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How LFAM is Helping in Liberia

How Life for African Mothers (LFAM) is Helping in LiberiaMaternal mortality rates in Liberia exceed regional averages, significantly impacting infant survival. Yet, recent years have seen a decline in these rates, from an average of 777 maternal deaths per 100,000 live births in 2000 to 652 births in 2020. An initiative like Life for African Mothers (LFAM) is helping Liberia contribute to this positive trend by providing crucial support for mothers in the country.

Challenges for Midwives

Midwives in Sub-Saharan Africa face severe challenges due to outdated equipment, lack of training and insufficient drugs. They struggle without the necessary tools and knowledge to save mothers’ lives during pregnancy and childbirth complications. This is where the vital support of nongovernmental organizations like LFAM becomes crucial in reducing maternal mortality rates and impacting the lives of both midwives and mothers positively.

Life for African Mothers

Since 2005, LFAM, a United Kingdom (U.K.)-based nongovernmental health organization, has been saving the lives of mothers and babies in Sub-Saharan Africa. Angela Gorman, a neonatal nurse, founded LFAM to address the region’s high maternal mortality rates. LFAM achieves its mission through various means, including distributing medication to prevent post-partum hemorrhage and conducting skill-sharing workshops to provide essential training to hundreds of midwives.

In 2007, the United Nations Population Fund (UNFPA) partnered with LFAM to support Liberia in reducing its high maternal mortality rate. Since then, LFAM has actively collaborated with four hospitals in Liberia, conducting clinical skills-sharing workshops and distributing medication to address the critical situation.

LFAM’s Impact on Liberian Communities

LFAM is helping in Liberia by training midwives and distributing maternal medication across multiple counties in Liberia. Furthermore, it has enhanced maternal health in Liberia by distributing more than $250,000 worth of medication at no cost. LFAM stands as the exclusive provider in Liberia of Misoprostol, a drug to prevent hemorrhaging. Pharmaceutical companies in the U.K. donate much of the medication with the stipulation that it be distributed free of charge.

Furthermore, LFAM collaborates with charities like IHP and Muntada Aid to secure medicine donations and finance midwifery trips. By supplying medications for childbirth complications, LFAM supports hospitals and health centers across Liberia, significantly reducing maternal mortality rates. Additionally, LFAM distributes infant clothing to underprivileged mothers. As of January 2023, it was noted that since 2016, LFAM has trained more than 500 traditional and medical midwives throughout Liberia.

LFAM facilitates visits to Liberia by clinical staff to share clinical experiences and provide additional resources to hospitals and communities. Overall LFAM is helping in Liberia, making significant contributions to maternal health care and helping lower the maternal mortality rate.

Looking Forward

The remarkable efforts of LFAM in Liberia are paving the way for a future where maternal mortality is not a foregone conclusion but a challenge to overcome. Through training midwives, distributing essential medications and fostering international partnerships, LFAM is crafting a legacy of improved health care for mothers and their infants. Moreover, this trajectory of progress promises not only healthier futures for families in Liberia but also serves as a beacon of hope for similar communities across Sub-Saharan Africa.

– Arabella Wood-Collins
Photo: Unsplash

Reducing Preterm Birth in Low-Income Countries

preterm birth in low-income countriesThere are stark differences between preterm births in low and high income countries. Although preterm birth happens worldwide, more than 90% of babies born before 28 weeks gestation in low-income countries die shortly after birth. In high-income countries, less than 10% of these babies die. South Asia and sub-Saharan Africa have the highest preterm birth rates.

Globally, preterm birth kills more children under 5 years old than any other cause. Disability is an additional outcome of preterm birth with grave consequences for families and communities. Preterm birth has multiple interconnected risk factors and initiatives to address preterm birth in low-income countries are underway.

Risk Factors for Preterm Birth

Humanitarian settings often expose expectant mothers to risk factors for early birth. These risk factors include infection, such as HIV and malaria, gender-based violence and unclean living conditions. Undernutrition, excess physical work, air pollution exposure, adolescent pregnancy and reduced time between pregnancies also contribute to preterm birth incidence.

In low-resource conditions, health care is often disrupted or inaccessible for mothers and preterm infants. Displacement can also create formidable language and monetary barriers to health care. Conflict also contributes to limited health care for women and newborns. About 90% of countries with the highest neonatal death rates are in high-conflict locations.

Initiatives To Improve Preterm Birth in Low-Income Countries

Many programs aim to reduce the incidence of preterm birth and improve outcomes in low-income countries. Since 2007, the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS) has partnered with several organizations to improve birth outcomes. In 2011, the Bill and Melinda Gates Foundation funded a $20 million GAPPS program called the “Preventing Preterm Birth Initiative.”

The program develops ways to prevent preterm birth and gives priority to low-resource settings. The funded research projects include a study on the connection between infections and preterm birth and a search for biomarkers to predict preterm birth. Additionally, the program runs research sites in Bangladesh and Zambia, enrolling pregnant women in studies to gain insights into the causes of preterm birth in these nations.

In 2014 GAPPS initiated the Scaling, Catalyzing, Advocating, Learning and Evidence-driven (Every Preemie-SCALE) project with a $9 million U.S. Agency for International Development (USAID) Cooperative Agreement. From 2014 to 2019, this program widened the use of preterm birth interventions in two dozen Asian and African countries. In 2016, Every Preemie published an analysis to promote the global utilization of antenatal corticosteroids in cases of impending early birth to boost the survival of newborns. In Malawi, Every Preemie evaluated the Family-Led Care Model, a strategy designed to improve facility and home care for preterm infants.

Since 2017, Birth With Dignity has provided education and training to health care providers in Uganda, a low-income country with high preterm birth rates. The organization provides education on postpartum hemorrhage, preeclampsia and emergency communication. The nonprofit’s work at Mbale Regional Referral Hospital and St. Francis Nsambya Hospital enhances high-risk care for mothers and babies.

Going Forward

Preterm birth in low-income countries is a critical issue. There are multiple approaches to improving its incidence and outcomes. In a 2023 global report, the World Health Organization (WHO) detailed strategies to prevent early birth, including quality care during pregnancy, sufficient nutrition and effective education. The report also recommended quality neonatal care for infections and breathing and feeding difficulties to reduce newborn mortality and disability. These strategies provide a path forward to improve global preterm birth.

– Kelly Carroll
Photo: Flickr

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Finding Hope for Women with Fistula

Finding Hope for Women with FistulaFistula is a medical condition faced by women of every nationality, background and income level. However, these factors affect the rate at which women encounter fistula. Although income level is the largest determinant, nationality is also highly influential in countries where women have limited economic opportunities. However, recent developments are providing hope for women with fistula.

What is Fistula?

Fistula is an abnormal connection between the organs that often occurs when women have troubles with pregnancy and labor—specifically when labor is prolonged. When fistula occurs, especially in places where women have financial and geographic access to medical care, medical experts can normally address the problem with procedures such as C-sections. However, for women who lack access to these services, the issue worsens.

The labor period can last for days, which causes extreme pain and usually causes the baby to die in the process. During labor, the baby’s head presses against the mother’s pelvis and disrupts blood flow. This disruption creates holes, or fistulae, between the vagina and bladder or rectum. Permanent leakage of waste occurs in the mother if the condition goes untreated. Thus, women’s health and well-being directly impact access to emergency medical treatment.

Women with fistula usually live in underprivileged parts of Africa and Asia. To make matters worse, these countries largely lack access to sanitation services or goods like running water and incontinence pads. Fistula causes severe physical and psychological pain in affected women: in addition to uncontrollable leakage of urine and stool, women with fistula also face social issues. For example, this condition causes an unpleasant scent that repels family and friends. This condition can also cause a plethora of infections with the potential to impact others.

One Woman’s Story

Edis, a Ugandan woman suffering from fistula, provides a powerful example of the struggle to receive adequate urgent care. With a recently deceased husband, Edisa gave prolonged birth at home because she could not access a nearby hospital to go through labor. As a result, she contracted a fistula with all of its negative side-effects. Fortunately for Edisa, she was eventually able to receive a treatment procedure. Despite accessing care from a USAID-funded hospital, however, Elisa was forced to travel 11 hours away and incur significant transportation costs as a result. For financially struggling women like Elisa, these expenses can become highly burdensome.

Many other women also face hidden costs when seeking fistula repair surgeries, even if the surgery itself is free. These expenses can include loss of income, child care during recovery and food. USAID is using this information to improve conditions for these women by drafting actions like providing financial support for these hidden costs.

Hope for the Future of Fistula

While women with fistula are still suffering across the globe, especially in impoverished areas, this condition is now much less common than in the past. Additionally, many efforts are being initiated to provide funding and support to women in need of care.

– Fahad Saad
Photo: Flickr

 How Young Women in Senegal are Gaining Reproductive Healthcare

Reproductive Healthcare in SenegalThe country of Senegal has made major strides over the past 10 years for access and care in women’s reproductive and maternal health. Here are some initiatives and four recent centers that have opened to provide women with reproductive healthcare in Senegal in both rural and urban settings.

Reproductive Healthcare Barriers for Senegalese Women

Senegal’s healthcare system is not free to the public. If one does not have the funds to pay for their needed care, they are refused treatment. With more than 50% of Senegal’s population in poverty, only 32.5% of births are performed with a healthcare professional, making the maternal death rate one in 61 women.

Senegalese women are averaged to have at least four children, which is often a result of early forced marriage and the patriarchal family structure. Young women are limited from attaining an education, inhibiting their ability to gain knowledge and power over their reproductive and maternal health.

Over 77% of Senegalese women who desire sexual contraception such as birth control, do not have access to that resource. This has led to unplanned pregnancies for women 20 years old and younger. Additionally, most young women do not receive sexual education in school or at home. This results in less than a third of women in Senegal having a comprehensive understanding of HIV/AIDs or how to protect themselves from such diseases. Government initiation and non-profit organizations are improving these statistics. More women in Senegal are receiving resources and education for their reproductive healthcare.

The Maputo Protocol

Before the 2000s, there was no access to national government or international organizations’ reproductive health for Senegalese women. In 2005 Senegal signed the agreement of the African Charter of Human Rights and Rights of Women, known as the Maputo Protocol, declaring Senegalese women’s reproductive health to be a “universal human right” that must be protected. Following the Maputo Protocol, the Senegalese healthcare system began providing contraception as well as pregnancy and STI testing for women over the age of 15.

4 Centers and Initiatives for Women’s Reproductive Healthcare in Senegal

  1. Keur Djiguene Yi Center: The Keur Djuguene Yi Center is the first public OBGYN clinic in Dakar, Senegal that provides complete reproductive and maternal care to women who cannot afford or have access to government-provided healthcare options. Opening its doors in 2017 with the help of Dr. Faye, the lead gynecologist on-site, more women than ever before in Senegal now have access to pre and post-natal exams, “education on contraception, HIV prevention, family planning and infant immunization,” free of cost. Dr. Faye has been consciously expanding on the center, adding another full-time gynecologist in 2019. She hopes to expand the center to operate at full capacity with an entire team of OBGYN professionals to help four times the number of patients the Keur Djiguene Yi Center services currently.

  1. VOICES mHealth Program: The World Health Organization partnered with the Voices project, created an initiative for reproductive and maternal awareness in Senegal. The VOICEmHealth Program uses voice messages to spread the word about openings of women’s healthcare centers as well as education on maternal care and child-feeding practices. The project works with Bajenu Gox, known as “community godmothers,” to extend the amount of knowledge and power for young women through home visits and information on their healthcare during and after their pregnancy to reach women who do not have access to a cellular device. Voices mHealth program is a highly effective project in its ability to have immediate, trusted contact with Senegalese women living in both rural and urban communities.

  1. Le Korsa: Le Korsa is a nonprofit organization that empowers communities and healthcare centers in Senegal to improve their provided healthcare with grants and educational resources. One of the organization’s most impactful recent projects was in 2017 when Le Korsa began the renovation of the Tambacounda Hospital’s Maternity and Pediatric Units. The project is expected to finish in 2021, providing more enhanced and comfortable care to the 47,000 annual visitors.

  1. Bajenu Gox Project — Action Et Developpement: The Action Et Developpement organization in Senegal has made major strides in having increased community inclusion and education on women’s healthcare with a global lense. Partnering with the Bajenu Gox of the Kaolack, Fatick, Saint Louis, Louga and Dakar regions in 2015, the Bajenu Gox project has brought new, needed knowledge to rural and urban Senegal. The Bajenu Gox in these locations are now trained on how to talk about the prevention of  STI’s and HIV/AIDs in their local communities. They are bringing a new wave of education to young women and forever changing the empowerment of women in Senegal through awareness of their rights.

With the remarkable breakthroughs in women’s reproductive healthcare in Senegal, women now have access to centers and initiatives. The foundation for a new perspective, action and approach towards the autonomy of a women’s health and reproductive system in Senegal is now able to grow and flourish.

– Nicolettea Daskaloudi

Photo: Flickr

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NGO Working to Reduce Maternal Mortality in Nigeria

Marie Stopes International Nigeria recently donated almost 1,500 units of the medication misoprostol to the Nigerian state Nasarawa. This donation will hopefully reduce maternal mortality in Nigeria, which, in Nasarawa, is higher than average. The donated misoprostol cost one million Nigerian Naira altogether, approximately $2,580.

What is Marie Stopes International?

Dr. Tim Black founded the current Marie Stopes International in 1976 when he purchased and revitalized the Marie Stopes Clinic in London, named after the late Dr. Marie Stopes. A year later, Dr. Black and his wife opened a clinic in Dublin, followed by another in New Delhi.

MSIN first came to Nigeria in 2009. These clinics provide ultrasounds, testing for pregnancy and sexually transmitted infections, counseling, and other related forms of reproductive healthcare. As of 2018, the Non-Governmental Organization has helped more than three million women in Nigeria alone, and Marie Stopes has opened clinics in 37 countries around the world. The NGO’s Nasarawa State Clinical and Training Officer Nathaniel Oyona praised Marie Stopes’s decision to “support the government by assisting pregnant women especially those that cannot afford to pay their bills.”

Why is Maternal Mortality in Nigeria So High?

A study from 1985 to 2001 at the University of Jos found that hemorrhage after delivery caused most maternal deaths, followed by sepsis and eclampsia. Furthermore, in 2015, Nigeria registered around 58,000 maternal deaths resulting in a maternal mortality ratio of more than 800 maternal deaths per 100,000 live births. By comparison, the WHO cited that the 46 most developed countries in the world had a maternal mortality ratio of 12 deaths per 100,000 live births in the same year.

As of 2017, childbirth causes the deaths of 7% of women in Nasarawa each year. Nasarawa’s shortage of medical staff, equipment and medicine means that many women do not trust the birth centers. Instead, many women choose to give birth at home without a doctor present. However, home births can pose problems if complications arise, such as a postpartum hemorrhage. Unfortunately, this situation leaves many pregnant women without proper access to much needed medical care.

How Does Misoprostol Help Maternal Mortality in Nigeria?

Misoprostol is an oral medication with multiple uses that can lower the chance of hemorrhage after childbirth. Various studies have found that misoprostol can reduce postpartum bleeding by 24% to 47%. Because misoprostol is taken orally, it is easy to distribute and administer. Heat exposure will also not negatively impact misoprostol’s effectiveness. Misoprostol’s versatility makes it useful for women who choose to have a home birth or lack access to birth centers.

MSIN specified that the 1,497 packs donated are earmarked for women without the means to afford postnatal care. The Commissioner for Health in Nasarawa confirmed the misoprostol will be distributed accordingly.

What Are the Next Steps to Fight Maternal Mortality in Nigeria?

Though the donation of misoprostol is a welcome short-term solution, long-term reform is needed to reduce maternal mortality in Nigeria. Since 2011, the government of Nasarawa has shifted to the Nigerian State Health Investment Project, in hopes of rebuilding trust with clinics and hospitals and giving better care to patients. The government has since granted multiple facilities in Nasarawa updated medical equipment and a better supply of necessary drugs. These reforms have caused a positive change in clientele and productivity.

As for Marie Stopes International, the NGO will continue to open clinics worldwide and train local people to provide reproductive healthcare. Through their social franchise networks, MSIN staff train Nigerian doctors and nurses to provide better reproductive healthcare and counseling in their facilities. Once local healthcare providers complete their program, MSIN gives them the medicine and other materials they may need for their practice. In Nigeria, 200 franchisees have completed the MSIN training program.

Though more work is necessary to combat maternal mortality in Nigeria, misoprostol has proven to be an accessible and effective tool to help prevent postpartum hemorrhage in women. This is one step in a larger plan to rebuild trust in the healthcare system and reduce maternal deaths in Nigeria.

– Jackie McMahon
Photo: Flickr

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Top 5 Facts About Women’s Health Care in Cambodia

Women’s Health care in CambodiaThe Southeast Asian nation of Cambodia is currently experiencing its worst in maternal mortality rates. In Cambodia, maternal-related complications are the leading cause of death in women ages 15 to 46. The Minister of Health has created several partnerships with organizations such as USAID to help strengthen its healthcare system. Here are five facts about women’s health care in Cambodia.

Top 5 Facts About Women’s Health Care in Cambodia

  1. Health Care Professionals and Midwives
    USAID has provided a helping hand when it comes to educating healthcare professionals and midwives. Since USAID’s partnership with the Ministry of Health, USAID has helped raise the percentage of deliveries assisted by skilled professionals from 32 percent to 71 percent. The Ministry of Health was also able to implement the Health Sector Strategic Plan to improve reproductive and women’s maternal health in Cambodia.
  2. Health Care Facilities
    Between 2009 and 2015, the number of Comprehensive Emergency Obstetric and Newborn Care (CEmONC) facilities increased from 25 to 37. With more access and an increase in healthcare facilities, 80 percent of Cambodian women are giving birth in health care facilities.
  3. Postpartum Care
    The Royal Government of Cambodia renewed the Emergency Obstetric & Newborn Care (EmONC) Improvement Plan and extended the Fast Track Initiative Roadmap for Reducing Maternal and Newborn Mortality to 2020. This aims to improve women’s health care in Cambodia to improve the lives of women living with postpartum depression. It is also used to improve newborn care and deliveries.
  4. Obstetric Care
    Obstetric care has improved rapidly. According to a 2014 Cambodia Demographic and Health Survey, 90 percent of mothers receive obstetric care two days after giving birth, and three-quarters of women receive care three hours after. Intensive obstetric care has helped drop Cambodia’s maternal mortality rate significantly. In 2014, Cambodia’s maternal mortality rates decreased from 472 deaths per 100,000 live births in 2005 to 170 deaths per 100,000 live births.
  5. U.N. Women
    U.N. Women is working closely to help address the AIDS epidemic in Cambodia. The organization’s efforts to reduce the epidemic focus on protection and prevention. In 2003, 3 percent of Cambodian women reported being tested for AIDS. It has also been observed women in urban areas are more likely to get tested than those in rural areas. Ultimately, Cambodia has set a goal to eradicate AIDS from the country by 2020 through prevention and protection.

Cambodia has seen much economic growth over the years, but the money provided for health care is minimal. Consequently, it is difficult for the government to provide all services. However, there have been great strides in improving women’s healthcare in Cambodia. By fighting to better the lives of women, the Cambodian government has set a goal to establish universal health care by 2030.

– Andrew Valdovinos
Photo: Flickr

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Addressing the Top Five Causes of Maternal Mortality

Top Causes of Maternal Mortality
Maternal mortality often increases in countries where poverty levels are high. According to the World Health Organization, 99 percent of maternal deaths occur in developing countries. This is because women do not always have access to sanitary birthing conditions, proper doctors or procedures for remedying labor complications.

However, some causes of maternal mortality are much more prominent than others, taking the lives of mothers every day. These are the top five causes of maternal mortality:

  1. Hemorrhaging, typically postpartum, claims the largest number of lives out of all the causes of maternal death. According to UNICEF, 27 percent of all maternal mortalities are due to hemorrhaging.Postpartum hemorrhaging refers to extremely heavy bleeding after giving birth. This bleeding should stop relatively soon as the uterus contracts to push out the placenta but if the contractions are not strong enough, blood may flow freely, causing a hemorrhage. Medical solutions to postpartum hemorrhaging may include getting a blood transfusion, which is incredibly difficult in remote and low-income parts of developing countries. 
  2. The existence of pre-existing conditions that are aggravated by pregnancy is the second leading killer of mothers during labor. There are many medical conditions that, when coupled with pregnancy, can cause death. In many cases of maternal mortality, mothers are unaware of pre-existing conditions or they are unable to access safe abortions because they are illegal or too expensive in their country.
  3. Hypertension during pregnancy is when a woman has high blood pressure during pregnancy. If it continues beyond week 20 of the pregnancy, it can lead to preeclampsia, causing complications for both mother and child. Preeclampsia can cause maternal mortality if not recognized and treated quickly.
  4. Maternal sepsis, also known as blood poisoning, is the body’s natural response to an infection, but it can quickly overwhelm the body’s functions and make it unable to cope. According to UNICEF, maternal sepsis claims eleven percent of maternal mortalities.Sepsis does have early warning signs, but these can be hard to notice and the situation can quickly become dangerous. In areas where access to antibiotics is limited, where it is difficult to reach a hospital quickly or where doctors are not properly trained, maternal sepsis may go unnoticed or untreated, resulting in maternal mortality. 
  5. Unsafe or unsanitary abortions are responsible for eight percent of maternal mortalities. In low-income or developing nations, abortions may be illegal, forcing pregnant women to turn to homemade abortions or local methods. Often times, abortions that are done without proper techniques, tools or sanitation lead to infection and eventually death.

These are the top causes of maternal mortality, all of which can be remedied through increased funding and accessibility to proper medical facilities in developing nations. More often than not, women are left without the money or access to solutions for their medical issues, perpetuating the cycle of maternal mortality.

– Liyanga de Silva

Photo: Flickr