Eight innovative ideas for transforming the field of maternal health are finalists in the online competition “Healthy Mothers, Strong World: The Next Generation of Ideas for Maternal Health,” sponsored by The Maternal Health Task Force at EngenderHealth and Ashoka’s Changemakers. They were chosen by a panel of expert judges as entrepreneurial solutions from local, citizen organizations that have the best potential to scale-up and achieve major impact.
These solutions, chosen from more than 200 entries, were submitted by community members of Changemakers.com from more than 40 countries in Asia, Africa, South, Central, and North America, the Caribbean, Europe, and the Pacific. The finalists are:
1. Jacaranda Health: Sustainable Maternity Clinics in Urban Slums – Kenya
2. Drishtee Maternal Health Care (Making It Sustainable: Investing in Developing Skilled Maternal Health Women Entrepreneurs) – India
3. Safe Delivery: Solar Suitcases that Save Mothers and Infants– USA
4. Training Informal Care Providers to Prevent Bleeding After Childbirth Through the Use of Misoprostol – USA
5. Wholistic Health for Mother and Baby, Reducing Maternal Mortality – Afghanistan
6. One Heart World-Wide – Mexico
7. Fatherhood, Care and Reproductive Rights – Brazil
8. Integrating Active Case-Finding for TB with Prevention of Mother-to-Child Transmission of HIV Services in Antenatal Clinics – USA
Anybody who visits the Changemakers.com site can vote between now and May 12, 2010 for the three most innovative entrepreneurial ideas. By participating and voting, you will help identify and support a new generation of professionals who will sustain the growing momentum to improve maternal health and end the cycle of maternal death and disability.
The three winning organizations will each win in-kind prizes worth up to $5,000 allowing them to attend a Change Summit at the Global Maternal Health Conference 2010 in New Delhi this coming August. There, the Changemakers prize winners will discuss their ideas and projects, meet funding organizations and other innovators, receive training, and get feedback and advice from maternal health experts.
In addition, the Changemakers online platform will identify 16 young leaders from around the world, Young Champions of Maternal Health, to develop their innovative ideas during 9-month mentorships with seasoned Ashoka Fellows working in the field of maternal health. During this time, the Young Champions will have access to maternal health experts through the Maternal Health Task Force and resources to further develop their ideas and projects.
According to Dr. Ann K. Blanc, Director of the Maternal Health Task Force, “The maternal health field is at a critical juncture and a new generation of leaders is essential to achieve our common goal: the eradication of preventable maternal mortality and morbidity. These Young Champions have the potential to see that goal achieved in their lifetimes,” she said.
All Young Champions will receive a monthly stipend and 100% financial support for travel, accommodation, insurance, and visa costs. The innovations and projects that emerge from the Young Champions Program will be publicized widely.
“This group of finalists is exciting proof that a new generation of ideas is emerging that will accelerate the strong progress made so far in the field of maternal health,” said Charlie Brown, Changemakers’ Executive Director. “Going forward, experienced innovators will be energized by working with and mentoring young champions of solutions to end the cycle of maternal death and disability.”
Leaders in Maternal Health Comment on the New Maternal Mortality Estimates: IMMPACT
Thursday, April 29th, 2010 by Raji Mohanam
The Maternal Health Task Force is looking to those working in maternal health to comment on the recent findings published in the Lancet that suggest a dramatic reduction in global maternal mortality.
IMMPACT is a global research initiative that aims to promote better health for mothers-to-be in developing countries. Their research focus is on evaluating safe motherhood intervention strategies. IMMPACT is based at the University of Aberdeen in Aberdeen, United Kingdom.
The following post is written by IMMPACT staff Lucia D’Ambruoso and David Braunholtz:
IMMPACT is an international research project tasked to clarify the complexity that characterises “what works” for maternal health in developing countries, IMMPACT (the Initiative for Maternal Mortality Programme Assessment at the University of Aberdeen) also read with great interest the recent Lancet paper that demonstrated the first ever cross- national reductions in maternal mortality (Hogan et al, 2010). Echoing Dr Sanghvi, we too hope that these estimates signal a turning point, whereby the prevailing lack of progress (and negativity) that surrounds progress in maternal health in resource-poor settings is beginning to change, and the efforts of many committed individuals and institutions are finally bearing fruit.
We are also, however, cautious about the findings, and their interpretation, and await careful comparison and analysis with other forthcoming (inter-agency sponsored) global estimates to develop our understanding of the reasons for differences between these and previous (WHO et al, 2007) figures. In the meantime we feel motivated to write a brief ‘blog’ articulating our concerns regarding these, and other, estimates of maternal mortality, and their use.
Specialising in the field of measurement of maternal mortality, the Immpact group has grappled with the inherent complexities and uncertainties of accurate measurement for over a decade, in many of the world’s poorest regions. Immpact is also acutely aware of the need for ‘good data’ to inform policy and planning, and to monitor progress towards wider health and development targets. It is in this sense that we make the following comments related to the recent Lancet article.
We note that the uncertainty intervals for the maternal mortality ratios (MMRs) published by Hogan et al don’t include uncertainty arising from the (likely considerable) uncertainties in estimates of adult female mortality, and in estimated fertilities, upon which the MMR estimates are based. Nevertheless, the uncertainty intervals in the Hogan et al estimates are quite wide, as should be expected given the relatively small number of deaths in most of the data-sets, and due to the fact that many countries have few or no data. Considerable further uncertainty also arises from the evident (but uncertain) biases in some or all of the different methods of measurement (e.g. sisterhood method, vital registration and so on) contributing data to the estimates. We feel that research into the causes, and sizes, of biases present in current methods will be critical in reducing the uncertainty in future estimates of maternal mortality.
Uncertainty in the measurement of maternal mortality is likely to be unavoidable, but uncertain information is better than no information. In terms of interpreting information, decision-makers need to be provided with the means to assess the (un)certainty of estimates. The development of good policy and planning decisions (i.e. those that will lead to improved outcomes) under uncertainty requires that the degree of uncertainty is known. Estimates without specified, and comprehensive, levels of uncertainty are not a good basis for decision-making, and are, in a sense, irresponsible in that they encourage readers to under-rate or even ignore uncertainty, and jump to unwarranted conclusions about differences or trends, quite possibly leading to poor decisions and potentially the sub-optimal allocation of scarce resources. Researchers have often not been meticulous in specifying uncertainty; there is a need for wider recognition of the importance of comprehensive descriptions of the uncertainty associated with estimates, and for the development of methods to make this feasible.
References
Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM et al. Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5. The Lancet In Press, Corrected Proof.
World Health Organization, UNICEF, UNFPA, and the World Bank. Maternal mortality in 2005 Estimates developed by WHO, UNICEF and UNFPA. Geneva: World Health Organization, 2007
Human Rights Watch Video on Maternal Mortality in India Nominated for a Webby Award!
Tuesday, April 27th, 2010 by KateMitch
Human Rights Watch has been nominated for a Webby Award for their video, In Silence: Maternal Mortality in India. Photographer Susan Meiselas and reporter Dumeetha Luthra traveled to India for Human Rights Watch to document the story of Kiran Yadav, an Indian woman who died in childbirth. In Silence is nominated for Best Documentary: Individual Episode.
Watch the video here.
Click here if you would like to register and cast your vote.
What is a Webby Award?
“Hailed as the ‘Internet’s highest honor’ by the New York Times, The Webby Awards is the leading international award honoring excellence on the Internet. This is the 14th year of the awards, which received 10,000 entries from over 60 countries worldwide.”
What Has Technology Done For You Lately?
Monday, April 26th, 2010 by KateMitch
Written by Raji Mohanam, Knowledge Management Specialist at the Maternal Health Task Force (MHTF)
I recently attended the NTEN Annual Conference (April 8-10) in Atlanta, Georgia. NTEN (Nonprofit Technology Network) is an organization that helps nonprofits navigate the high-speed, constantly-changing landscape that defines the world of technology today.
I was among 1400 participants comprised of both tech gurus as well as the tech-challenged. However, the mind-boggling array of workshops and sessions ensured everyone learned something new.
The big take-away for me was the simple fact that there are just so many wonderful tech tools and applications out there, especially for social media, that can truly make a difference in our work. However, many of us in the nonprofit sector—with our limited time and resources—often miss the chance to effectively apply these technologies. So, I am going to do my little part for those of us working tirelessly toward MDG 5 and shed some light on a few nifty tools and tricks. I’ll be sharing these tidbits with you over the course of the next few months in a series of posts entitled “What has technology done for you lately?”. Here are a few to kick things off:
• By now, most of us use Google Analytics to track metrics on our websites, right? We also all have a Facebook Fan Page set up. But Google Analytics for Facebook Fan Pages? Wow! Learn how you can track metrics on your FB page here!
• Many of us have realized the impact and power of using maps/GIS on our websites. There is nothing more appealing to your audience than a visual representation of your program activities on a map, especially the interactive kind. Yet, depending on what needs to be mapped it can be tedious and expensive depending on software and staff time required—even when using open-source tools (take it from me!). So, some of you might want to consider using this cool site. PolicyMap is highly rated by nonprofits and have paid and free versions of their GIS tools. They can also create maps for you when you provide them with raw data. Talk about a time-saver!
• Does your program strategy have a mobile phone component? If it does, you are definitely headed in the right direction. For the rest of us, let’s get on board! With cell phone subscriptions expected to reach and surpass 5 billion this year, it is no wonder that global health programs are increasingly using the medium to deliver their messages. It is a relatively economical investment, easy to implement, and fast. If you have done your research and think you are ready to start a mobile campaign (even on a trial basis), here is one resource to help you begin.
We’ll definitely be exploring some of these things here at the MHTF this year and hope that you will too. If you do, please give us your feedback. We would also love to hear your top technology tips as well. What makes your organization innovative?
This Thursday: Policy Discussion on Family Planning in Fragile States
Monday, April 26th, 2010 by KateMitch
Don’t forget! This event is this Thursday, April 29th!
Please join the Centre for Development and Population Activities (CEDPA), the Woodrow Wilson Center’s Global Health Initiative and Environmental Change and Security Program, the Maternal Health Task Force (MHTF), and the United Nations Population Fund (UNFPA) for the fourth event of the series on Advancing Policy Dialogue on Maternal Health.
Family Planning in Fragile States: Overcoming Cultural and Financial Barriers
The event will feature:
Nabila Zar Malick, Director, Rahnuma Family Planning Association of Pakistan
Karima Tunau, OB/GYN, Usmanu Danpodiyo Hospital
Grace Kodindo, Assistant Professor of Population and Family Health, Columbia University
Sandra Krause, Reproductive Health Program Director, Women’s Refugee Commission
April 29, 2010
3:00 p.m. – 5:00 p.m.
6th Floor Flom Auditorium
Woodrow Wilson International Center for Scholars
1300 Pennsylvania Avenue, NW
Please RSVP to globalhealth@wilsoncenter.org with your name and affiliation.
Countries threatened by conflict rank lowest on maternal and newborn health indicators and have fewer resources for reproductive health services such as family planning and emergency obstetric care. Improving access to sexual and reproductive health services in fragile states may challenge cultural beliefs and gender relations within a country. Program managers, policymakers, and donors can mitigate these tensions through culturally sensitive approaches and increased female participation during peacebuilding efforts.
Nabila Zar Malick, director, Rahnuma Family Planning Association of Pakistan, Karima Tunau, OB/GYN, Usmanu Danpodiyo Hospital in Nigeria, and Grace Kodindo, Chadian OB/GYN and assistant professor of population and family health, at Columbia University will discuss their experiences implementing family planning services in Pakistan, Nigeria, and Chad and address the cultural and financial barriers they overcame to increase investments for maternal and reproductive health in their countries. Sandra Krause, reproductive health program director, Women’s Refugee Commission, will offer recommendations on how policymakers can improve access to reproductive health services for women in fragile settings.
About the Maternal Health Policy Series
The reproductive and maternal health community finds itself at a critical point, drawing increased attention and funding, but still confronting more than a half million deaths each year and a high unmet need for family planning. The Policy Dialogue series seeks to galvanize the community by focusing on important–and in some cases controversial–issue within the maternal health community.
The Wilson Center’s Global Health Initiative is pleased to present this series with its co-conveners, the Maternal Health Task Force and the United Nations Population Fund (UNFPA), and is grateful to USAID’s Bureau for Global Health for further technical assistance.
If you are interested, but unable to attend the event, please tune into the live or archived webcast at www.wilsoncenter.org. The webcast will begin approximately 10 minutes after the posted meeting time. You will need Windows Media Player to watch the webcast. To download the free player, visit: http://www.microsoft.com/windows/windowsmedia/download.
Location: Woodrow Wilson Center at the Ronald Reagan Building: 1300 Pennsylvania Ave., NW (”Federal Triangle” stop on Blue/Orange Line), 6th Floor Flom Auditorium. A map to the Center is available here.
Note: Photo identification is required to enter the building. Please allow additional time to pass through security.
For information on previous and future events in this series, click here.
Leaders in Maternal Health Comment on the New Maternal Mortality Estimates: Dr. Harshad Sanghvi
Friday, April 23rd, 2010 by KateMitch
The Maternal Health Task Force is looking to those working in maternal health to comment on the recent findings published in the Lancet that suggest a dramatic reduction in global maternal mortality.
Dr. Harshad Sanghvi is Vice President and Medical Director of Jhpiego, a Baltimore-based, global health non-profit working to improve and save the lives of women and their families around the world. Jphiego is an affiliate of Johns Hopkins University.
Dr. Sanghvi shares his response to the recent maternal mortality study published in the Lancet:
For the many dedicated to saving women’s lives, a new study reporting a decline in maternal mortality is heartening news, an affirmation of the decades of work and investment in improving health outcomes for women across the globe. The study published in The Lancet (“Maternal Deaths Decline Sharply Across the Globe,” NYT, 4/13/2010) found that maternal deaths dropped from 526,300 in 1980 to 342,900 in 2008, a decline researchers attributed to lower pregnancy rates, greater access to education for women, improved nutrition and skilled professional care at childbirth.
But no one should mistake the findings for a reason to shift our focus from a most shameful truth – too many women are dying from conditions that are preventable or can be treated successfully. In 2008, 342,900 women died in the very process of giving life. Behind that number hides an even greater tragedy, the massive morbidity as a result of pregnancy and childbirth.
From my days working in Kenya, I can still picture a very young woman who had life threatening pelvic sepsis following childbirth in a remote part of the country. The woman managed to reach a mission hospital almost 3 days after giving birth at home. She had to have multiple abdominal surgeries, and finally a hysterectomy. As we prepared to discharge her, she told me that she would have rather died. We had saved her life. But she had certainly not recovered, like the millions who are left with energy sapping anemia following postpartum hemorrhage, or with renal damage following eclampsia or worse still with fistula.
The Lancet study highlights that we are on the right track. As we move forward, we must increase our emphasis on quality of care, so that women who have been convinced and motivated to seek skilled care are not met with health system failures. And we must ensure that the fullest potential of skilled professional care is realized by ensuring the rights of health care providers to be trained for the job they expected to perform, to a work environment that is supportive and to be motivated by being provided a living wage.
And to complement this , we need a package of community-based interventions including birth preparedness and complication readiness education, calcium supplementation and iron supplementation, misoprostol to prevent postpartum hemorrhage, all of which can be safely provided by community volunteers who are willing and able to take care to women where they are.
Women’s lives can be saved with evidence-based interventions and the will to implement them from home to hospital. With what we know and the work we’ve done, no woman should have to die giving life.
World Malaria Day: The Burden of Malaria in Pregnancy in East India
Friday, April 23rd, 2010 by KateMitch
April 25th (this Sunday) is World Malaria Day. Recently, researchers from the Center for Global Health and Development at Boston University and the Indian National Institute of Malaria Research (NIMR) conducted studies to better understand the burden of malaria among pregnant women in east India. In honor of World Malaria Day, the Maternal Health Task Force invited Bram Brooks and David Hamer to share with our readers an overview of what they have learned.
Written by Bram Brooks, MPH & David Hamer, MD
Study team in action--evaluating pregnant women in Jharkhand
Global Overview
Malaria in pregnancy (MiP) can have serious health outcomes for both the mother and infant and thus presents a major public health challenge. Studies have shown that MiP increases the chances of fetal death, prematurity, low birth weight, and maternal anemia [1-4]. An estimated 10,000 women and 200,000 of their infants die each year as a result of malaria infection during pregnancy [5].
Current Research
As most MiP studies were conducted in sub-Saharan Africa, limited epidemiological data exist for MiP outside of Africa. Several studies conducted by researchers at Boston University and the Indian National Institute of Malaria Research (NIMR) have been recently implemented in east India with the aim of building the empirical evidence to better define the global risk map of MiP.
The India MiP study consisted of a series of cross-sectional surveys and involved the collection of both quantitative and qualitative data in several urban and rural districts in the Indian states of Jharkhand and Chhattisgarh [6-8]. Between all the study sites, over 5,082 pregnant women were enrolled at antenatal clinics and 1,746 in delivery units. The study findings indicated that the prevalence of malaria among pregnant women in east India was approximately 2-3%. In addition, malaria parasites were more common in pregnant women with fever, those living in rural areas, and women who were pregnant for the first time. Furthermore, mean birth weight was lower among women with placental malaria versus those without placental infection. In terms of the use of malaria control measures as reported by the participants, indoor residual spraying and untreated bed nets were common, whereas insecticide-treated bed nets and malaria chemoprophylaxis were rarely used. It was also noted through qualitative interviews that misconceptions and use of unproven prevention and treatment methods are common among pregnant women in eastern India.
The results from the series of MiP studies in India support other findings that show malaria mortality and morbidity in pregnant women are much lower outside of Africa. Although the magnitude of malaria-associated morbidity outside of Africa is smaller, we must remember that the number of global individuals at risk is considerable. A recent study by the Malaria in Pregnancy Consortium estimated that approximately 125 million pregnancies around the world are at risk from malaria every year [9]. With large population numbers at risk, even small prevalence rates can translate into significant mortality and morbidity numbers.
Prevention and Management of MiP
The global community has in its arsenal several evidence-based strategies to control MiP that are recommended by WHO: insecticide treated nets, intermittent preventative therapy, and effective case management [5]. Meta-analyses of intervention trials suggest that successful prevention of MiP reduces the risk of severe maternal anemia by 38%, low birth weight by 43%, and fetal death by 27% among pregnant women [10]. Prevention and control of MiP is an important goal that can be achieved. The challenge is to implement these strategies within national guidelines and programs so that these are effective in reducing MiP-associated mortality and morbidity.
1. Guyatt HL, Snow RW. Impact of malaria during pregnancy on low birth weight in sub-Saharan Africa. Clin Microbiol Rev 2004; 17:760-769.
2. Steketee RW, Nahlen BL, Parise ME, Menendez C. The burden of malaria in pregnancy in malaria endemic areas. Am J of Trop Med Hyg 2001; 64(1-2):28-35.
3. Shulman CE, Graham WJ, Jilo H, Lowe BS, New L, Obiero J, et al. Malaria is an important cause of anaemia in primigravidae: evidence from a district hospital in coastal Kenya. Trans R Soc Trop Med Hyg 1996; 90(5):535-539.
4. Verhoeff FH, Brabin BJ, Chimsuku L, Kazembe P, Broadhead RL. Malaria in pregnancy and its consequences for the infant in rural Malawi. Ann Trop Med Parasitol 1999; 93(1):S25-S33
5. Marchesini P, Crawley J. Reducing the burden of malaria. MERA/RBM/WHO Jan 2004.
6. Hamer DH, Singh MP, Wylie BJ, Yeboah-Antwi K, Tuchman J, Desai M, Udhayakumar V, Gupta P, Brooks MI, Shukla MM, Awasthy K, Sabin L, MacLeod WB, Dash AP, Singh N. Burden of malaria in pregnancy in Jharkhand State, India. Malaria Journal 2009, 3:8:210.
7. Sabin LL, Rizal A, Brooks MI, Tuchman J, Wylie B, Gill CJ, Singh MP, Setterlund KG, Joyce KM, Yeboah-Antwi K, Singh N, Hamer DH. “Attitudes, knowledge, and practices regarding malaria prevention and treatment among pregnant women in Jharkhand, India: A qualitative study.” Am J Trop Med Hyg, in press.
8. Singh N, Singh MP, Hussain M, Shukla MM, Dash AP, Wylie B, Yeboah-Antwi K, Udhayakumar V, Desai M, Hamer D. “Burden of malaria in pregnancy in Chhattisgarh State India.” Abstract 010-O. International Symposium on Tribal Health, February 27-March 1, 2009. Jabalpur, India.
9. Dellicour S, Tatem AJ, Guerra CA, Snow RW, ter Kuile FO. Quantifying the number of pregnancies at risk of Malaria in 2007: A demographic study. PLOS Medicine 2010; 7(1):e1000221.
10. Desai M, ter Kuile FO, Nosten F, McGready R, Asamoa K, Brabin B, Newman RD. Epidemiology and burden of malaria in pregnancy. Lancet Infect Dis 2007; 7 (2):93-104.
Leaders in Maternal Health Comment on the New Maternal Mortality Estimates: Dr. Marco Gomes
Thursday, April 22nd, 2010 by KateMitch
The Maternal Health Task Force is looking to those working in maternal health to comment on the recent findings published in the Lancet that suggest a dramatic reduction in global maternal mortality.
Dr. Marco Gomes is the Health and HIV Policy Adviser for the Centre for Health Policy and Innovation.
Dr. Gomes shares the Centre’s reactions to the recent Lancet publication that shows a dramatic reduction in global maternal mortality:
The Centre for Health Policy and Innovation acknowledges and welcomes the results and findings from the Lancet paper, published April 2010. However, we also would like to acknowledge that the scope of the study finds missing gaps and certain missed analysis which does not paint the full picture in research of maternal health and its barriers in reducing incidence of maternal and child death. Reducing “the rate of maternal mortality by 75% by 2015″ is one of the development targets that has been endorsed at numerous international meetings. This target was selected because maternal ill health is the largest contributor to the disease burden affecting women in developing countries; because the lifetime risk of maternal death is much greater in the poorest countries than in the richest (1 in 12 for women in east Africa compared with 1 in 4000 in northern Europe); and because interventions are cost effective (costing £2 ($3) per woman and £153 ($230) per death averted).
The technical interventions needed to prevent maternal deaths are well understood. Traditional maternal and child health interventions, such as providing antenatal care and training traditional birth attendants, have failed. The availability, accessibility, use, and quality of essential obstetric care for life threatening conditions, including complications after abortion, need to be improved. What is less clear is how an environment can be created to enable interventions to be made in settings with few resources.
Creating a functioning health system is the most obvious means of providing this type of environment. Research conducted for the Centre for Health Policy and innovation indicate that most of the resources needed to improve essential obstetric care exist as integral parts of district health systems, even if some of the parts do not function well or need updating. In a functioning district health system the availability, accessibility, use, and quality of essential obstetric care are expected to be high and maternal mortality is expected to be low. Some developing countries, such as China, Sri Lanka, and Malaysia, have reduced maternal mortality dramatically after improving the coverage and quality of their health services. Conversely in Zimbabwe the progressive erosion of the general standard of health services has been associated with rising maternal mortality. Maternal mortality has been proposed for use as an indicator of accessible and functional health services.
In the long term, sustaining affordable improvements in safe motherhood depends on improving the functioning of health systems as a whole. Gains made in countries such as Malaysia and Sri Lanka were achieved by making maternity care a priority that guided changes in health services. Efforts to achieve similar gains in other developing countries need pragmatic support. Sector-wide approaches and other routes to health system reform, intended to offer alternatives to failing public systems and provide improved health services in a spirit of equity, are compatible with a focus on maternal health services. If performance, as measured by indicators of safe motherhood as well as other essential health indicators, was a condition of funding, the placing of maternal health services at the centre of the sector could be assured. In political environments in which partnerships between donors and governments are likely to succeed, sector-wide approaches present a unique opportunity for advocates of safe motherhood to make a sustainable impact on maternal mortality.
Please share your comments below!
Leaders in Maternal Health Comment on the New Maternal Mortality Estimates: Claire Bangser
Wednesday, April 21st, 2010 by ablanc
The Maternal Health Task Force is looking to those working in maternal health to comment on the recent findings published in the Lancet that suggest a dramatic reduction in global maternal mortality.
Claire Bangser is the Program Coordinator for the Young Champions of Maternal Health program at Ashoka, a partnership with the Maternal Health Task Force to identify 16 “young champions of maternal health” who will spend 9 months working on a maternal health project abroad and being mentored by an Ashoka Fellow.
Claire shares her thoughts on the recent Lancet paper on maternal mortality:
The findings in this report give the maternal health community reason to be optimistic. We now must work to sustain this momentum and continue to foster an entrepreneurial community of changemakers improving maternal health in the communities and countries where women still lack access to the quality health services they deserve. We should be looking to innovators from the areas of greatest need to inform the decisions of the international maternal health community.
Learn more about the Young Champions for Maternal Health program here.
Are you a blogger? Learn about Ashoka’s Maternal Health Blogging Competition here.
Leaders in Maternal Health Comment on the New Maternal Mortality Estimates: IMMPACT
Thursday, April 29th, 2010 by Raji MohanamThe Maternal Health Task Force is looking to those working in maternal health to comment on the recent findings published in the Lancet that suggest a dramatic reduction in global maternal mortality.
IMMPACT is a global research initiative that aims to promote better health for mothers-to-be in developing countries. Their research focus is on evaluating safe motherhood intervention strategies. IMMPACT is based at the University of Aberdeen in Aberdeen, United Kingdom.
The following post is written by IMMPACT staff Lucia D’Ambruoso and David Braunholtz:
IMMPACT is an international research project tasked to clarify the complexity that characterises “what works” for maternal health in developing countries, IMMPACT (the Initiative for Maternal Mortality Programme Assessment at the University of Aberdeen) also read with great interest the recent Lancet paper that demonstrated the first ever cross- national reductions in maternal mortality (Hogan et al, 2010). Echoing Dr Sanghvi, we too hope that these estimates signal a turning point, whereby the prevailing lack of progress (and negativity) that surrounds progress in maternal health in resource-poor settings is beginning to change, and the efforts of many committed individuals and institutions are finally bearing fruit.
We are also, however, cautious about the findings, and their interpretation, and await careful comparison and analysis with other forthcoming (inter-agency sponsored) global estimates to develop our understanding of the reasons for differences between these and previous (WHO et al, 2007) figures. In the meantime we feel motivated to write a brief ‘blog’ articulating our concerns regarding these, and other, estimates of maternal mortality, and their use.
Specialising in the field of measurement of maternal mortality, the Immpact group has grappled with the inherent complexities and uncertainties of accurate measurement for over a decade, in many of the world’s poorest regions. Immpact is also acutely aware of the need for ‘good data’ to inform policy and planning, and to monitor progress towards wider health and development targets. It is in this sense that we make the following comments related to the recent Lancet article.
We note that the uncertainty intervals for the maternal mortality ratios (MMRs) published by Hogan et al don’t include uncertainty arising from the (likely considerable) uncertainties in estimates of adult female mortality, and in estimated fertilities, upon which the MMR estimates are based. Nevertheless, the uncertainty intervals in the Hogan et al estimates are quite wide, as should be expected given the relatively small number of deaths in most of the data-sets, and due to the fact that many countries have few or no data. Considerable further uncertainty also arises from the evident (but uncertain) biases in some or all of the different methods of measurement (e.g. sisterhood method, vital registration and so on) contributing data to the estimates. We feel that research into the causes, and sizes, of biases present in current methods will be critical in reducing the uncertainty in future estimates of maternal mortality.
Uncertainty in the measurement of maternal mortality is likely to be unavoidable, but uncertain information is better than no information. In terms of interpreting information, decision-makers need to be provided with the means to assess the (un)certainty of estimates. The development of good policy and planning decisions (i.e. those that will lead to improved outcomes) under uncertainty requires that the degree of uncertainty is known. Estimates without specified, and comprehensive, levels of uncertainty are not a good basis for decision-making, and are, in a sense, irresponsible in that they encourage readers to under-rate or even ignore uncertainty, and jump to unwarranted conclusions about differences or trends, quite possibly leading to poor decisions and potentially the sub-optimal allocation of scarce resources. Researchers have often not been meticulous in specifying uncertainty; there is a need for wider recognition of the importance of comprehensive descriptions of the uncertainty associated with estimates, and for the development of methods to make this feasible.
References
Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM et al. Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5. The Lancet In Press, Corrected Proof.
World Health Organization, UNICEF, UNFPA, and the World Bank. Maternal mortality in 2005 Estimates developed by WHO, UNICEF and UNFPA. Geneva: World Health Organization, 2007
Human Rights Watch Video on Maternal Mortality in India Nominated for a Webby Award!
Tuesday, April 27th, 2010 by KateMitchHuman Rights Watch has been nominated for a Webby Award for their video, In Silence: Maternal Mortality in India. Photographer Susan Meiselas and reporter Dumeetha Luthra traveled to India for Human Rights Watch to document the story of Kiran Yadav, an Indian woman who died in childbirth. In Silence is nominated for Best Documentary: Individual Episode.
Watch the video here.
Click here if you would like to register and cast your vote.
What is a Webby Award?
“Hailed as the ‘Internet’s highest honor’ by the New York Times, The Webby Awards is the leading international award honoring excellence on the Internet. This is the 14th year of the awards, which received 10,000 entries from over 60 countries worldwide.”
What Has Technology Done For You Lately?
Monday, April 26th, 2010 by KateMitch
Written by Raji Mohanam, Knowledge Management Specialist at the Maternal Health Task Force (MHTF)
I recently attended the NTEN Annual Conference (April 8-10) in Atlanta, Georgia. NTEN (Nonprofit Technology Network) is an organization that helps nonprofits navigate the high-speed, constantly-changing landscape that defines the world of technology today.
I was among 1400 participants comprised of both tech gurus as well as the tech-challenged. However, the mind-boggling array of workshops and sessions ensured everyone learned something new.
The big take-away for me was the simple fact that there are just so many wonderful tech tools and applications out there, especially for social media, that can truly make a difference in our work. However, many of us in the nonprofit sector—with our limited time and resources—often miss the chance to effectively apply these technologies. So, I am going to do my little part for those of us working tirelessly toward MDG 5 and shed some light on a few nifty tools and tricks. I’ll be sharing these tidbits with you over the course of the next few months in a series of posts entitled “What has technology done for you lately?”. Here are a few to kick things off:
• By now, most of us use Google Analytics to track metrics on our websites, right? We also all have a Facebook Fan Page set up. But Google Analytics for Facebook Fan Pages? Wow! Learn how you can track metrics on your FB page here!
• Many of us have realized the impact and power of using maps/GIS on our websites. There is nothing more appealing to your audience than a visual representation of your program activities on a map, especially the interactive kind. Yet, depending on what needs to be mapped it can be tedious and expensive depending on software and staff time required—even when using open-source tools (take it from me!). So, some of you might want to consider using this cool site. PolicyMap is highly rated by nonprofits and have paid and free versions of their GIS tools. They can also create maps for you when you provide them with raw data. Talk about a time-saver!
• Does your program strategy have a mobile phone component? If it does, you are definitely headed in the right direction. For the rest of us, let’s get on board! With cell phone subscriptions expected to reach and surpass 5 billion this year, it is no wonder that global health programs are increasingly using the medium to deliver their messages. It is a relatively economical investment, easy to implement, and fast. If you have done your research and think you are ready to start a mobile campaign (even on a trial basis), here is one resource to help you begin.
We’ll definitely be exploring some of these things here at the MHTF this year and hope that you will too. If you do, please give us your feedback. We would also love to hear your top technology tips as well. What makes your organization innovative?
This Thursday: Policy Discussion on Family Planning in Fragile States
Monday, April 26th, 2010 by KateMitchDon’t forget! This event is this Thursday, April 29th!
Please join the Centre for Development and Population Activities (CEDPA), the Woodrow Wilson Center’s Global Health Initiative and Environmental Change and Security Program, the Maternal Health Task Force (MHTF), and the United Nations Population Fund (UNFPA) for the fourth event of the series on Advancing Policy Dialogue on Maternal Health.
Family Planning in Fragile States: Overcoming Cultural and Financial Barriers
The event will feature:
Nabila Zar Malick, Director, Rahnuma Family Planning Association of Pakistan
Karima Tunau, OB/GYN, Usmanu Danpodiyo Hospital
Grace Kodindo, Assistant Professor of Population and Family Health, Columbia University
Sandra Krause, Reproductive Health Program Director, Women’s Refugee Commission
April 29, 2010
3:00 p.m. – 5:00 p.m.
6th Floor Flom Auditorium
Woodrow Wilson International Center for Scholars
1300 Pennsylvania Avenue, NW
Please RSVP to globalhealth@wilsoncenter.org with your name and affiliation.
Countries threatened by conflict rank lowest on maternal and newborn health indicators and have fewer resources for reproductive health services such as family planning and emergency obstetric care. Improving access to sexual and reproductive health services in fragile states may challenge cultural beliefs and gender relations within a country. Program managers, policymakers, and donors can mitigate these tensions through culturally sensitive approaches and increased female participation during peacebuilding efforts.
Nabila Zar Malick, director, Rahnuma Family Planning Association of Pakistan, Karima Tunau, OB/GYN, Usmanu Danpodiyo Hospital in Nigeria, and Grace Kodindo, Chadian OB/GYN and assistant professor of population and family health, at Columbia University will discuss their experiences implementing family planning services in Pakistan, Nigeria, and Chad and address the cultural and financial barriers they overcame to increase investments for maternal and reproductive health in their countries. Sandra Krause, reproductive health program director, Women’s Refugee Commission, will offer recommendations on how policymakers can improve access to reproductive health services for women in fragile settings.
About the Maternal Health Policy Series
The reproductive and maternal health community finds itself at a critical point, drawing increased attention and funding, but still confronting more than a half million deaths each year and a high unmet need for family planning. The Policy Dialogue series seeks to galvanize the community by focusing on important–and in some cases controversial–issue within the maternal health community.
The Wilson Center’s Global Health Initiative is pleased to present this series with its co-conveners, the Maternal Health Task Force and the United Nations Population Fund (UNFPA), and is grateful to USAID’s Bureau for Global Health for further technical assistance.
If you are interested, but unable to attend the event, please tune into the live or archived webcast at www.wilsoncenter.org. The webcast will begin approximately 10 minutes after the posted meeting time. You will need Windows Media Player to watch the webcast. To download the free player, visit: http://www.microsoft.com/windows/windowsmedia/download.
Location: Woodrow Wilson Center at the Ronald Reagan Building: 1300 Pennsylvania Ave., NW (”Federal Triangle” stop on Blue/Orange Line), 6th Floor Flom Auditorium. A map to the Center is available here.
Note: Photo identification is required to enter the building. Please allow additional time to pass through security.
For information on previous and future events in this series, click here.
Leaders in Maternal Health Comment on the New Maternal Mortality Estimates: Dr. Harshad Sanghvi
Friday, April 23rd, 2010 by KateMitchThe Maternal Health Task Force is looking to those working in maternal health to comment on the recent findings published in the Lancet that suggest a dramatic reduction in global maternal mortality.
Dr. Harshad Sanghvi is Vice President and Medical Director of Jhpiego, a Baltimore-based, global health non-profit working to improve and save the lives of women and their families around the world. Jphiego is an affiliate of Johns Hopkins University.
Dr. Sanghvi shares his response to the recent maternal mortality study published in the Lancet:
For the many dedicated to saving women’s lives, a new study reporting a decline in maternal mortality is heartening news, an affirmation of the decades of work and investment in improving health outcomes for women across the globe. The study published in The Lancet (“Maternal Deaths Decline Sharply Across the Globe,” NYT, 4/13/2010) found that maternal deaths dropped from 526,300 in 1980 to 342,900 in 2008, a decline researchers attributed to lower pregnancy rates, greater access to education for women, improved nutrition and skilled professional care at childbirth.
But no one should mistake the findings for a reason to shift our focus from a most shameful truth – too many women are dying from conditions that are preventable or can be treated successfully. In 2008, 342,900 women died in the very process of giving life. Behind that number hides an even greater tragedy, the massive morbidity as a result of pregnancy and childbirth.
From my days working in Kenya, I can still picture a very young woman who had life threatening pelvic sepsis following childbirth in a remote part of the country. The woman managed to reach a mission hospital almost 3 days after giving birth at home. She had to have multiple abdominal surgeries, and finally a hysterectomy. As we prepared to discharge her, she told me that she would have rather died. We had saved her life. But she had certainly not recovered, like the millions who are left with energy sapping anemia following postpartum hemorrhage, or with renal damage following eclampsia or worse still with fistula.
The Lancet study highlights that we are on the right track. As we move forward, we must increase our emphasis on quality of care, so that women who have been convinced and motivated to seek skilled care are not met with health system failures. And we must ensure that the fullest potential of skilled professional care is realized by ensuring the rights of health care providers to be trained for the job they expected to perform, to a work environment that is supportive and to be motivated by being provided a living wage.
And to complement this , we need a package of community-based interventions including birth preparedness and complication readiness education, calcium supplementation and iron supplementation, misoprostol to prevent postpartum hemorrhage, all of which can be safely provided by community volunteers who are willing and able to take care to women where they are.
Women’s lives can be saved with evidence-based interventions and the will to implement them from home to hospital. With what we know and the work we’ve done, no woman should have to die giving life.
World Malaria Day: The Burden of Malaria in Pregnancy in East India
Friday, April 23rd, 2010 by KateMitchApril 25th (this Sunday) is World Malaria Day. Recently, researchers from the Center for Global Health and Development at Boston University and the Indian National Institute of Malaria Research (NIMR) conducted studies to better understand the burden of malaria among pregnant women in east India. In honor of World Malaria Day, the Maternal Health Task Force invited Bram Brooks and David Hamer to share with our readers an overview of what they have learned.
Written by Bram Brooks, MPH & David Hamer, MD
Study team in action--evaluating pregnant women in Jharkhand
Global Overview
Malaria in pregnancy (MiP) can have serious health outcomes for both the mother and infant and thus presents a major public health challenge. Studies have shown that MiP increases the chances of fetal death, prematurity, low birth weight, and maternal anemia [1-4]. An estimated 10,000 women and 200,000 of their infants die each year as a result of malaria infection during pregnancy [5].
Current Research
As most MiP studies were conducted in sub-Saharan Africa, limited epidemiological data exist for MiP outside of Africa. Several studies conducted by researchers at Boston University and the Indian National Institute of Malaria Research (NIMR) have been recently implemented in east India with the aim of building the empirical evidence to better define the global risk map of MiP.
The India MiP study consisted of a series of cross-sectional surveys and involved the collection of both quantitative and qualitative data in several urban and rural districts in the Indian states of Jharkhand and Chhattisgarh [6-8]. Between all the study sites, over 5,082 pregnant women were enrolled at antenatal clinics and 1,746 in delivery units. The study findings indicated that the prevalence of malaria among pregnant women in east India was approximately 2-3%. In addition, malaria parasites were more common in pregnant women with fever, those living in rural areas, and women who were pregnant for the first time. Furthermore, mean birth weight was lower among women with placental malaria versus those without placental infection. In terms of the use of malaria control measures as reported by the participants, indoor residual spraying and untreated bed nets were common, whereas insecticide-treated bed nets and malaria chemoprophylaxis were rarely used. It was also noted through qualitative interviews that misconceptions and use of unproven prevention and treatment methods are common among pregnant women in eastern India.
The results from the series of MiP studies in India support other findings that show malaria mortality and morbidity in pregnant women are much lower outside of Africa. Although the magnitude of malaria-associated morbidity outside of Africa is smaller, we must remember that the number of global individuals at risk is considerable. A recent study by the Malaria in Pregnancy Consortium estimated that approximately 125 million pregnancies around the world are at risk from malaria every year [9]. With large population numbers at risk, even small prevalence rates can translate into significant mortality and morbidity numbers.
Prevention and Management of MiP
The global community has in its arsenal several evidence-based strategies to control MiP that are recommended by WHO: insecticide treated nets, intermittent preventative therapy, and effective case management [5]. Meta-analyses of intervention trials suggest that successful prevention of MiP reduces the risk of severe maternal anemia by 38%, low birth weight by 43%, and fetal death by 27% among pregnant women [10]. Prevention and control of MiP is an important goal that can be achieved. The challenge is to implement these strategies within national guidelines and programs so that these are effective in reducing MiP-associated mortality and morbidity.
1. Guyatt HL, Snow RW. Impact of malaria during pregnancy on low birth weight in sub-Saharan Africa. Clin Microbiol Rev 2004; 17:760-769.
2. Steketee RW, Nahlen BL, Parise ME, Menendez C. The burden of malaria in pregnancy in malaria endemic areas. Am J of Trop Med Hyg 2001; 64(1-2):28-35.
3. Shulman CE, Graham WJ, Jilo H, Lowe BS, New L, Obiero J, et al. Malaria is an important cause of anaemia in primigravidae: evidence from a district hospital in coastal Kenya. Trans R Soc Trop Med Hyg 1996; 90(5):535-539.
4. Verhoeff FH, Brabin BJ, Chimsuku L, Kazembe P, Broadhead RL. Malaria in pregnancy and its consequences for the infant in rural Malawi. Ann Trop Med Parasitol 1999; 93(1):S25-S33
5. Marchesini P, Crawley J. Reducing the burden of malaria. MERA/RBM/WHO Jan 2004.
6. Hamer DH, Singh MP, Wylie BJ, Yeboah-Antwi K, Tuchman J, Desai M, Udhayakumar V, Gupta P, Brooks MI, Shukla MM, Awasthy K, Sabin L, MacLeod WB, Dash AP, Singh N. Burden of malaria in pregnancy in Jharkhand State, India. Malaria Journal 2009, 3:8:210.
7. Sabin LL, Rizal A, Brooks MI, Tuchman J, Wylie B, Gill CJ, Singh MP, Setterlund KG, Joyce KM, Yeboah-Antwi K, Singh N, Hamer DH. “Attitudes, knowledge, and practices regarding malaria prevention and treatment among pregnant women in Jharkhand, India: A qualitative study.” Am J Trop Med Hyg, in press.
8. Singh N, Singh MP, Hussain M, Shukla MM, Dash AP, Wylie B, Yeboah-Antwi K, Udhayakumar V, Desai M, Hamer D. “Burden of malaria in pregnancy in Chhattisgarh State India.” Abstract 010-O. International Symposium on Tribal Health, February 27-March 1, 2009. Jabalpur, India.
9. Dellicour S, Tatem AJ, Guerra CA, Snow RW, ter Kuile FO. Quantifying the number of pregnancies at risk of Malaria in 2007: A demographic study. PLOS Medicine 2010; 7(1):e1000221.
10. Desai M, ter Kuile FO, Nosten F, McGready R, Asamoa K, Brabin B, Newman RD. Epidemiology and burden of malaria in pregnancy. Lancet Infect Dis 2007; 7 (2):93-104.
Leaders in Maternal Health Comment on the New Maternal Mortality Estimates: Dr. Marco Gomes
Thursday, April 22nd, 2010 by KateMitchThe Maternal Health Task Force is looking to those working in maternal health to comment on the recent findings published in the Lancet that suggest a dramatic reduction in global maternal mortality.
Dr. Marco Gomes is the Health and HIV Policy Adviser for the Centre for Health Policy and Innovation.
Dr. Gomes shares the Centre’s reactions to the recent Lancet publication that shows a dramatic reduction in global maternal mortality:
The Centre for Health Policy and Innovation acknowledges and welcomes the results and findings from the Lancet paper, published April 2010. However, we also would like to acknowledge that the scope of the study finds missing gaps and certain missed analysis which does not paint the full picture in research of maternal health and its barriers in reducing incidence of maternal and child death. Reducing “the rate of maternal mortality by 75% by 2015″ is one of the development targets that has been endorsed at numerous international meetings. This target was selected because maternal ill health is the largest contributor to the disease burden affecting women in developing countries; because the lifetime risk of maternal death is much greater in the poorest countries than in the richest (1 in 12 for women in east Africa compared with 1 in 4000 in northern Europe); and because interventions are cost effective (costing £2 ($3) per woman and £153 ($230) per death averted).
The technical interventions needed to prevent maternal deaths are well understood. Traditional maternal and child health interventions, such as providing antenatal care and training traditional birth attendants, have failed. The availability, accessibility, use, and quality of essential obstetric care for life threatening conditions, including complications after abortion, need to be improved. What is less clear is how an environment can be created to enable interventions to be made in settings with few resources.
Creating a functioning health system is the most obvious means of providing this type of environment. Research conducted for the Centre for Health Policy and innovation indicate that most of the resources needed to improve essential obstetric care exist as integral parts of district health systems, even if some of the parts do not function well or need updating. In a functioning district health system the availability, accessibility, use, and quality of essential obstetric care are expected to be high and maternal mortality is expected to be low. Some developing countries, such as China, Sri Lanka, and Malaysia, have reduced maternal mortality dramatically after improving the coverage and quality of their health services. Conversely in Zimbabwe the progressive erosion of the general standard of health services has been associated with rising maternal mortality. Maternal mortality has been proposed for use as an indicator of accessible and functional health services.
In the long term, sustaining affordable improvements in safe motherhood depends on improving the functioning of health systems as a whole. Gains made in countries such as Malaysia and Sri Lanka were achieved by making maternity care a priority that guided changes in health services. Efforts to achieve similar gains in other developing countries need pragmatic support. Sector-wide approaches and other routes to health system reform, intended to offer alternatives to failing public systems and provide improved health services in a spirit of equity, are compatible with a focus on maternal health services. If performance, as measured by indicators of safe motherhood as well as other essential health indicators, was a condition of funding, the placing of maternal health services at the centre of the sector could be assured. In political environments in which partnerships between donors and governments are likely to succeed, sector-wide approaches present a unique opportunity for advocates of safe motherhood to make a sustainable impact on maternal mortality.
Please share your comments below!
Leaders in Maternal Health Comment on the New Maternal Mortality Estimates: Claire Bangser
Wednesday, April 21st, 2010 by ablancThe Maternal Health Task Force is looking to those working in maternal health to comment on the recent findings published in the Lancet that suggest a dramatic reduction in global maternal mortality.
Claire Bangser is the Program Coordinator for the Young Champions of Maternal Health program at Ashoka, a partnership with the Maternal Health Task Force to identify 16 “young champions of maternal health” who will spend 9 months working on a maternal health project abroad and being mentored by an Ashoka Fellow.
Claire shares her thoughts on the recent Lancet paper on maternal mortality:
The findings in this report give the maternal health community reason to be optimistic. We now must work to sustain this momentum and continue to foster an entrepreneurial community of changemakers improving maternal health in the communities and countries where women still lack access to the quality health services they deserve. We should be looking to innovators from the areas of greatest need to inform the decisions of the international maternal health community.
Learn more about the Young Champions for Maternal Health program here.
Are you a blogger? Learn about Ashoka’s Maternal Health Blogging Competition here.
Empowering Women Through the Control of Neglected Tropical Diseases
Friday, April 30th, 2010 by KateMitchThis guest blog post was written by the Global Network for Neglected Tropical Diseases staff.
According to the new maternal mortality estimates recently published in the Lancet, 342,900 women die annually while pregnant or from childbirth. This is a dramatic improvement over numbers released in 1980, but is still unacceptably high and must be addressed. Because of the inextricable link between maternal health and neglected tropical diseases (NTDs), reducing the number of women suffering from hookworm and schistosomiasis for instance, will also greatly improve global maternal health—and the woman’s overall health and well being.
According to a paper written by Dr. Peter Hotez, Distinguished Research Professor, Chair of his Department at George Washington University, and President of the Sabin Vaccine Institute, titled “Empowering Women and Improving Female Reproductive Health through the Control of Neglected Tropical Diseases,” one of the greatest risks to a pregnancy is anemia, a decrease in red blood cells caused by a lack of iron. Anemia during pregnancy can result in low birth weight, infection, miscarriage, or the death of the mother. It is estimated that 20% of maternal deaths in Africa can be attributed to anemia. One of the major causes of anemia is hookworm, an intestinal worm which infects an estimated 576 million people worldwide. That includes 44 million pregnant women worldwide and up to one-third of the pregnant women in sub-Saharan Africa. In one study in Nepal, hookworm was found responsible for 54% of anemia during pregnancy. By feeding on the blood of the host, the hookworm also robs the fetus of dearly needed iron and other nutrients. By treating this parasite, countless cases of maternal anemia could be avoided, leading to decreased maternal mortality and healthier children.
Another major cause of anemia is schistosomiasis, also known as bilharzia. This is a parasite, which infects over 207 million people worldwide, is endemic in the water supplies of impoverished areas, especially in Africa which, if untreated, can lead to cancer and organ failure. Schistosomiasis is especially dangerous because the eggs of the parasite can be deposited in the placenta, further complicating pregnancy.
The good news is that there are proven, cost-efficient, and effective solutions for these diseases. Hookworm can be treated with Albendazole, which also treats other intestinal worms, and schistosomiasis can be treated by a single dose of Praziquantel. Both of those drugs are donated by drug companies or made available for sale at discounted prices. The inclusion of these drugs in antenatal care packages has proven to be successful at avoiding anemia and saving lives. By treating NTDs, we can stop many cases of entirely preventable maternal deaths and treat some of the most destructive diseases facing humanity in one fell swoop.
Visit the Global Network for Neglected Tropical Diseases website to learn more about their work–and take a look at their blog, End the Neglect.
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Tags: Africa, Albendazole, anemia, anemia during pregnancy, antenatal care, bilharzia, cancer, child health, childbirth, Dr. Peter Hotez, drug companies, Empowering Women and Improving Female Reproductive Health through the Control of Neglected Tropical Diseases, End the Neglect, George Washington University, global maternal health, Global Network for Neglected Tropical Diseases, hookworm, infection, intestinal worms, iron, Lancet, low birth weight, maternal anemia, maternal death, maternal health, miscarriage, neglected tropical diseases, Nepal, new estimates, new maternal mortality estimates, NTDs, nutrients, nutrition, organ failure, parasites, placenta, Praziquantel, pregnancy complications, pregnant, preventable maternal death, Sabin Vaccine Institute, schistosomiasis, sub-Saharan Africa, The Lancet, water supplies
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