Free Healthcare for Women and Children in Sierra Leone

In April of 2010, Sierra Leone implemented a policy of free healthcare for pregnant women, breastfeeding mothers, and children under five. The policy has reduced mortality rates for pregnant women and deaths from malaria for small children.

Robert Yates, a senior health economist in Britain’s Department for International Development said the results in Sierra Leone have been “nothing short of spectacular.” His figures suggest a 214 percent increase in the number of children under 5 getting care at health facilities, a 61 percent decrease in mortality rates in difficult pregnancy cases, and an 85 percent drop in the malaria fatality rate for children.

Government figures show that since the introduction of the initiative, more women are accessing antenatal care and delivering their babies in health facilities. However, many women continue to face serious challenges in accessing the drugs and medical care crucial for safe pregnancy and childbirth. An Amnesty International report, At a Crossroads: Sierra Leone’s Free Health Care Policy, revealed that many women are being charged for the care they receive. The report called upon Sierra Leone to strengthen and establish systems of monitoring and accountability to ensure health care interventions are accessible to women and girls and to guarantee their access to effective remedies for violations of their human rights.

Although challenges remain, the new policy has dramatically improved material health within Sierra Leone.

- Madeline R. Lee 

SOURCE: New York Times 

A Ugandan Midwife's Mission to Save Lives

Another miracle is brought into this world in the Katine village of North East Uganda.  New mother, Priscilla Alupo, smiles from ear to ear as she eagerly shows off her new son, George, to visitors.

Esther Madudu, one of three midwives at Tiriri health center, helped to deliver George along with the births of four other babies all in a single night's shift.  Midwife for 11 years, Madudu, 31, is passionate about what she does.  "I love talking about the mothers I help deliver.  We deliver 45 to 50 mothers every month, so I save 45 to 50 mothers and babies a month."  During her time at Tiriri, no mother has died during childbirth.

The problem here lies in the condition of the center.  Giving birth at night is a bit difficult with no electricity. So how do these women overcome this hurdle?  Well, they use the light cast by mobile phones, which are held in their mouths to ensure the beams are directed where needed.  The damage that has taken place eight years ago to the Katine village has left the health center no power supply, but fortunately their water source is still in tact.

Scheduled to attend the Women's Forum Global meeting, in Deauville, France, Madudu will address delegates about her work and the health challenges faced by women in Africa.  With the launch of her campaign, Up for African Mothers, coming up, the severity of this continent's high maternal mortality rates will hopefully raise the much needed political attention.  Looking on a larger scale, it goes without saying that the millennium goals to reduce death rates among women and children in these poor countries will not be met by 2015 if the sufficient funds aren't received.

Here are some statistics to think about:

• An estimate of 358,000 women die in pregnancy or childbirth every year due to lack off access to basic medical care or trained staff
• Majority of deaths occur in sub-Saharan Africa
• 70% of women don't receive prenatal care and half of all deliveries take place at home without medical assistance

In a rural village like Katine, the wages are low and the housing is inadequate.  Yet, these factors are looked past.  "When you love your work and want to save lives of mothers, you go there.  That's why I stay in Tiriri.  The pay is little, but God pays me because I know I have saved lives," explains Madudu.  Within the next few years, she will travel the world to promote the African mother's campaign.

"My dream was to save lives. When you hear a baby cry on delivery, everyone begins to rejoice."

- Esther Madudu, Midwife and Advocate

-Georisa Chang

Source: The Guardian

Innovative Ways To Deal With Maternal And Infant Mortality

Two of the most important issues in Millennium Development Goals (MDGs) are maternal and infant mortality. More than 350,000 women still die each year around the world from complications of childbirth, and 3 million children die in the first month of life which makes these issues a grave one. A new report from the U.N.'s Every Woman, Every Child Innovation Working Group presents some of the most capable and innovative projects that could help tackle these problems. The report sheds light on five interesting projects in developing region that other countries could use as models in fighting against high maternal and infant mortality.

Project: ColaLife, Zambia

The first one is Project ColaLife of Zambia which is a time and space saving project dealing with health supplies. ColaLife takes advantage of Coca-Cola's extensive supply chain to provide isolated communities in rural areas of developing countries with essential medical supplies. The medical supply kit filled with basic health supplies can fit into any unused crate space of Coca-Cola and are delivered to local contacts when beverage supplies are distributed. ColaLife is currently working on an anti-diarrheal kit that would carry rehydration salts, soap, water treatment tools and educational materials as Diarrhea, a preventable and treatable disease is one of the leading causes of death for children under five in the developing world.

Project: HERproject, Bangladesh, China, Egypt, India, Mexico, Pakistan and Vietnam

HERproject (Health Enables Returns) trains female employees at their workplace to teach their peers about reproductive health, nutrition, infectious disease and other health issues. The project operates in more than 70 factories manufacturing everything from Levis to Microsoft in above mentioned seven countries. The project also connects women to health services, either by improving in-factory clinics or directing women to outside government services.

Project: Cell-Life, South Africa

This project takes advantage of cell-phone technology and provides assistance to HIV-AIDS programs. In South Africa, 40% of children under five still die from AIDS-related diseases, partially because many mothers do not complete the mother-to-child prevention programs by taking the medication correctly. Cell-Life developed a 10-week program of text message reminders designed to help mothers remember when to attend appointments, and give medication. The program also tells the mothers how to safely feed their babies. The result of the trial so far suggests that mothers using the SMS program are more likely to get their babies tested for HIV.

Project: LifeSpring, India

This program works in low-income families in India who cannot afford regular maternal and child healthcare. LifeSpring developed a chain of hospitals for women who earn about between $3 to $6 per day. The facilities provide an all-inclusive maternal care package for about half or one-third what other private facilities might offer. The program breaks down complex processes into different tasks so that less-skilled professionals can perform some of the responsibilities.

Project: SMS for Life, Tanzania

SMS for Life is an innovative approach for dealing with shortage of medical supplies. A partnership between several private groups, including Novartis and the ministry of health in Tanzania designed the SMS for Life system in an attempt to end stock-outs. When a clinic in Sub-Saharan Africa runs out of malaria medication, it becomes a life-and-death issue for patients. It has been reported that SMS messages on stock levels, along with a data system used to map distribution helped reduce the proportion of health facilities reporting malaria medication shortages from 78% to 26% in just 21 weeks.

These are some innovative ways to deal with the maternal and infant mortality problems. Let’s hope that all countries dealing with these problems copy these models in their respective countries and achieve better results in future.

-Nisha Noor

SOURCE: PBS NEWSHOUR

Maternal Deaths in Bangladesh 40% Down

Maternal deaths in Bangladesh have declined from 322 per 100,000 in 2001 to 194 in 2010, a 40 percent decline in 9 years, according to a joint survey from Bangladesh Government, USAID, AusAID and UNFPA. This decrease in maternal and birth-related mortality is the result of several combined factors and efforts: better care seeking, successful family planning programs, improved access to and quality of referral-care, a scale up of emergency obstetric care, and increasing education of girls and women. This is a significant progress in the accomplishment Millennium Development Goal 5 (50%reduction in maternal deaths), and the possibility to completely fulfill this goal by 2015. Bangladesh has already been awarded by UN for its advances in other MDGs, particularly in number 4 (reducing child mortality).

Family planning and maternal health have been two development-related priorities for the government of Bangladesh. Several other international agencies and organizations have worked in these fields for more than a decade, so these results could be obtained. USAID in particular has focused its efforts in Bangladesh in family planning, girls' education, disease prevention and childbirth attention. According to Amanda Glassman, Director of Global health Policy, "the results are also a good reminder that investments in family planning and girls’ education drive much of maternal health outcomes, and that USAID investment in social marketing of family planning and health seems to be paying off in improved health."

- David Nebreda

SOURCE: USAID

Borgen Project

Saving Lives At Birth

During the critical 48 hours after the childbirth, 150,000 women and 1.6 million newborns die. This means that every 2 minutes, a woman dies in childbirth. Infection, hemorrhage, hypertension disorders, obstructed labor or child asphyxia are some of the multiple complications faced during birth. This problem is much more severe in poor countries, particularly in Sub-Saharan Africa and South Asia. In fact, a Sub-Saharan woman is 136 times more likely to die during childbirth than those living in developed countries. This is so important that not only one but two of the Millennium Development Goals (4 and 5) are actually involved in its solution.

To face this terrible issue, a new initiative has born. A partnership between the World Bank, USAID, The Bill and Melinda Gates Foundation, Grand Challenges Canada and the Government of Norway called "Saving Lives at Birth" will fight maternal and birth complications from a new perspective. To do so, they will rely on modern technologies, science and innovative approaches to prevention and treatment. The project will focus on three working areas: technologies to detect, prevent and treat maternal and newborn problems; service delivery of high quality care, including transportation of sick newborns or mothers, training, recruiting and retaining skilled or alternative personnel; and empowering and engaging pregnant women and families in prevention or health habits, including the search for care during childbirth.

If successful, this project will save thousands of lives by providing cheap and effective healthcare material for mothers and newborns, and also a better informed and engaged population. Media and information technologies have a core role in this program, since the role of individuals and societies is considered the base of the changes wanted.

- David Nebreda

SOURCE: Saving Lives at Birth official website

Tanzania Promises To Tackle Infant And Maternal Mortality

The Tanzanian Minister for Health and Social Welfare, Dr. Haji Mponda has vowed to reduce infant and maternal mortality in order to achieve Millennium Development Goals by 2015. The minister promised to reduce infant and maternal deaths by improving the health sector. It can be noted that Tanzania is still lagging behind other East African nations in terms of achieving the MDGs. According to UNICEF, the under-one infant mortality rate declined to 67 per 1000 live births in 2008 from 97 per 1000 live births in 1990. But the rate is still high compared to other nations.

-Nisha Noor

SOURCE: FIGO

Angola Plans To Reduce Maternal And Infant Mortality Rate By 2012

Carlos Alberto Masseca, the health deputy minister of Angola said that his government intends to reduce maternal and infant mortality rate by 50% next year. While addressing on "expansion of health services", in the National Forum on the Eradication of Poverty, the deputy minister said that the Angolan government is committed to achieve these goals by building new hospitals and improving existing central and local health services. The event was promoted by the Civil Office of the Presidency of Republic, and attended by members of parliament, government officials, governors and administrators.

-Nisha Noor

SOURCE: ANGOP HEALTH

Borgen Project

The Philippines Making Progress

After a long controversial battle with the Catholic Clergies the Reproductive Health Bill will finally be top priority for the up coming Legislative Executive Development Advisory Council (LEDAC). The Philippines has yet to make significant progress on the 2015 goals set by the Millennium Development Goals. Hopefully, the RH Bill is the push they need to get on the path in reducing infant mortality and improving maternal health.

The RH Bill will inform the people of their rights of parenting and the freedom of choice. “The bill is constitutional because it is consistent with the injunction against abortion and in fact would considerably reduce the incidence of abortion as unwanted and unintended pregnancies are avoided,” The Albay Lawmaker. In the November 2010 Pulse Asia Poll for or against the RH Bill, 69% accepted, 22% were undecided and only 7% disagreed with the bill. The majority of the Philippines are for accepting the bill and making progress in the battle to improve maternal and child health.

-Teal Peterson

SOURCE: Inquirer.net

Optimism for UN’s Promises on Maternal Health

According to a World Health Organization (WHO) report, a woman in Sierra Leone faces a 1 in 21 chance of dying during pregnancy or childbirth, whereas the risk of maternal mortality for a British woman is 1 in 4,700. The discrepancy between maternal health care in a developing country and a developed country is vast as you can tell.

The UN aims to save the lives of 16 million women and children by year 2015. This UN initiative is more promising than past initiatives because of the high level of government/political involvement. Countries of the G8 have committed to the cause as well as some developing countries who promised to make major policy and financial pledges. Afghanistan committed to triple public spending on health care. And Niger pledged to introduce legislation to lift the legal age of marriage to 18 and to increase female literacy.

The WHO will also create a timeline for progress on maternal health while a group of 25 appointed global leaders gather information for this report – which will also shed light on what countries are fulfilling their commitments, thereby holding them more accountable.

-Clare O.

SOURCE: The Guardian

Dear Mom. An Insight From the Womb

In school we learned that we are shaped primarily by our genes and the environment we grow up in. There is now a third aspect that shapes us. Believe it or not, researchers are finding indications that obesity, diabetes and mental illness among adults are all related in part to what happened in the womb decades earlier.

One indication of whether an adult would suffer from heart disease half a century after they were born is birth weight. Yes, scrawny babies are more likely to suffer from heart problems in middle age. Skeptic? Yes, so was everyone else. When that study was first published in 1989, there was plenty of disbelief. As we know, the fetal period is imperative for the babies' health later on. It also affects physiology decades later.

In studies conducted by researchers, the most striking finding is that poverty repeats itself because of a stressful uterine environment. What this means is that pregnant women who live in low-income areas are exposed to chemicals, toxins, pesticides, depression, anxiety, and pollution. In addition, they may be more likely to smoke or drink and less likely to eat healthy, take vitamin supplements, and ensure a proper pregnancy environment.

The result is children that start life at a disadvantage may be a part of the cycle of poverty. Children who face stress before birth appear to have "lower educational attainment, lower incomes and worse health throughout their lives (www.nytimes.com)."

Need proof?

"Stress in mothers seems to have particularly strong effects on their offspring, perhaps through release of cortisol, a hormone released when a person is anxious. Studies show that children who were in utero during the Arab-Israeli Six-Day War of 1967 were more likely to have schizophrenia diagnosed as adults. And The Journal of the American Medical Association reported that Chinese born during the terrible famine from 1959 to 1961 were twice as likely to develop schizophrenia as those born at other times.

As for obesity, Ms. Paul describes several British scientists who fed pregnant rats junk food: doughnuts, marshmallows, potato chips and chocolate chip muffins. The offspring of those rats turned out to have a sweet tooth as well: they were more likely to choose junk food when it was offered and ended up 25 percent fatter than rats whose mothers were fed regular rodent chow (www.blogger.com)."

Although there is significant research yet to conduct on this topic, there are precautions we can take. Keeping pregnant women out of areas that are highly polluted, are surrounded by toxins, and radiation exposure will help ensure the well-being of the child even before we have tested this for safety.

-Shereen Alibhai

SOURCE: NY Times

The Importance of Women's Health

Did you know that investing in women's health contributes to not only economic growth, but builds and secures nations? The launch of The Global Strategy for Womens and Children's Health can be found here.

Fact: Maternal deaths worldwide dropped 34% from 1990 to 2008, a decline attributed to increased training of midwives, strengthening of hospitals and health centers, among other factors.

Taking a closer look we see that the strategy focuses largely on the ways that already effective, qualified, and known services are delivered and implemented.This contributes to over 170 countries and organizations worldwide. Encouraging women to have better health care, take advantage of health services, and educating women on foundations and resources is just the beginning.

What's being done, you ask? "A diverse group of stakeholders, including the World Bank, pledged more than $40 billion toward the plan, which aims to prevent the deaths of more than 15 million children under five; 33 million unwanted pregnancies; and 740,000 women from dying from complications relating to pregnancy and childbirth, before 2015."

-Shereen Alibhai

SOURCE: Chicago NOW, World Bank Blog

Cell Phones Save Lives in Rwanda

The Rwandan government has created a program to give out hundreds of cell phones in an effort to help pregnant women and their babies. Almost 500 volunteer healthcare workers in Musanze, Rwanda have been given free phones in order to monitor expectant mothers. The workers send text messages with monthly checkup information to a central health clinic to which doctor's can respond back if there are any complications. In an emergency texts can be sent to the clinics. A response will be sent back quickly and an ambulance will arrive within minutes.

Before the cell phone system it could take up to an hour to get help. Rwanda is ranked among the world's worst for maternal mortality. Rwandan women mostly have their babies at home with untrained midwives, where many die from bleeding or infection. These issues are easily preventable with the right care. "We tend to lose people who are actually supposed to be developing this nation," said Dr. John Kalach, the director of the closest hospital in Ruhengeri. "We don't want to be in a nation where we lose pregnant ladies while they are giving life to others."

The program has been a big success. Since the program launched last year there have been no maternal deaths reported in the Musanze district, compared to reported deaths in 2008. According to UNICEF the next step will be to give out over 17,000 phones to health workers in charge of monitoring maternal health. Eventually they plan to distribute 50,000 phones to every volunteer health worker in the country. The program may even expand to other sectors like agriculture and education.

- Clara Hill

SOURCE: "Cell phones save lives in Rwandan villages" - CNN

Rwanda Provides Healthcare for $2 a Year

While the healthcare debate rages in the US, Rwanda, one of the world's poorest countries, has been providing near universal health insurance for 11 years. 92% of Rwandans are covered by the national plan and people must only pay only $2 each once a year to be covered. Even though the hospitals and outreach clinics are still far behind Western standards, they do treat the biggest killers in Africa- diarrhea, pneumonia, malaria, infected cuts, and malnutrition. Hospitals are equipped with most of the major medicines that the World Health Organization has deemed essential.

The program's low costs are sustained by charitable donations and foreign aid, the majority of which comes from the United States. Despite all the successes, the program still has some flaws, namely that every Rwandan pays the exact same $2 bill, regardless of whether they live in a mansion or a hut. However, the successes greatly outweigh the shortcomings. Rwanda's policies have made home delivery illegal (causing maternal and infant deaths to plummet) while also making treatments for the region's biggest killers widely accessible. These policies have helped increased the life expectancy of Rwandans by 4 years over the course of the program.The New York Times article linked below discusses the Rwandan healthcare system in more detail.

-Matthew Thwaites

SOURCES:A Poor Nation, With a Health Plan

Indian Successes to be Duplicated in Africa

A success story that reduced neonatal mortality in the heart of Uttar Pradesh province of India by 54% will be duplicated throughout Africa according to Melinda Gates of the Bill and Melinda Gates Foundation.

The Bill and Melinda Gates Foundation had committed $9.9 million to the project in India and found that simple efforts of educating mothers and their in-laws reduced infant mortality by 54% in just 18 months within the UP province.

Asserting that India's success in reducing maternal and child mortality was absolutely crucial for the world's chances of reaching the Millennium Development Goals by 2015, Gates urged India to increase its health budget from 1% of its GDP at present to 3% as promised.

According to Melinda, all lives have equal value.

- Tiffanie Depew

SOURCE: Times of India

“Impatient Optimists”, Bill and Melinda Gates, Highlight 50 Years Of Progress Made Toward Global Poverty Reduction

According to the Gates’, significant strides have been made over the past 50 years. As the US and other countries have increased their investment in the fight against global poverty, there has been a corresponding decrease in the number of child deaths as well as a decrease in the cost of drugs to combat Malaria, HIV, Tuberculosis, and Small Pox. Melinda Gates also notes that efforts in family planning have successfully resulted in a decrease to the number of children being born to women, which has correlated to an increase in child survival because families are better able to care for their children.

This short video clip highlights a recent speech made by the Bill and Melinda Gates Foundation on behalf of the strides made in the last 50 years in the battle against global poverty. Gates cites the halving of child deaths due to preventable diseases as well as the lowering of drug costs as just two improvements that have occurred in the past 50 years as a result of US investment in the developing world.

- Tiffanie Depew

SOURCE: Bill and Melinda Gates Foundation

Hope for the Motherless

If a woman dies during childbirth in a developing country, the child has a very slim chance of surviving. By taking in those newborns, the Berega Orphanage in Tanzania works to reverse this pattern. They are different than most orphanages since they care for children only during the first 2-3 years. When the children grow old enough to digest cow's milk or eat regular food, they return to their village to be cared for by their extended family. To make the reintegration process easier on the young toddler, a female relative is usually present throughout the years spent at the orphanage. This way, the child builds a bond with a caretaker who will be able to take him or her back to the village. At the same time, these young women are provided with a basic education that they would not have been able to receive otherwise. The innovative program has saved the lives of many children.

Source: NY Times

High Price of Childbirth

Death due to complications in childbirth is almost unheard of in our country and throughout the rest of the developed world. Unfortunately, this is not the case in poorer countries that lack proper equipment, medicine, and facilities. As a result, many women die from bleeding, infection, or high blood pressure- complications which are easily treatable. One of the main problems is the price of giving birth in a hospital; for many, it is too expensive and they resort to giving birth at home with a birth attendant who doesn't have any formal training. A midwife would charge $2, whereas a hospital birth would cost $6 and an emergency Caesarean would be $15. It's tragic that so many women's lives are taken each day simply because they cannot afford to get proper medical attention during childbirth.
Source: NY Times.