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India Doubles
The Indian Parliament has recently passed a bill that more than doubles the nationally mandated paid maternity leave from 12 weeks to 26 weeks. The policy change makes India the country with the third-longest paid leave for mothers in the world, trailing behind only Norway and Canada. The new requirements for paid maternity leave in India will expand opportunities for many women.

The bill requires implementation in businesses with more than 10 employees. In a country that has been previously criticized for its lack of gender equality, the bill is revolutionary to the growing economy. The new legislation also requires businesses with more than 50 employees to provide nurseries for childcare in close proximity to their offices.

The months following the birth of a child often call for a reassessment of finances and economic security. Families in developing communities can be hit especially hard by new expenses.

In the U.S., no federal law requires employers to provide paid leave for new parents. Only a few U.S. states have legislation that addresses the issue. This lack of legislation is often harmful, and the Census Bureau reported in 2011 that more than 40 percent of new mothers are forced to take unpaid leave. Human Rights Watch has also conducted studies on the impact of a lack of paid leave for new parents in the U.S. After conducting in-depth interviews with 64 American couples, the organization found that just more than a third of the families had gone into debt in the months following the birth of a child.

Activists have stated that the extension of paid maternity leave in India will encourage women to more deeply explore potential economic opportunities. A survey that was released last year by the Associated Chambers of Commerce and Industry of India brought to light the fact that a quarter of Indian women in urban areas quit their jobs after having their first child. Hopefully, the new bill will help lower this number.

The Indian Prime Minister, Narendra Modi, expressed on social media that the new bill is a “landmark moment in our efforts towards women-led development.” The Minister of Women and Child Development, Maneka Gandhi, says that the law will “help thousands of women and produce much healthier children.”

In terms of social norms and gender stereotypes, India has a long way to go before women are on the same playing field as men. The extension of paid maternity leave in India has the potential to encourage economic participation from women across the country, and hopefully, it will do just that.

Not only will the law help women in India, many are additionally optimistic that it will inspire other countries to follow suit.

Peyton Jacobsen

Photo: Flickr

Maternal Health in Haiti a Concern For UNFPA
The U.N. Population Fund has expressed concern over the effects that Hurricane Matthew will have on the more than 8,400 pregnant women in the country and those who will need cesarean sections or other maternal care. It has pledged to make maternal health in Haiti a key aspect of its response to Hurricane Matthew.

The organization has pledged to send 252 emergency reproductive health kits to 450,000 people in the next three months. These kits will include resources such as medicine and supplies for safe deliveries, rape treatment and voluntary family planning. The organization also plans to certify local midwives through their own UNFPA supported schools and to open clinics that these midwives will staff. In total, UNFPA hopes to raise $5 million for this project.

UNFPA Executive Director Dr. Babatunde Osotimehin explained the necessity for the project, stating, “Hurricane Matthew delivered a severe blow to Haiti’s health facilities, whether by flooding these centers or blowing off their roofs and putting them out of service. Our urgent task is to protect the health and rights of women and girls and to ensure that their basic needs, which are often overlooked in humanitarian situations, are quickly met. We will work to help women give birth and live, despite this tragedy.”

Maternal health in Haiti has been an issue in the country since well before Hurricane Matthew. Haiti has the highest maternal and infant death rates in the western hemisphere and, in light of Matthew’s aftermath, these rates are expected to rise. UNFPA warned in a press release that an estimated 13,650 women are expected to give birth in the next three months, and the storm’s destruction of many healthcare facilities on the island has raised serious concern among human rights groups.

According to the World Health Organization, approximately 830 women die each day from causes related to pregnancy and childbirth, and 99 percent of these deaths occur in the developing world.

Adolescent pregnancies are very common in Haiti, and since family planning has been interrupted by the storm, such pregnancies are expected to rise in the next few months. According to a 2012 survey, approximately 11 percent of adolescent girls in the country have at least one child.

Magdala Bourdeau, a midwife in Haiti told UNFPA, “Since November 3, we have carried out several deliveries and received several types of pathologies, such as pre-eclampsia, severe anemia, high blood pressure and premature pregnancies.”

Dr. Joanne Liu, the international president of Médecins Sans Frontières, reports that the five main causes of maternal death include hemorrhage, sepsis (infection), complications resulting from unsafe abortion, hypertensive disorders and obstructed labor. Such conditions are usually preventable with access to medical care, but maternal death rates remain high in areas where disaster or conflict has limited access to such care.

The U.N. Population Fund aims to protect maternal health in Haiti and hopes to raise the $5 million that it needs in time to do so.

Eva Kennedy

Photo: Flickr

Mother's Delivery Kits Provide Affordable Birthing Supplies
After a close friend died during childbirth, Adepeju Jaiyeoba founded the Brown Button Foundation, an organization in Nigeria that trains birthing attendants in 2011.

Training the birthing attendants led Jaiyeoba to another realization: the supplies being used to deliver babies often were not sterile and posed hazards to the health of both the mother and baby. In response, Jaiyeoba started the Mother’s Delivery Kits in 2013, a for-profit company that provides affordable birthing kits with safe and sterile equipment.

Jaiyeoba intended for her kits to be used as a safe alternative. However, it is not uncommon for dangerous practices to be used when health care practitioners and families lack access to safe and sterile birthing tools.

This is especially common in rural Nigeria. For example, traditional birth attendants may cut the baby’s umbilical cord with a rusty blade or suck mucus out from the baby’s nostrils to prevent them from asphyxiating. Both practices can lead to infection. In contrast, the Mother’s Delivery Kit provides sterilized scalpel blades and a mucus extractor along with another 13 to 15 sterilized delivery tools.

Development of the Mother’s Delivery Kit has been so influential that Jaiyeoba was recognized by President Barack Obama during the Washington Fellowship for Young African Leaders Presidential Summit in 2014 for her ventures.

Mother’s Delivery Kits provides birthing kits for health centers, hospitals, university teaching hospitals, maternal and child health organizations and Traditional Birth Attendants. They have about 205 attendants and institutions that have registered for a consistent supply. Over 7,500 kits were sold in the first year alone. Such use has yielded a 100 percent safe delivery record.

As of 2015, 11,000 kits have been delivered. This life-saving company hopes to continue expansion through Nigeria and franchise their model to other organizations in countries with similar problems of high maternal and infant mortality rates during childbirth.

Laura Isaza

Photo: Flickr

Health_mother_ Child Mortality
USAID is working with the Ethiopian government to reduce maternal, neonatal and child mortality rates, according to their website. Ethiopia has one of the highest rates of maternal deaths in the world.

“Women have a one-in-52 chance of dying from childbirth-related causes each year,” according to USAID. “Every year, more than 257,000 children under the age of five die and 120,000 die in the neonatal period. More than 60 percent of infant and 40 percent of under-five deaths in Ethiopia are neonatal deaths.”

This dire situation calls for extensive health care services. Ninety percent of Ethiopian women give birth in their homes in order to observe cultural traditions and be surrounded by company they trust. Health facilities can spread awareness about the value of institutional delivery in decreasing mother and child mortality rates; many mothers have never heard the benefits of skilled birth attendance and postnatal care.

Preventable complications like hemorrhage, infection, unsafe abortion, hypertensive disorders and obstructed labor are to blame for 80 percent of maternal deaths.

USAID has intervened in family, community and facility care by increasing accessibility of health services. A health extension program includes basic obstetric and newborn care, essential newborn care, management of neonatal and childhood illnesses, coverage of immunizations and the early identification and treatment of sick children, all of which go a long way to decreasing the child mortality rate.

Additionally, they funded the Integrated Family Health Project, an activity that seeks to promote and strengthen family planning and maternal, newborn and child health practices and services. With the cooperation of health programs throughout Ethiopia, the IFHP impacts about 40 percent of the country’s entire population.

The Health Ministry and various organizations provide health facilities with ambulances, equipment and skilled staff. The majority of communities in Ethiopia lay in rural regions that place women in a vulnerable position when a complication arises during childbirth, and many fatalities occur in the transfer to a health facility.

The Government of Germany recently contributed 10 million euro to UNICEF, bolstering its emergency response to drought affected regions in Ethiopia. This support will provide life-saving assistance to severely malnourished children and pregnant and lactating women. Lack of nutrition threatens close to half of a million children under the age of five and nearly 140,000 lactating women in the Somali area.

By providing preventive, promotional and basic curative health and nutrition services to mothers, infants and young children, USAID and other organizations like UNICEF are saving lives and combating illness and disability.

Emily Ednoff

Photo: Flickr

Destigmatization of Breastfeeding in Urban India
World Breastfeeding Week is celebrated internationally every year from August 1-7th. Each year, there are various events and activities intended to educate about the benefits and encourage the practice. The theme this year was ‘Women and work – Let’s make it work.’ This year, added emphasis was placed on advocating for widespread maternity leave and other accommodations for working mothers.

Many organizations such as UNICEF, World Health Organization (WHO), and the Breastfeeding Promotion Network of India (BPNI) have worked both independently and jointly with the Indian government to provide information and spread awareness throughout the country. The breastfeeding rates are higher in the rural Northern states than the urban South.

UNICEF Nutrition Specialist, Gayatri Singh states, “The government of India has laws, policies and programmes to protect, promote, and support breastfeeding. UNICEF supports national and state governments in the development and implementation of infant and young child feeding policies and plans for promoting optimal breastfeeding.”

Singh goes on to say, “Communication and advocacy activities on breastfeeding are also a key component of UNICEF’s support. We also support governments to design of strategies for social and behavior change communication and in the implementation of the strategies through multiple communication channels.”

In an effort to promote breastfeeding, the Indian government enacted the Infant Milk Substitute (IMS) Amendment Act in 2003 which prohibits any form of advertising claiming newborn formula as an equivalent option.

“In India, between 2006 and 2013, there has been an improvement in the breastfeeding rates. The latest data shows that 44.6 per cent children are put to breastfeeding within one hour of birth and 64.9 per cent children under six months of age are exclusively breastfed,” states Singh. He goes on to add that while knowledge of health benefits appear to be even higher, there are societal factors hindering the practice.

Dalvinder Kaur, a public relations specialist, states, “A lot of people, while thinking of breasts, automatically think of sex, as if that’s their primary reason for existence. I feel that it is pretty much the heart of the matter. Women’s breasts are often defined as sex objects–and nothing more. And since sex is basically a taboo in the public realm, breastfeeding ends up being perceived as some sort of indecent, out-of-bounds behavior.”

Dhanya Ranjit, a software engineer and mother speaks on the stigma attached to breastfeeding, “Women find it difficult to breastfeed and more so, to nurse in public because of the lack of support from any quarter. They also don’t see it happening around them. While I was very hesitant to breastfeed my older child in front of others but the encouragement and exposure to information through the Facebook support groups made me realize that it is as natural as an adult eating food in public.”

As is the case with many social movements, the internet can be utilized very effectively to raise awareness and garner support. “Big Latch On” is an international gathering that occurs in many cities during World Breastfeeding Week and event calls for mothers to join together publicly and breastfeed together. Through a social media campaign, a “Big Latch On” event was held this past August 1st in Hyderabad, Telangana, India. The organization started in New Zealand, but has spread to many countries around the world.

Recent attempts at normalization in mainstream media have begun to manifest themselves as well. Indian cinema has begun to prominently display breastfeeding such as in the recent blockbuster movie Baahubali. The highly anticipated film cost $40 million and is the most expensive movie in Indian history. Whether purposeful or not, the display of breastfeeding in such a popular film shows marked progress towards shifting attitudes of the viewers.

Frasier Petersen

Sources: India Times, Jantaka Reporter, IBN Live
Photo: Flickr

Maternal_and_Child_HealthDuring the 2015 Call To Action Summit, health ministers and global experts take a look at the progress that has been made. USAID has helped save the lives of an estimated 2.5 million children and nearly 200,000 mothers since 2008.

It has been a little over a year, in June 2014, since USAID introduced its newest strategic plan for maternal and child health. They hope to prevent the deaths of 15 million children and 600,000 mothers by 2020.

At the summit the participants reviewed the impact the USAID’s support has had all around the world; often putting a name and a face to those benefitting from the aid provided.

In India, mothers like Satyawati now know how to best take care of their newborns and other children thanks to the ability to obtain health-related knowledge and help from a local health worker.

Because Satyawati has access to this information, she has had her children properly vaccinated and employs proper hygiene practices in her home. In 1990 in India, children under the age of five had a mortality rate of 126 per 1,000 live births but in 2013 that number has been reduced to 53 per 1,000 live births.

Also, thanks to the support of the USAID, 27 hospitals in Malawi now have a device called a Pumani bCPAP that helps newborns with underdeveloped lungs breathe until they can do so own their own.

This device has tripled the survival rate of babies like Gloria Mtawila’s son Joshua, who stayed on the machine for a month until he could breathe on his own and is now a completely healthy baby.

All across the world bundles of joy are being born to tired but radiant mothers. Hospital staff assures that both have the best possible care in these first crucial hours, days and sometimes weeks after childbirth.

But also all across the world there are mothers on makeshift cots or laying on dirt floors. They and their babies do not have dedicated hospital staff looking after them.

Mom did not have access to prenatal vitamins and baby may not have access to life-saving vaccines. With poor living conditions, poor pre and post-birth care, and a poor quality of life all around, mom and her little one may not make it.

This is what USAID is working to prevent. USAID’s maternal and child health programs focus on cost-effective initiatives such as enabling access to nutritional supplements and vaccines.

The USAID has achieved great success. Maternal death rates have decreased by five percent in each of its 24 target countries while child mortality rates went down by four percent.

But this is still not enough. The USAID hopes to receive $850 million in funding for the maternal and child health program in order “to reduce child mortality to 20 or fewer deaths per 1,000 live births in every country by 2035, and to end preventable maternal deaths” (interaction.org).

Through this initiative, the USAID has inspired developing countries to develop strategies to reach these goals, and make the eradication of unnecessary maternal and child deaths possible.

Drusilla Gibbs

Sources: USIAD, Interaction, Call to Action
Photo: Google Images

saving Premature Babies
Malawi has the highest percentage of pre-term births in the world at more than 18 percent of live births. Pre-term babies are those who are delivered at less than 37 weeks of gestation. Complications that arise from such an early birth are the leading cause of death for children less than 5 years old. Nearly 1 million children died of preterm birth complications in 2013.

According to the World Health Organization, “Malawi faces a number of challenges including inadequate finances to support poverty reduction programmes; high levels of illiteracy; and critical shortage of capacity in institutions implementing development programmes.”

As a low-income country, Malawi is lacking in quality medical care for pre-term babies. However, the care available for pre-term babies is improving. The decrease in child mortality rate has the country as the first of its neighbors to achieve the Millennium Development Goal 4, a goal set by the United Nations to decrease the number of under-five child mortalities by two-thirds.

The Malawian government recently initiated the Every Newborn Action Plan in 2014, with a commitment to reduce the chances of neonatal mortality from 31 out of 1,000 to 25 out of 1,000 by the year 2020.

One of the low-cost ways pre-term babies in Malawi have been cared for recently has been through the Kangaroo Mother Care intervention plan. This method incorporates the skin-to-skin contact between mother and baby to keep the baby warm and breastfed. This helps monitor the baby’s temperature and encourages rapid weight gain, which is crucial for the baby’s health.

There are more than 120 Kangaroo Mother Care units in Malawi and at least one in each district. Kangaroo Mother Care is especially effective in low-income countries such as Malawi when incubators are hard to come by and are extremely expensive.

Another cost-effective solution for pre-term complications is the bubble continuous positive airway pressure device designed by engineering students at Rice University, Texas.

The device is called Pumani, a word meaning breathe in Chichewa, a Malawian language. It is used to help pre-term babies whose lungs have not yet fully developed and has saved more than 1,000 pre-term babies since 2006.

With the implementation of these low-cost methods to care for pre-term babies, pre-term babies in Malawi have a better chance of survival than ever before.

Iona Brannon

Sources: World Health Organization 1, World Health Organization 2, World Health Organization 3, Healthy Newborn Network 1, Healthy Newborn Network 2
Photo: Pexels

Wood for Haitian Maternal Health Care
The island nation of Haiti is the poorest country in the Western Hemisphere, with one in four inhabitants of this small Caribbean nation living in extreme poverty. Plagued by political instability, as well as the devastating aftermath of the 2010 earthquake, the country of Haiti is still struggling for recovery.

In the wake of the worst earthquake in a 200-year history for Haiti, an estimated 1.5 million people were left homeless. The rehabilitation process for the affected population is crippled by the financial hardships of the country. According to a World Bank report, one in two Haitians live in poverty, living on less than $3 a day.

The extreme poverty conditions in the country have unsurprisingly affected the healthcare system as well. The insufficient healthcare system was dealt a further blow after the earthquake of 2010, which is estimated to have destroyed 60 percent of the healthcare infrastructure in Haiti.

The deterioration of the healthcare system has especially affected the maternal and neonatal health in the country. According to UNICEF, maternal mortality in Haiti is 35 women out of every thousand; neonatal health care is equally abysmal, with 3.1 percent of newborns dying within the first month after birth.

Most of the maternal and neonatal deaths are considered largely preventable, given adequate healthcare resources. Accessibility to these resources is another important issue, with less than 36 percent of pregnant women giving birth in any healthcare facility.

The poor state of maternal health has spurred Maternal Life International — a nonprofit organization based in Montana — to direct its efforts for better maternal and neonatal health care at Haiti. Its objective is to build family health offices in the country to assist pregnant women and newborns.

As laudable as its mission is, it is faced with the difficulties of resource scarcity in Haiti. The lack of lumber in Haiti is a major obstacle in rebuilding the country.

The deforestation of Haiti has long been an issue of concern for the island nation, affecting the economic and ecological health of the country. Wood is quite significant for building structures in Haiti, as cement buildings are a danger in a region susceptible to earthquakes.

The volunteers for Wood for Haiti have a solution to the problem: lumber for the family healthcare facility building shipped straight from the forests of Montana. The group of volunteers from Missoula will assist in providing Maternal Life International procure 5 tons of lumber for construction of the family healthcare facility in Haiti.

The volunteers are working first to gather lumber in Butte, where Maternal Life International is based. The lumber is currently stored in a warehouse in Butte to be shipped to Haiti later when the construction projects begin.

The Wood for Haiti is a commendable effort by the Montana lumber industry. The donation of building materials is somewhat of a novel idea in an era of usually monetary donations. It does, however, provide for the delivery of natural resources, which Haiti needs but lacks.

It is not to say that lumber is all Wood for Haiti provides. It also provides vocational training to Haitians for the construction and rebuilding projects. With a combination of resource provision and training local labor, Haiti can be brought that much closer to economic stability.

The collaborative efforts of Wood for Haiti and Maternal Life International are anticipated to be a stepping stone toward improving the standards of maternal health in Haiti and ultimately conditions across the country.

Atifah Safi

Sources: MATR, UNICEF, Doctors Without Borders, Maternal Life International, CIA
Photo: Google Images

z1 Grunge Metal Surface
In March, the Government of Rwanda approved a bill granting mothers full compensation while on a 12-week maternity leave. If implemented, the Maternity Leave Benefits Scheme would increase maternity coverage by 80 percent for the second half of their leave from the workplace.

Throughout the spring, the bill moved through parliament but was temporarily tabled in the House because of other pressing issues. Members of parliament are set to discuss this important legislation in the next few weeks, though, according to an article in Equal Times.

Because of the current system, many Rwandan women on maternity leave return to the workplace after just six weeks because they cannot afford to lose 80 percent of their compensation for that time.

Minister of Finance and Economic Planning Claver Gatete said that the current plan is not conducive to supporting a mother and her child both socially and financially.

The new legislation will have employers compensating mothers for the first six weeks and a social security fund covering compensation for the second six weeks. As an insurance scheme rather than a government fund, the additional compensation will come from a new income tax.

Public and private sector employees will make a 0.6 percent contribution of their salary to the insurance scheme in order to cover the costs of this fund. Contributions are set to be taken through the existing Rwanda Social Security Board, but the scheme funds are set to be distinct from other social security funds.

There is widespread support throughout Rwanda for this legislation, many calling this bill “long overdue.” Dominique Bicamumpaka, president of the Congrés du Travail et de la Fraternité — Rwanda (CONTRAF) was quoted in Equal Times, explaining her and other campaigners’ support for this legislation.

“[CONTRAF was] involved in the whole process and we encourage all the citizens to embrace this new initiative wholeheartedly because when a woman gives birth, it is not only for the family but also for the society,” she said.

If adopted, this bill will improve living conditions for mothers and their newborns, while also giving mothers more value and credibility in Rwandan society.

Many Rwandans consider this legislation a major step toward improving working conditions for women throughout the country. However, advocates such as Andre Mutsindashyaka, secretary general of the Rwanda Extractive Industry Workers Union, hope that this is just the first step of many other adjustments in making the workplace more mother-friendly.

“We are trying to make it easier for mothers, especially those nursing, by finding ways how they can work but also look after their babies,” he was quoted in Equal Times.

“So far, there is a plan that we hope to launch in five years, which will see each office have a daycare centre where mothers can breastfeed their babies. So far, some places like [the Rwandan Tea Authority] are providing [daycare facilities] and we hope that eventually, every office can do the same.”

Arin Kerstein

Sources: All Africa, Equal Times, Republic of Rwanda

Twin_births
Multiple births, two or more babies born at the same time, are a relatively small percentage of all the births worldwide. Twins represent only 3.3 percent of births in the United States (CDC) and, depending on the global region looked at, the rate is even lower in the developing world.

But even with such small numbers, twin births can present a large health concern for both mother and unborn children alike. The risks are even more pronounced in the developing world.

Twins have a much higher chance of being born prematurely, and they can be underweight, which often leads to more time in the NICU. Also twin-twin transfusion, “when identical twins share a placenta and one baby gets too much blood flow, while the other baby doesn’t get enough,” is a possibility. The most startling statistic is that in the developing world, “among stillbirths, the proportion of twins is probably somewhat higher than among live births, as fetal (and neonatal) mortality is higher among twins.”

Complications rise when mothers do not receive adequate prenatal care. Women in the developing world often do not receive enough care when they are pregnant with a single child, let alone the need for additional monitoring and ultrasounds when having a multiple birth.

A study conducted in urban Guinea-Bissau found that “sixty-five percent (245/375) of the mothers who delivered at the hospital were unaware of their twin pregnancy.” Sometimes a mother will not measure larger than average to indicate a twin pregnancy, a second heartbeat is not always discernable, and/or bloodwork is not drawn to measure hCG (pregnancy hormone). Even if any of those previous criteria were met, only an ultrasound can confirm a multiple birth.

The unborn children are not the only ones at risk; mothers also face pregnancy complications at a higher rate when carrying multiple children, like pre-term labor, anemia, gestational diabetes, preeclampsia, hyperemesis gravidarum (severe morning sickness), polyhydramnios (too much amniotic fluid), miscarriage/stillbirth, postpartum depression and postpartum hemorrhage.

While these issues have the possibility to effect all mothers experiencing a multiple birth, the complications can be exacerbated when they live in poverty. Access to a hospital for an emergency may not be possible, especially in regions that are remote. Finances to afford a hospital stay can also be an issue, especially since many multiple births are delivered through c-section.

A 2008 study done in a rural mission tertiary hospital in Nigeria found that of the twin deliveries that happened there, 60 percent of the twins were delivered c-section, 36.4 percent were vaginal deliveries and the remaining 4 percent had vacuum deliveries. C-sections are often performed due to emergencies, premature delivery and fetal malpresentation.

Even though it seems like twin pregnancy is bleak, the opposite can be true. The UN’s fifth Millennium Development Goal is to improve maternal health. While multiple births are not specifically addressed, the positive improvements to help mothers and their unborn babies will also help those pregnant with twins. Multiple births must be monitored as a high-risk pregnancy but not all (or any) complications may occur. But with improved medical care, when those complications do arise they can be addressed and the rate of stillborn twins can decline even further.

Megan Ivy

Sources: NIH 1, CDC, March of Dimes, UN, NIH 2, NIH 3
Photo: Babies Magz