs.

As the United Nations Population Fund (UNFPA) declares, “The deficits are highest in the areas where needs are greatest.” Luckily, the UNFPA and other programs are pushing to increase the number of LMIC midwives, midwifery education and midwifery regulation.

UNFPA: Supporting LMIC Midwives

Supporting LMIC midwives and building an LMIC midwifery workforce has been the focus of UNFPA since 2008. The organization works with more than 40 global partners and more than 300 national partners. Together they work on strengthening competency-based midwifery training and bringing it to scale. The focus is developing strong regulatory processes to analyze outcomes, supporting midwives in gaining a stronger voice through the creation of midwife organizations and increasing funding for midwife services. As of the end of 2018, the UNFPA trained more than 105,000 midwives and 8,500 midwifery tutors in 650 midwifery schools. This has helped create 250 midwifery associations and branches. The UNFPA’s midwifery support extends to more than 120 countries, including 39 countries with the highest global maternal mortality rates.

Tunza Mama: Midwifery Network in Kenya

While the UNFPA works globally, there are also national programs striving to support LMIC midwives. There is a shortage of midwives in public health facilities in Kenya because the government cannot afford to pay them. The African Medical and Research Foundation (Amref) International University launched the Tunza Mama network in 2018. This provides an alternative option to access midwives and improve the socio-economic status of Kenyan midwives.

Tunza Mama midwives visit women at their homes. Clients pay directly to the Tunza Mama bank account and the midwives get 95% of the fee. Tunza Mama spreads awareness of its existence using social media, which is how 70% of mothers came to know about the program. During the COVID pandemic, Tunza Mama is using mobile and e-learning digital platforms to reduce the need for in-person sessions by 75%. Some challenges include the fact that Tunza Mama is a paid service so only the middle-class can use it. The next steps include subsidizing the system so marginalized women can also gain access.

SWEDD Midwifery Training in the Sahel

In Mali, according to 2016 demographic data, the shortage of midwives and obstetric nurses is severe. There are only 1.4 midwives per 10,000 people versus the WHO recommendation of 23 doctors, nurses or midwives per 10,000 people. Also, according to 2018 data, 36% of teenagers have begun childbearing. Pregnancy and childbirth are the leading cause of death among adolescent girls.

Mali is part of the Sahel, the semi-arid region of north-central and western Africa. The Sahel also includes Benin, Burkina Faso, Chad, Cote d’Ivoire, Mali, Mauritania and Niger. The maternal and neonatal mortality rate in this region is one of the highest rates in the world. In response, in 2016, the World Bank began working with Sahel governments with support from the UNFPA to launch the Sahel Women’s Empowerment and Demographic Dividend (SWEDD) project, which provides midwifery training. Since the launch, more than 6,600 midwives have been trained. In addition to training LMIC midwives, SWEDD’s overarching goal is to achieve the “demographic dividend” by empowering women and girls through education, family planning and more.

Together, global organizations such as the UNFPA, local networks such as Tunza Mama and regional collaborations including SWEDD are pushing to boost the number of LMIC midwives. This will significantly lower maternal and newborn mortality in areas that need it the most.

– Shelly Saltzman
Photo: Flickr

Female Empowerment in PoliticsThe high rate of preventable maternal mortality rates in developing countries continues to be a cause of concern. The World Health Organization (WHO) defines maternal mortality “as the death of a woman from pregnancy-related causes during pregnancy or within 42 days of pregnancy.” Maternal mortality occurs almost entirely (99%) in low-income countries. The maternal mortality ratio (MMR) of impoverished countries estimates 239 maternal deaths per 100,000 live births. This rate is 12 per 100,000 in high-income countries. Research shows that female empowerment in politics links to reduced maternal mortality rates.

Reasons for High Maternal Mortality in Developing Countries

Female Representation in Government

Global female representation in government has increased to more than 20% while maternal mortality has declined by 44% since 1990. Is this a cause-and-effect scenario or merely coincidence? A recent study titled, “Maternal Mortality and Women’s Political Participation” offers data to support that it is not just happenstance and that female empowerment in politics has a direct effect on maternal mortality levels.

In 2020, female participation in parliament reached 24.9% globally. One reason for the rise in women’s representation in government is the fact that several countries are adopting gender quotas. Gender quotas secure a number of seats in government for women. At least 130 countries have adopted gender quotas and have an average of 26.9% female representation. Countries that have implemented quotas have seen maternal mortality decline at an accelerated rate. Estimates have determined that gender quota application results in an average of a 9-12% drop in maternal mortality.

Female Policymakers Prioritize Women’s Health

Health is a vital contributing factor in empowering women. Women statistically prioritize policies aimed at improving female conditions at a higher rate than their male counterparts. These policies often target issues such as education, child marriage and maternal health. Countries with gender quotas in place show an estimated 8-11% rise in “skilled birth attendance” and a 6-11% rise in the use of prenatal care.

A paper that Cambridge University published in 2016 asserted that an increase of only 1% in women’s representation in government resulted in five fewer maternal deaths and 80 fewer infant deaths out of 100,000 live births. These studies and statistics conclude that women’s participation in legislatures improves the health of its female constituents.

Eradicating Maternal Mortality

Female empowerment in politics contributes to the Sustainable Development Goals (SDGs). The Sustainable Development Goals, which the U.N. established, include reducing maternal mortality (SDG 3.1) and increasing the number of women in government (SDG 5.5). These goals are complementary to each other. By working toward SDG 5.5, which is to “Ensure women’s full and effective participation and equal opportunities for leadership at all levels of decision-making in political, economic and public life,” it is reasonable to conclude that the world could achieve, SDG 3.1, which is to “reduce the global maternal mortality ratio to less than 70 per 100,000 live births” by 2030, in tandem.

Rachel Proctor
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
Maternal mortality is a devastating cause of death for women around the world, especially those who live in low-resource communities or developing countries. Many conditions that cause maternal mortality are preventable. However, progress is occurring to save the lives of mothers and babies all over the globe.

Maternal Health Issues

The World Health Organization (WHO) has a commitment to reaching maternal health goals and improving healthcare systems. It is reaching towards this by working with partners to address inequality of access to healthcare, researching all possible causes of maternal deaths and providing clinical and programmatic guidance and more.

 The U.S. Agency for International Development (USAID) is a global leader in solving maternal health issues. It has a commitment to improving maternal, newborn and child healthcare services. In fact, it has partnered with governments to help meet the needs of mothers and babies with country-specific plans. USAID has saved the lives of over 340,000 mothers. It also protects the life of the mothers’ babies after delivery with immunization and sanitation resources available.

Merck for Mothers, or MOMs, is a global initiative that focuses on creating a world where no woman dies while giving birth. MOMs boasts helping over 13 million mothers deliver their babies safely. In addition, it also supports over 100 strategic investments aimed at programs that help the cause. Its focus countries are India, Nigeria, Kenya and the United States. It also has a global corporate grants program supporting nongovernmental organizations worldwide.

MOMs in India

India has a high maternal mortality rate of 145 deaths for every 100,000 births (56 highest of 182 countries in January 2020). MOMs focuses on supporting programs that help struggling mothers in India use technology. One such partnership is with USAID, the Bill & Melinda Gates Foundation and other organizations that work with the Alliance for Savings Mothers and Newborns (ASMAN) to digitally monitor the health of mothers during labor and delivery.

ASMAN provides links to healthcare providers for a Safe Delivery App – a smartphone application that shows “up-to-date clinical guidelines on obstetric care and can be used as an immediate life-saving reference during complicated deliveries.”

Solving delivery complications requires quick thinking and action on the spot, which is a MOMs specialty. The initiative utilizes MOMs’ resources to enhance already existing solutions. It creates a “failing fast” learning method to quickly get hands-on experience that can save lives.

An Indian digital health company, Avegen, has also partnered with MOMs to help release a web-based platform to educate women about quality maternal care. It gives them the ability to rate the services they receive on a public platform for others to read. This gives women the power to educate themselves and choose an accessible healthcare provider that meets their needs. It also gives healthcare providers the feedback they need to improve the quality of care.

MOMs in Africa

Developing nations such as Nigeria are more susceptible to maternal mortality and other delivery complications because of poor healthcare systems. Nigerian women are around 500 times more likely to die during childbirth compared to the most advanced nations. Nigeria’s high level of maternal mortality comes from a multitude of factors such as poverty, food insecurity and low healthcare resources.

Nigeria had the fourth highest maternal mortality rate in the world of 182 countries ranked in January 2020. In 2021, Merck reported it as the highest.

In Nigeria, health conditions like diabetes and hypertension are on the rise. These health risks can be precursors to eclampsia/preeclampsia, a high cause of maternal death. MOMs has a dedication to locating indirect causes of maternal mortality such as malaria and cardiovascular disease by partnering with Nigerian healthcare initiatives to identify how to manage these risks.

MOMs is bringing unidentified maternal death statistics to light by collaborating with Africare and Nigeria Health Watch to support an advocacy program, “Giving Birth in Nigeria.” The program lets communities report otherwise unreported maternal deaths online. Many maternal deaths do not get reported because they do not happen in hospitals or do not receive confirmation. However, communities need to understand why women in certain areas are at risk and how their deaths can undergo prevention.

MOMs began partnering with LifeBank, a technological healthcare supply distribution system based in Nigeria. LifeBank aims to bring much-needed medical supplies to patients quickly with a multi-modal transportation network. It has saved the lives of over 10,000 people and served 676 hospitals, with a focus on providing blood and other medical supplies to mothers during childbirth.

Continuing Maternal Health Success

MOMs provides service around the world to help mothers before, during and after pregnancy survive and live a healthy life with their babies. Measures can sometimes prevent the loss of a woman to maternal mortality, especially in impoverished countries. MOMs and its partners have been working to ensure that healthcare systems are more efficient, that women are empowered to share their experiences and to ensure that healthcare workers are up-to-date on childbirth procedures.

– Julia Ditmar
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

How the Maternal Mortality Rate is Decreasing in Sierra LeoneThe capital of Sierra Leone, Freetown, is historically known for being a home for freed slaves during the transatlantic slave trade, giving Sierra Leone a prominent place in history. However, the small west African country boarding Guinea has faced many adversities. One is the significant increase in adolescent pregnancies and fertility being some of the highest in the world. Women in Sierra Leone have “a one in 17 lifetime chance of dying during pregnancy, delivery or its aftermath.” This article will discuss the main reasons for the decreasing maternal mortality rate in Sierra Leone.

Data Behind the Mortality Rate in Sierra Leone

For the government of Sierra Leone, keeping a consistent record of deaths was nearly nonexistent during the Ebola outbreak. According to an article by Financial Times, Dr. Sesay, who is “the government’s director of reproductive and child health,” conducts the government’s response to the maternal deaths. According to Dr. Sesay, procedures are set out to lower the maternal mortality rate in Sierra Leone. “We’ve put in place a maternal death surveillance and response team, and developed a technical guideline. When a death is reported, they go and confirm.”

Part of the surveillance is ensuring that reporting the deaths is imperative. This requires health workers within communities to report the deaths to major health facilities. Furthermore, this is vital to decreasing the maternal mortality rate in Sierra Leone as it ensures that all families are accounted for and not misrepresented in the sample population. However, the same health workers reporting the data are the same ones attempting to save these expectant mothers’ lives, which stretches on the ground workers.

Looking at the Numbers

Maternal mortality in Sierra Leone had reached 1,070 deaths between January to June of 2020. According to a report by the ministry of health and sanitation in Sierra Leone, from January to March of 2020, there was a total of 581 maternal deaths. And from April to June of 2020, the total was 489 maternal deaths.

Equally as important, the predominant reference of data for maternal deaths is CRVS (Civil Registration and Vital Statistics). The issue is that Sierra Leone doesn’t recognize this system of data reporting. When this occurs, other data systems are created, such as surveys and various studies, which leaves more room for inaccurate information. The organizations the World Health Organization, the United Nations International Children’s Emergency Fund, the United Nations Population Fund and the World Bank Group have collectively concluded that not all deaths can be recorded due to “systematic error.” Meaning the data presented won’t be accurate due to the actual number being lower or higher and this will impact how the maternal mortality rate is decreasing in Sierra Leone.

However, when using CRVS, “records will be systematically lower than the true number because there will always be deaths that go unreported. This is referred to as a systematic error.” Along with systematic error, there is the possibility of “random error,” meaning when a health worker records inaccurate information. This increases the inaccuracy of maternal deaths in Sierra Leone. Considering health workers are underpaid and overworked, random error is present when recording maternal deaths.

How to Improve Maternal Mortality Rate Efforts

There are multiple ways of decreasing the maternal mortality rate in Sierra Leone. However, today’s most beneficial way is by increasing and encouraging education for traditional birth attendants (TBAs). Undergoing childbirth for many women in Sierra Leone in the past meant being at home and having a TBA present. Usually, a TBA is an elderly woman from within the community and is often referred to as “auntie” or “mother.” Although this may sound beneficial and comfortable, such as having a midwife or doula, according to the government, TBAs were the primary reason for the country’s maternal deaths.

If patients were to have any complications during delivery, the TBA would inform the patient that emergency transportation would take too long to arrive and going to the nearest clinic would take too much time. In most cases, patients would bleed out as healthcare officials would arrive too late. The government attempted to resolve this issue by ratifying a law in 2010 forbidding TBAs to assist in deliveries outside of a clinical environment. If a TBA and anyone else taking part in the process, including the expectant mother, were caught defying this law they would face extreme retribution.

Established in 2001, the non-governmental organization IsraAID is working towards providing “emergency and long-term development settings in 50 plus countries.” The organization also has a medical care program that targets “reproductive health,” along with expanding educational opportunities. For the maternal mortality rate to decrease, the government of Sierra Leone has to establish effective maternal mortality reporting data and education for TBAs.

—Montana Moore
Photo: Flickr

empowering women improvesIn recent years, great strides have been made in improving women’s and children’s health. Fertility rates in both low and middle-income countries have significantly declined and life expectancy has increased by more than 10 years. Despite this progress, the WHO reports that a vast majority of maternal deaths (94%) occur in low-resource settings and most could have been prevented through adequate maternal care and other factors. Political and societal efforts to mitigate these disparities as well as ground-level health interventions are key to guarantee enduring improvements in women’s and children’s health. Empowering women improves maternal and child health outcomes in several ways.

Empowering Women Improves Maternal Health

Although the role of women’s empowerment as a social determinant of maternal and child health outcomes has not been as widely acknowledged as other social determinants such as education, it is a leading opportunity to improve the well-being of women and children around the world. Women’s empowerment is positively associated with an array of positive maternal and child health outcomes,  such as improved antenatal care, contraceptive use, child mortality and nutrition levels.

Improved Maternal Health in Guinea and India

Another facet of maternal health that is linked with women’s empowerment is increased access to quality maternity care. The Republic of Guinea has committed to alleviating maternal and child health disparities by increasing women’s liberty. According to the 2018 Guinea Demographic Health Surveys, mothers who received higher quality antenatal care (ANC) also exhibited several aspects of women’s empowerment, such as having a proactive role in healthcare decisions and being employed.

In Varanasi, India, women’s autonomy and empowerment were also found to positively influence maternal health. A study of 300 women found that women with greater autonomy were more likely to deliver their baby in a clinic and employ higher levels of antenatal care.

Improved Maternal Health in Africa

Uniformly, a regional analysis of Africa revealed that dimensions of women’s empowerment impacted maternal health and utilization of health services. Researchers found that having greater control over money or household decisions correlated with higher Body Mass Index (BMI) in the Democratic Republic of Congo, Ghana, Uganda and Zambia. This is important because low maternal weight is a risk factor for low birth weight babies and adverse infant outcomes. Additionally, facility delivery was significantly associated with positive attitudes toward gender roles in Nigeria. Delivering in a clinic plays a large role in reducing maternal mortality as the majority of fatal pregnancy complications can be prevented if intervened by a skilled clinician.

Empowering Women Improves Child Health

In addition to improving maternal health, empowering women improves and enriches the health of their children. Studies have found a nexus between women’s empowerment and good child health outcomes, including higher utilization of health care services and immunizations, improved nutritional status and lower child mortality.

Women in Nepal who own land are significantly more likely to have authority over household decisions,and similarly, children of mothers who own land are significantly more likely to be a healthy weight. The connection between land ownership and feelings of empowerment mean women are more likely to use income to contribute to the well-being of the children and the family overall.

Organizations for Women’s Empowerment

Mending educational and economic inequalities and disadvantages that women and girls face are fundamental in empowering women and marking long-term and sustained improvements in women’s health. Offering scholarships, making schools a safe environment for girls and transforming beliefs and gender-biased social norms that perpetuate discrimination and inequality are avenues to create equal education opportunities. Additionally, governments and policymakers are pertinent to allocate resources necessary for gender equity and improving female health.

Self Help Groups (SHGs) are a great example of a simple yet effective solution to empower women who live in lower-income communities. Find Your Feet is an organization based in the U.K. that is working in Malawi and rural India to end rural poverty. The organization works with families in remote areas of Asia and Africa by helping them earn incomes and expand access to vital services. A key facet of its work is geared toward women’s empowerment and it has created SHGs throughout the poorest districts in India.

The Way Forward

Empowering women is a catalyst for not only better maternal and child health outcomes, but investing in a woman’s health and empowerment has a ripple effect, helping families, communities and countries to rise out of poverty.

– Samantha Johnson
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