By Sara Stratton, IntraHealth International
This post was originally published on IntraHealth’s Global Health Blog.
To the business world, it’s location, location, location. Here in Delhi, though, at the Global Maternal Health Conference, the mantra is context, context, context. There are many ways to improve and save women’s lives, but the success of any given intervention depends on local context. What works in one country or one community may not work in another. Many people here are talking about the importance and value of understanding how and why an intervention succeeds or fails at the local level. This means investigating and evaluating not just how widely an intervention reaches or the quality of the services, but also the specific, local factors that play into its uptake and impact. How do these realities affect whether an intervention that saved lives in one place would work equally well somewhere else?
This idea of the importance of the local context became woven into presentations on the first day of this groundbreaking conference. In one session, a representative of the SEWA Rural Society for Education, Welfare and Action, Rural (SEWA Rural) talked about how they had found that in Gujarat, India, a woman’s decision to deliver at home or in a hospital in her last pregnancy often influences where she delivered in a subsequent pregnancy. The question for us all to ponder was raised: is the key to saving women’s lives to encourage them all to deliver in hospitals? If so, how much would this cost? Can governments really afford this now? How far would women have to travel to a hospital? The reality, though, is that for some communities, encouraging hospital- or health facility-based delivery may be part of the answer, but in others it may still be an impractical approach. This question led to a discussion about home delivery versus institution-based delivery—as well as the value of traditional and trained birth attendants.
Whether we are talking about where women deliver, how they deliver, who helps them deliver, what we are really talking about is how we evaluate and minimize a woman’s risk during pregnancy and childbirth. Where distance and a lack of health facilities make facility-based delivery improbable, a community may need programs that improve the quality of care offered by trained birth attendants during a home delivery even though in an ideal world there would be another option. What I’m hearing in Delhi is, in some ways, what I already know. There are no easy answers. We must support communities to succeed within the context of their own limitations in terms of the availability of and access to health facilities and health workers. At the same time, we have to remain committed to helping communities to change these limitations.
Sara Stratton is the director of MNCH/FP programs at IntraHealth International.
Stay up to date with the conference happenings! Follow the Maternal Health Task Force and EngenderHealth on Twitter: @MHTF and @EngenderHealth. The conference hashtag is #GMHC2010.
For more posts about the Global Maternal Health Conference, click here.
For the live stream schedule, click here.
Check back soon for the archived videos of today’s presentations.
Local Context Matters to Women’s Lives: A Report from Delhi
Tuesday, August 31st, 2010 by KateMitch
I am 27. And I am a maternal health advocate.
Tuesday, August 31st, 2010 by ablanc
Written by Janna Oberdorf, Women Deliver
These are two things I’m very proud of. I’m proud to be young (or at least young-ish) and passionate about women and mothers. I’m proud that when I see images of women giving birth in low-quality health facilities, I want to yell at the world. I’m proud that the first time I learned what fistula is, I wanted to smash my computer screen and say, “Why didn’t I even know about this before?” This is a fight that I’m ready and willing to take – the fight for mothers around the world.
But why are there so few young people involved in maternal health, at the research level, at the advocacy level, and at the policy level?
Today, at the Global Maternal Health Conference I got to watch five Young Champions of Maternal Health speak with the same passion that I feel.
I watched:
· Hellen Kotlolo talk about her project to send SMS text messages to pregnant women and new mothers that give them both health advice, but also loving, empowering messages that increase their self-esteem;
· Zubaida Bai talk (via a video recording) about her project to distribute clean birth kits to communities;
· Egwaoje Ifeyinwa Madu talk about using SisterFriends, a trusted network of women in communities, to share information on maternal health and act as a safe and compassionate resource;
· Carolina Araujo Damasio Santos talk about her project The Art of Being Born which uses music, poetry, and other art forms to humanize the process of pregnancy and birth in Brazil;
· and Seth Cochran talk about Operation OF, a project to reintegrate fistula survivors into communities who have shunned them for their injuries.
I couldn’t have been more inspired. But I had to ask the question: How do we get more young people on board? It seems that when it comes to maternal health, it’s hard to reach young people in a way that make them understand this is an issue that affects them. Many young people care about sexual and reproductive health – they want safe sex, contraception, safe abortions. But when you mention maternal health, they think about their mothers.
Sitting in front of five Young Champions who certainly inspired this conference of almost 700 people, I hope that one day maternal health will resonate with young people on a bigger, broader level. I hope that one day when we mention maternal health, young people will think of themselves and not just their mothers. And I hope that organizations like the Maternal Health Task Force, Ashoka, and more continue to respect young people’s opinions and innovative ideas, and properly support them with information, guidance, mentoring and funding.
Learn more about the Young Champions of Maternal Health program, a partnership between the Maternal Health Task Force and Ashoka.
Janna Oberdorf is the Communications Manager at Women Deliver.
Stay up to date with the conference happenings! Follow the Maternal Health Task Force and EngenderHealth on Twitter: @MHTF and @EngenderHealth. The conference hashtag is #GMHC2010.
For more posts about the Global Maternal Health Conference, click here.
For the live stream schedule, click here.
Check back soon for the archived videos of today’s presentations.
Maternal Health Realities: Accountability and Behavior Change
Tuesday, August 31st, 2010 by Raji Mohanam
Written by Calyn Ostrowski, Woodrow Wilson Center for Scholars
Four days ago a young woman died giving birth in a bustling marketplace in New Delhi. Just steps away from Parliament, this woman was left to die and no emergency care was sent to her–no midwives, nurses, or doctors; just people walking around her accepting the situation as normal and an uncontrollable way of life. But this is Delhi…not a remote tribal village where the nearest health clinic is hours away (on foot).
This juxtaposition lingers on in me as I sit in the plenary session of day two at the Global Maternal Health Conference and listen to Syeda Hameed, member of the Indian Parliament Planning Commission, discuss her recent visit to a remote village where every house has 10 children living in filth, flies, and emptiness.
Although I have been working on such development issues for the last five years I do not work in the field, nor do I visit the developing world on a regular basis. Hearing these stories, coupled with my firsthand experience of witnessing poverty here in Delhi reminds me of the daily reality of those 342,900 women who die every year. This is their way of life and I think it’s poignant that today’s sessions emphasize community based care, family planning, accountability, behavior change, and culture.
“Context, context, context,” said Wendy Graham of IMMPACT at yesterday’s plenary session. I agree, the context of social and cultural norms is an underlying factor that must be taken into consideration when implementing maternal and child health (MNCH) programs. With a background in psychology, I appreciated when Dr. Zulfiqar Bhutta, of Aga Khan University, recognized the toll of poverty on the imagination and the mentality of fatalism.
That is why it is so essential to “ask the people how they feel and bring their voices into the forums where policy decisions are made,” said Hameed. It is also important to hold key players accountable and include men in MNCH activities.
During the side session Male Involvement in Reproductive and Maternal and Newborn Health six field experts (in which half the panelists and audience members were men!) discussed effective methods for increasing male participation in family planning, vasectomies, gender equality, and hospital care.
The key findings from this discussion include:
• Targeted interventions that educate men about danger signs and pregnancy complications correlates with behavior change and increased facility births.
• Many young married men feel pressured to prove their fertility. A sample of men was evaluated and those who had increased education and income were more likely to delay first pregnancy.
• Vasectomy is not something men want to talk about with family planning fieldworkers; however, official recognition of the vasectomy benefits by the government did increase referrals.
• Puppet and theater shows that demonstrate gender equity behaviors provide an opportunity for dialogue. Women in this study reported increased gender equity in family planning decision-making.
There are so many variables that exacerbate the maternal mortality cycle, but evidence presented here provides REAL solutions. It is time to scale up these solutions and political willpower will be essential.
Calyn Ostrowski is the Coordinator of the Maternal Health Dialogue Series in partnership with the Maternal Health Task Force and UNFPA at the Woodrow Wilson International Center for Scholars.
Stay up to date with the conference happenings! Follow the Maternal Health Task Force and EngenderHealth on Twitter: @MHTF and @EngenderHealth. The conference hashtag is #GMHC2010.
For more posts about the Global Maternal Health Conference, click here.
For the live stream schedule, click here.
Check back soon for the archived videos of today’s presentations.
Clean Birth Kits: Do We Need Them?
Tuesday, August 31st, 2010 by Raji Mohanam
Written by Janna Oberdorf, Women Deliver
Clean Birth Kits. It seems like a no-brainer. And, as one audience member at the Global Maternal Health Conference said, “There’s no doubt these would work.”
But, there is doubt, as I learned at today’s session, “Clean birth kits: do we need them?”. There’s serious speculation on what impact and effect clean birth kits (CBKs) would have on saving lives. The session panelists presented a review of the existing evidence on clean birth practices and the potential role for CBKs in supporting these preventive practices, and they found serious gaps in knowledge and research.
One thing that all panelists agreed on is that clean births are necessary to reduce maternal mortality – each year around 1 million newborns and mothers die from infections soon after birth, and this burden is highest for the poorest families. Of the world’s 60 million home births each year, many occur without adequate hygiene, and some facility births also lack basic hygienic care. There are “six cleans” that make up a clean birth: clean hands, clean perineum, clean delivery surface, clean cord cutting implement, clean cord tying, and clean cord care.
But CBKs are not a new idea. They have been around for decades… centuries. The problem is that little research exists that shows how these kits are used, and more importantly, what effect they have on women and providers.
Wendy J. Graham, from Immpact and University of Aberdeen, used this panel to discuss the Birth Kit Working Group, a compilation of health experts who are assessing existing research on CBKs, and considering the development of a decision guide to assist in the planning of overall strategies relating to the use of CBKs. Their key focus has been on CBKs for use in facilities, and trying to determine whether these kits are a help or a hindrance.
“The fact is: We don’t know,” said Graham, who highlighted the gaps in knowledge and research around CBKs effects. “We’ve heard so much about poor quality of care, and we need to identify catalysts for change.”
Though, as Graham and her colleagues Bilal Avan and Vanora Hundley discussed, the CBKs could work as a catalyst for change in a positive way, or a negative way. The presenters and the participants had a heated debate on how the kits could be distributed: would it be more effective if they are housed at health facilities and used when pregnant women arrive for delivery, or should they be given to pregnant women at antenatal visits. Giving women CBKs might actually deter them from having facility births, thinking that they can use the kit at home. Or, it might empower and enable them to return to the facility for their birth. On the other hand, housing the kits at facilities might create dependence from health providers that would be problematic when supplies run out. Or, the kits could sit on a shelf and never be used.
“This is not black or white; not positive or negative,” said Graham. “It depends on where we’re talking about. And it’s hard to really find out about adverse effects when studies don’t talk about failures.”
In the a community that likes to so often stress, “There’s no magic bullet for maternal health,” the CBKs offer the possible potential of what the bed net has done to curb malaria. Moderator, Ann Starrs of Family Care International, put the CBK issues into a broader global advocacy perspective. “Kits are being looked at and promoted almost as an advocacy tool, and as a way to sell this issue to a broad range of audiences as a problem for which there are quick and easy solutions,” said Starrs.
The main takeaway seems to be clean births are essential, and there is serious potential for CBKs to have an impact on maternal health and maternal mortality. The problem is: We have no idea what that impact will be. And before we roll out (and massively fund) the creation of distribution of CBKs, we need to be clear on what the likely outcomes will be.
MORE QUESTIONS TO CONSIDER:
1. What are the most important contextual factors to consider regarding introducing CBKs into facilities? How do we address equity and ensure that poor women and women most in-need receive them?
2. What should a kit include? What’s the criteria?
3. What are the potential uses for CBKs, specifically in conflict or disaster situations?
4. Are birth kits just an expensive diversion? Read a post on this issue by Ann Blanc, Director of the Maternal Health Task Force.
Stay up to date with the conference happenings! Follow the Maternal Health Task Force and EngenderHealth on Twitter: @MHTF and @EngenderHealth. The conference hashtag is #GMHC2010.
For more posts about the Global Maternal Health Conference, click here.
For the live stream schedule, click here.
Check back soon for the archived videos of today’s presentations.
Task-Shifting–Or Why Doctors Might Not Always Be Necessary to Save Mothers’ Lives
Tuesday, August 31st, 2010 by KateMitch
Written by Maria M. Pawlowska, Cambridge University Gates Scholar
The Global Maternal Health Conference 2010 is underway! Unfortunately, I’m not there in New Delhi to witness it all first-hand but the organisers are kindly live streaming some of the sessions so I can still feel like I’m participating in this extraordinary event, while sitting in my office in Cambridge, UK.
The theme of the live streamed afternoon session (which took place in the early morning UK time yesterday) was “Strengthening access to maternal health” and I tuned in to listen about the importance of human resources.
The White Ribbon Alliance has been doing an amazing job the past months and spreading the word about the importance of skilled birth attendants and campaigning for funds to train health workers. The presentations in this session further stressed the importance of training staff who are not necessarily obstetricians and gynaecologists, available to help and treat birthing women.
Helen de Pinho from AMDD talked about the changing situation in Africa, where increasing numbers of non-physician clinicians (NPC) are broadening the scope of health services they provide. NPCs already provide emergency obstetric care in 6 countries and this number is bound to increase in the near future. De Pinho stressed task-shifting as the key – it’s been proven that NPCs can provide, regular and emergency obstetric care with equal success to doctors. Importantly, their training is shorter, quicker and cheaper with no loss in the quality of services they provide to their patients.
In keeping with the theme, Jeffrey Smith, Jhpiego regional director in Asia spoke about the advantages of midwifery services and what it takes to educate a midwife in the developing world. He argued that the aim of a midwife’s education should be to produce a “health worker [who] is competent, employed and able to work effectively”. Thus, it’s important to focus midwives’ education on clinical practice and continually assess the learning process. Students must be given the permission to provide care, obviously under supervision at least at first, and not just watch others providing it. In order to really gain the skills they require to effectively treat their patients they must have the hands-on clinical experience. Once their education is done, the key is to make sure the midwife is employed and her skills are properly taken advantage of – therefore she must have access to at least basic drugs and a space where she can safely see her patients. A “clinic” without a roof and no medical supplies just won’t do it! It’s also important to remember that both the midwives themselves, and communities tend to benefit most from medical training if the midwife is allowed to return to practice in her home village/town after graduation.
The role of training health workers is hard to overestimate and it will take time to train the health professionals we are currently lacking. In the mean time it should be remembered that there are other very cheap and highly effective methods of combating maternal mortality in the short run. Ndola Prata, and colleagues, from the University of California, Berkeley, School of Public Health have very recently published an analysis showing that the cheapest and most effective way of preventing maternal deaths is investing in family planning and misoprostol (a drug for stomach ulcers turned haemorrhage prevention and treatment “miracle” pill). Misoprostol has recently been gaining mainstream media attention for how incredibly cheap, safe and effective it is at saving lives.
Stay up to date with the conference happenings! Follow the Maternal Health Task Force and EngenderHealth on Twitter: @MHTF and @EngenderHealth. The conference hashtag is #GMHC2010.
For more posts about the Global Maternal Health Conference, click here.
For the live stream schedule, click here.
Check back soon for the archived videos of today’s presentations.
Global Progress on Maternal Health: The Numbers and their Implications
Tuesday, August 31st, 2010 by Raji Mohanam
Written by Kate Mitchell, Maternal Health Task Force
The opening plenary, Global progress on maternal health: the numbers and their implications, of the Global Maternal Health Conference 2010 in Delhi focused on global progress on maternal health and explored recent maternal mortality estimates. Speakers discussed the numbers and asked questions not only about what the numbers mean–but also about how the maternal health community can use the numbers.
Over-arching questions from the session were:
Which numbers should we use, those published in the recent Lancet report or those soon to be published by the United Nations (presuming that the numbers will be quite different)?
Will these two sets of numbers prove to be a hurdle in the struggle to bring unity to the maternal health community? If so, how can we reconcile this and avoid a divide in the community?
Will the two sets of numbers push the maternal health community to establish better and more robust methods of measuring maternal mortality and morbidity?
Has the maternal health community collectively neglected the measurement of maternal morbidity–and how can we begin to focus on measuring not only mortality but morbidity as well?
Brief insights from the opening plenary speeches:
Rafael Lozano, Professor of Global Health at the Institute for Health Metrics and Evaluation, succinctly summarized the statistical analysis behind the recent Lancet publication in one slide. (Presentations will soon be available online here: www.maternalhealthtaskforce.org/gmhc2010) He also described many of the lessons learned from the research that led to the Lancet piece–the gaining of ground in the reduction of maternal mortality, an improved picture of what the key drivers of progress really are, the correlation between HIV/AIDS and maternal health outcomes, and the importance of communication with countries and local researchers.
Lale Say, Medical Doctor and Epidemiologist at the World Health Organization, discussed the inter-agency approach of monitoring progress on maternal health–stressing the importance of country level consultations and technical collaboration. While she did not present the latest maternal mortality estimates, she talked in depth about the methodology that the World Health Organization, UNICEF, UNFPA, and the World Bank use to estimate global maternal mortality.
Wendy J. Graham, Principal Investigator with Immpact at the University of Aberdeen, urged the maternal health community to understand that failure is not a bad word. She explained that we often emphasize the successes of our efforts so much so that we neglect to learn from our failures. Wendy also reiterated the importance of context when implementing maternal health programs saying, “context, context, context”–and explaining that because an initiative succeeds in one place, there is no guarantee that it will succeed in the next. We must consider the unique context of each setting where we work.
Saroj Pachauri, Regional Director for South and East Asia at the Population Council, asked a number of thought provoking questions throughout her presentation; We count numbers but do numbers count for policy change? Is there a culture of evidence-based programming? How can we address measurement challenges and improve the use of information? Saroj also noted staggering inequities in maternal deaths between and within countries. She explained that the lifetime risk of maternal death in South Asia is 1 in 43 compared to 1 in 30,000 in Sweden–citing this as an example of a failure to bridge the divide between rich and poor.
For more brief insights from our conference presenters, follow the Maternal Health Task Force and EngenderHealth on Twitter: @MHTF and @EngenderHealth. The conference hashtag is #GMHC2010.
For more posts about the Global Maternal Health Conference, click here.
For the live stream schedule, click here.
Check back soon for the archived videos of the conference presentations.
Global Maternal Health Conference 2010: Empowering the Next Generation
Monday, August 30th, 2010 by Christopher Lindahl
Written by Calyn Ostrowski, Woodrow Wilson Center for Scholars
“We do not need new legislation… we need affordable, effective, and scalable solutions,” said Shn Gulamnabi Azad, Minister of Health, India, at the opening ceremony of the first-ever Global Maternal Health Conference in New Delhi.
Co-hosted by the Maternal Health Task Force and the Public Health Institute of India, this three-day technical meeting builds upon the momentum of Women Deliver and the G8 summit by bringing together 700 researchers, program managers, advocates, media, and young people to exchange ideas, share data, develop strategies, and identify solutions for reducing maternal mortality.
In order to reduce India’s maternal mortality rates, Azad called for the repositioning of family planning programs to include maternal and child health and not limit the scope of services to population control as historically executed. Improving family planning and maternal health services must also address the reproductive health needs of adolescent girls and India is currently developing a new ministry that will target gender inequality, poverty, early child marriages, as well as other critical health issues important to young girls such as the dissemination of sanitary napkins.
“Although the legal age of marriage is 18, there are districts in India where 35 percent of the population is married between the ages of 15-18,” said Azad. During the side event Adolescent Girls: Change Agents for Healthy Mother and Child technical experts such as Anil Paranjap of the Indian Institute of Health Management presented scientific evidence that girls who marry between 15-18 are five times more likely to die during childbirth than women in their early 20’s.
“We still have deep-rooted subordination that makes it very difficult for young women to realize their sexual and reproductive health rights,” said Sanam Anwar with the Oman Medical College. Interventions such as the UDAAN project–a private-public partnership between CEDPA and the Government of India–demonstrate promising solutions for empowering young people through the use of existing infrastructure. In collaboration with teachers, parents, principals, and students this project successfully increased leadership skills and improved youth knowledge on menstruation, health, friendship, peer pressure, early marriage, and reproductive health, said Sudipta Mukhopadhyay of CEDPA.
Empowering “young people” to improve maternal health also requires that the community support committed new thinkers and future leaders. The Young Champions of Maternal Health Program is a unique and refreshing group of young professionals from 13 countries dedicated to improving maternal health, and I look forward to learning how this new energy will further the maternal health agenda.
Calyn Ostrowski is the Coordinator of the Maternal Health Dialogue Series in partnership with the Maternal Health Task Force and UNFPA at the Woodrow Wilson International Center for Scholars.
Stay up to date with the conference happenings! Follow the Maternal Health Task Force and EngenderHealth on Twitter: @MHTF and @EngenderHealth. The conference hashtag is #GMHC2010.
For more posts about the Global Maternal Health Conference, click here.
For the live stream schedule, click here.
Check back soon for the archived videos of today’s presentations.
Power to the People: How to Use Policy and Advocacy Tools to Improve Maternal Health
Monday, August 30th, 2010 by KateMitch
Written by Janna Oberdorf, Women Deliver
At today’s session on “Policy and advocacy tools,” panelists presented on web-based and new media options for disseminating maternal health research and messages. Though online technology is an often-untapped resource for the maternal health field, the panelists laid out specific ideas and strategies that have the potential to catalyze policy change.
Panelists discussed:
• Leveraging new and online technology for maternal health advocacy and communication; Mari Tikkanen, M4ID
• An Atlas of Birth: mapping the global challenges and solutions to maternal mortality; Sarah Neal, University of Southampton
• Lives Saved Tool: influencing maternal and child health policy; Koki Agarwal, MCHIP
“Maternal health doesn’t have a global movement,” said Tikkanen. “We need these tools to reach out to a broader audience.”
It was interesting to hear the panel talk about the need to present evidence in ways that capture attention and provoke action among a diverse array of stakeholders. It’s true. Research is incredibly important. But we also need to take scientific research, like the data used in the Lives Saved Tool (LiST), and make it accessible. Data visualization and creative maps, like those created in the Atlas of Birth, are fantastic ways to capture policymakers and express complex issues quickly.
But maps are a natural next step for researchers and academics. What else can we be doing? We can be blogging, updating our Facebook pages, tweeting, downloading iPhone apps, sending text alerts, and more. I am a strong supporter of all new media initiatives, but I think it’s important to remember the difference between awareness-raising and advocacy. Though raising awareness is a step towards advocacy, we should be mindful that our social networking and online tools have an intended impact on policy change. It is not enough to just exist on social networks; we must strategize and use tools that benefit our organizational mission and the broader maternal health cause. And we must tailor our messages to specific audiences.
We also need to work hard to combat those who think online tools are trivial. Betsy McCallon of the White Ribbon Alliance and moderator of the session gave a great example: “In the US, where global development aid support is sliding, policymakers need to hear from their constituents that these issues are important,” she said.
I encourage maternal health organizations who look down on new media, or who fear the rapid pace and inherent transparency, I encourage you to join the movement. Social media and online tools put the power in the hands of the people. It’s our job, as maternal health advocates, to make sure that power is maximized and targeted.
Stay up to date with the conference happenings! Follow the Maternal Health Task Force and EngenderHealth on Twitter: @MHTF and @EngenderHealth. The conference hashtag is #GMHC2010.
For more posts about the Global Maternal Health Conference, click here.
For the live stream schedule, click here.
Check back soon for the archived videos of today’s presentations.
Day One at the GMHC2010: Numbers and their Implications, Quality of Care, and the Role of Abortion in Reducing Maternal Mortality
Monday, August 30th, 2010 by Raji Mohanam
Written by Saumya RamaRao, Population Council
It is 6pm in New Delhi on August 30, 2010 and I’ve just come back to my hotel room after attending a whole day of sessions at the Global Maternal Health Conference. As I sit at my computer reliving the events of the day, I am jotting down key points to share with you—points that struck a chord with me.
I attended four sessions today: the inaugural session, the plenary on “Global progress on maternal health: the numbers and their implications”, “Assessing program performance and quality of care,”, and “The role of abortion in reducing maternal mortality”. The inaugural session brought together key stakeholders each of whom representing a different voice and role: elected government representatives, policy makers, academics, advocates, and youth. Each of the technical sessions I attended had interesting presentations and excellent Q&A sessions.
My take away messages from today are:
Failure is not a bad word. Wendy Graham in the plenary made a call that often we emphasize the successes of our efforts to the detriment of lessons that can be learnt from failures. She made a call for participants to “become connoisseurs of failure” as there can be a lot of learning from failure that will be useful for going forward.
The emphasis on quality of care was repeated several times during the day. Several presenters remarked that increased skilled attendance of deliveries in the absence of improvements in quality of care will lead to nought. Sustained declines in maternal morbidity and mortality can be achieved with an emphasis on quality. This is an argument that the reproductive health field has heard before and understands well. One of my favourite comments of the day came during a Q&A session where the commentator indicated that in the initial phases of increased facility deliveries, we should expect to see increases in maternal deaths before declines occur; however there can be pressure on record keepers to present only positive indicators and hence the supportive environment needs to be one of “fact finding” than “fault finding.”
The importance of data was discussed at several times—its importance for advocacy, for monitoring progress towards MDG 5, to monitor quality and process, for evaluation to learn what works and why, for resource allocation, and to aid decision-making. However, it is just as important that these data be of good quality. One of my other favourite comments came during another Q&A session when the commentator suggested that improving the quality of data be included as part of interventions to improve the quality of care.
I was heartened to attend a session on issues related to safe abortion services. Innovative models are being tested in several countries involving communities and health facilities, with technologies such as misoprostol and mifepristone, and advocating for policy and program change. It will be important to begin paying attention to issues of logistics and supplies of medical abortion as these programs scale up.
It is always energizing to be around thoughtful, committed and insightful professionals and looking forward to the next two days at the meetings.
Saumya RamaRao is an economic demographer with research interests in safe motherhood, abortion and postabortion care, and family planning. She has experience in monitoring and evaluation of reproductive health programs, cost analysis, and the use of data for program design and improvement.
Stay up to date with the conference happenings! Follow the Maternal Health Task Force and EngenderHealth on Twitter: @MHTF and @EngenderHealth. The conference hashtag is #GMHC2010.
For more posts about the Global Maternal Health Conference, click here.
For the live stream schedule, click here.
Check back soon for the archived videos of today’s presentations.
Local Context Matters to Women’s Lives: A Report from Delhi
Tuesday, August 31st, 2010 by KateMitch
I am 27. And I am a maternal health advocate.
Tuesday, August 31st, 2010 by ablancWritten by Janna Oberdorf, Women Deliver
These are two things I’m very proud of. I’m proud to be young (or at least young-ish) and passionate about women and mothers. I’m proud that when I see images of women giving birth in low-quality health facilities, I want to yell at the world. I’m proud that the first time I learned what fistula is, I wanted to smash my computer screen and say, “Why didn’t I even know about this before?” This is a fight that I’m ready and willing to take – the fight for mothers around the world.
But why are there so few young people involved in maternal health, at the research level, at the advocacy level, and at the policy level?
Today, at the Global Maternal Health Conference I got to watch five Young Champions of Maternal Health speak with the same passion that I feel.
I watched:
· Hellen Kotlolo talk about her project to send SMS text messages to pregnant women and new mothers that give them both health advice, but also loving, empowering messages that increase their self-esteem;
· Zubaida Bai talk (via a video recording) about her project to distribute clean birth kits to communities;
· Egwaoje Ifeyinwa Madu talk about using SisterFriends, a trusted network of women in communities, to share information on maternal health and act as a safe and compassionate resource;
· Carolina Araujo Damasio Santos talk about her project The Art of Being Born which uses music, poetry, and other art forms to humanize the process of pregnancy and birth in Brazil;
· and Seth Cochran talk about Operation OF, a project to reintegrate fistula survivors into communities who have shunned them for their injuries.
I couldn’t have been more inspired. But I had to ask the question: How do we get more young people on board? It seems that when it comes to maternal health, it’s hard to reach young people in a way that make them understand this is an issue that affects them. Many young people care about sexual and reproductive health – they want safe sex, contraception, safe abortions. But when you mention maternal health, they think about their mothers.
Sitting in front of five Young Champions who certainly inspired this conference of almost 700 people, I hope that one day maternal health will resonate with young people on a bigger, broader level. I hope that one day when we mention maternal health, young people will think of themselves and not just their mothers. And I hope that organizations like the Maternal Health Task Force, Ashoka, and more continue to respect young people’s opinions and innovative ideas, and properly support them with information, guidance, mentoring and funding.
Learn more about the Young Champions of Maternal Health program, a partnership between the Maternal Health Task Force and Ashoka.
Janna Oberdorf is the Communications Manager at Women Deliver.
Stay up to date with the conference happenings! Follow the Maternal Health Task Force and EngenderHealth on Twitter: @MHTF and @EngenderHealth. The conference hashtag is #GMHC2010.
For more posts about the Global Maternal Health Conference, click here.
For the live stream schedule, click here.
Check back soon for the archived videos of today’s presentations.
Maternal Health Realities: Accountability and Behavior Change
Tuesday, August 31st, 2010 by Raji MohanamWritten by Calyn Ostrowski, Woodrow Wilson Center for Scholars
Four days ago a young woman died giving birth in a bustling marketplace in New Delhi. Just steps away from Parliament, this woman was left to die and no emergency care was sent to her–no midwives, nurses, or doctors; just people walking around her accepting the situation as normal and an uncontrollable way of life. But this is Delhi…not a remote tribal village where the nearest health clinic is hours away (on foot).
This juxtaposition lingers on in me as I sit in the plenary session of day two at the Global Maternal Health Conference and listen to Syeda Hameed, member of the Indian Parliament Planning Commission, discuss her recent visit to a remote village where every house has 10 children living in filth, flies, and emptiness.
Although I have been working on such development issues for the last five years I do not work in the field, nor do I visit the developing world on a regular basis. Hearing these stories, coupled with my firsthand experience of witnessing poverty here in Delhi reminds me of the daily reality of those 342,900 women who die every year. This is their way of life and I think it’s poignant that today’s sessions emphasize community based care, family planning, accountability, behavior change, and culture.
“Context, context, context,” said Wendy Graham of IMMPACT at yesterday’s plenary session. I agree, the context of social and cultural norms is an underlying factor that must be taken into consideration when implementing maternal and child health (MNCH) programs. With a background in psychology, I appreciated when Dr. Zulfiqar Bhutta, of Aga Khan University, recognized the toll of poverty on the imagination and the mentality of fatalism.
That is why it is so essential to “ask the people how they feel and bring their voices into the forums where policy decisions are made,” said Hameed. It is also important to hold key players accountable and include men in MNCH activities.
During the side session Male Involvement in Reproductive and Maternal and Newborn Health six field experts (in which half the panelists and audience members were men!) discussed effective methods for increasing male participation in family planning, vasectomies, gender equality, and hospital care.
The key findings from this discussion include:
• Targeted interventions that educate men about danger signs and pregnancy complications correlates with behavior change and increased facility births.
• Many young married men feel pressured to prove their fertility. A sample of men was evaluated and those who had increased education and income were more likely to delay first pregnancy.
• Vasectomy is not something men want to talk about with family planning fieldworkers; however, official recognition of the vasectomy benefits by the government did increase referrals.
• Puppet and theater shows that demonstrate gender equity behaviors provide an opportunity for dialogue. Women in this study reported increased gender equity in family planning decision-making.
There are so many variables that exacerbate the maternal mortality cycle, but evidence presented here provides REAL solutions. It is time to scale up these solutions and political willpower will be essential.
Calyn Ostrowski is the Coordinator of the Maternal Health Dialogue Series in partnership with the Maternal Health Task Force and UNFPA at the Woodrow Wilson International Center for Scholars.
Stay up to date with the conference happenings! Follow the Maternal Health Task Force and EngenderHealth on Twitter: @MHTF and @EngenderHealth. The conference hashtag is #GMHC2010.
For more posts about the Global Maternal Health Conference, click here.
For the live stream schedule, click here.
Check back soon for the archived videos of today’s presentations.
Clean Birth Kits: Do We Need Them?
Tuesday, August 31st, 2010 by Raji MohanamWritten by Janna Oberdorf, Women Deliver
Clean Birth Kits. It seems like a no-brainer. And, as one audience member at the Global Maternal Health Conference said, “There’s no doubt these would work.”
But, there is doubt, as I learned at today’s session, “Clean birth kits: do we need them?”. There’s serious speculation on what impact and effect clean birth kits (CBKs) would have on saving lives. The session panelists presented a review of the existing evidence on clean birth practices and the potential role for CBKs in supporting these preventive practices, and they found serious gaps in knowledge and research.
One thing that all panelists agreed on is that clean births are necessary to reduce maternal mortality – each year around 1 million newborns and mothers die from infections soon after birth, and this burden is highest for the poorest families. Of the world’s 60 million home births each year, many occur without adequate hygiene, and some facility births also lack basic hygienic care. There are “six cleans” that make up a clean birth: clean hands, clean perineum, clean delivery surface, clean cord cutting implement, clean cord tying, and clean cord care.
But CBKs are not a new idea. They have been around for decades… centuries. The problem is that little research exists that shows how these kits are used, and more importantly, what effect they have on women and providers.
Wendy J. Graham, from Immpact and University of Aberdeen, used this panel to discuss the Birth Kit Working Group, a compilation of health experts who are assessing existing research on CBKs, and considering the development of a decision guide to assist in the planning of overall strategies relating to the use of CBKs. Their key focus has been on CBKs for use in facilities, and trying to determine whether these kits are a help or a hindrance.
“The fact is: We don’t know,” said Graham, who highlighted the gaps in knowledge and research around CBKs effects. “We’ve heard so much about poor quality of care, and we need to identify catalysts for change.”
Though, as Graham and her colleagues Bilal Avan and Vanora Hundley discussed, the CBKs could work as a catalyst for change in a positive way, or a negative way. The presenters and the participants had a heated debate on how the kits could be distributed: would it be more effective if they are housed at health facilities and used when pregnant women arrive for delivery, or should they be given to pregnant women at antenatal visits. Giving women CBKs might actually deter them from having facility births, thinking that they can use the kit at home. Or, it might empower and enable them to return to the facility for their birth. On the other hand, housing the kits at facilities might create dependence from health providers that would be problematic when supplies run out. Or, the kits could sit on a shelf and never be used.
“This is not black or white; not positive or negative,” said Graham. “It depends on where we’re talking about. And it’s hard to really find out about adverse effects when studies don’t talk about failures.”
In the a community that likes to so often stress, “There’s no magic bullet for maternal health,” the CBKs offer the possible potential of what the bed net has done to curb malaria. Moderator, Ann Starrs of Family Care International, put the CBK issues into a broader global advocacy perspective. “Kits are being looked at and promoted almost as an advocacy tool, and as a way to sell this issue to a broad range of audiences as a problem for which there are quick and easy solutions,” said Starrs.
The main takeaway seems to be clean births are essential, and there is serious potential for CBKs to have an impact on maternal health and maternal mortality. The problem is: We have no idea what that impact will be. And before we roll out (and massively fund) the creation of distribution of CBKs, we need to be clear on what the likely outcomes will be.
MORE QUESTIONS TO CONSIDER:
1. What are the most important contextual factors to consider regarding introducing CBKs into facilities? How do we address equity and ensure that poor women and women most in-need receive them?
2. What should a kit include? What’s the criteria?
3. What are the potential uses for CBKs, specifically in conflict or disaster situations?
4. Are birth kits just an expensive diversion? Read a post on this issue by Ann Blanc, Director of the Maternal Health Task Force.
Stay up to date with the conference happenings! Follow the Maternal Health Task Force and EngenderHealth on Twitter: @MHTF and @EngenderHealth. The conference hashtag is #GMHC2010.
For more posts about the Global Maternal Health Conference, click here.
For the live stream schedule, click here.
Check back soon for the archived videos of today’s presentations.
Task-Shifting–Or Why Doctors Might Not Always Be Necessary to Save Mothers’ Lives
Tuesday, August 31st, 2010 by KateMitchWritten by Maria M. Pawlowska, Cambridge University Gates Scholar
The Global Maternal Health Conference 2010 is underway! Unfortunately, I’m not there in New Delhi to witness it all first-hand but the organisers are kindly live streaming some of the sessions so I can still feel like I’m participating in this extraordinary event, while sitting in my office in Cambridge, UK.
The theme of the live streamed afternoon session (which took place in the early morning UK time yesterday) was “Strengthening access to maternal health” and I tuned in to listen about the importance of human resources.
The White Ribbon Alliance has been doing an amazing job the past months and spreading the word about the importance of skilled birth attendants and campaigning for funds to train health workers. The presentations in this session further stressed the importance of training staff who are not necessarily obstetricians and gynaecologists, available to help and treat birthing women.
Helen de Pinho from AMDD talked about the changing situation in Africa, where increasing numbers of non-physician clinicians (NPC) are broadening the scope of health services they provide. NPCs already provide emergency obstetric care in 6 countries and this number is bound to increase in the near future. De Pinho stressed task-shifting as the key – it’s been proven that NPCs can provide, regular and emergency obstetric care with equal success to doctors. Importantly, their training is shorter, quicker and cheaper with no loss in the quality of services they provide to their patients.
In keeping with the theme, Jeffrey Smith, Jhpiego regional director in Asia spoke about the advantages of midwifery services and what it takes to educate a midwife in the developing world. He argued that the aim of a midwife’s education should be to produce a “health worker [who] is competent, employed and able to work effectively”. Thus, it’s important to focus midwives’ education on clinical practice and continually assess the learning process. Students must be given the permission to provide care, obviously under supervision at least at first, and not just watch others providing it. In order to really gain the skills they require to effectively treat their patients they must have the hands-on clinical experience. Once their education is done, the key is to make sure the midwife is employed and her skills are properly taken advantage of – therefore she must have access to at least basic drugs and a space where she can safely see her patients. A “clinic” without a roof and no medical supplies just won’t do it! It’s also important to remember that both the midwives themselves, and communities tend to benefit most from medical training if the midwife is allowed to return to practice in her home village/town after graduation.
The role of training health workers is hard to overestimate and it will take time to train the health professionals we are currently lacking. In the mean time it should be remembered that there are other very cheap and highly effective methods of combating maternal mortality in the short run. Ndola Prata, and colleagues, from the University of California, Berkeley, School of Public Health have very recently published an analysis showing that the cheapest and most effective way of preventing maternal deaths is investing in family planning and misoprostol (a drug for stomach ulcers turned haemorrhage prevention and treatment “miracle” pill). Misoprostol has recently been gaining mainstream media attention for how incredibly cheap, safe and effective it is at saving lives.
Stay up to date with the conference happenings! Follow the Maternal Health Task Force and EngenderHealth on Twitter: @MHTF and @EngenderHealth. The conference hashtag is #GMHC2010.
For more posts about the Global Maternal Health Conference, click here.
For the live stream schedule, click here.
Check back soon for the archived videos of today’s presentations.
Global Progress on Maternal Health: The Numbers and their Implications
Tuesday, August 31st, 2010 by Raji MohanamWritten by Kate Mitchell, Maternal Health Task Force
The opening plenary, Global progress on maternal health: the numbers and their implications, of the Global Maternal Health Conference 2010 in Delhi focused on global progress on maternal health and explored recent maternal mortality estimates. Speakers discussed the numbers and asked questions not only about what the numbers mean–but also about how the maternal health community can use the numbers.
Over-arching questions from the session were:
Which numbers should we use, those published in the recent Lancet report or those soon to be published by the United Nations (presuming that the numbers will be quite different)?
Will these two sets of numbers prove to be a hurdle in the struggle to bring unity to the maternal health community? If so, how can we reconcile this and avoid a divide in the community?
Will the two sets of numbers push the maternal health community to establish better and more robust methods of measuring maternal mortality and morbidity?
Has the maternal health community collectively neglected the measurement of maternal morbidity–and how can we begin to focus on measuring not only mortality but morbidity as well?
Brief insights from the opening plenary speeches:
Rafael Lozano, Professor of Global Health at the Institute for Health Metrics and Evaluation, succinctly summarized the statistical analysis behind the recent Lancet publication in one slide. (Presentations will soon be available online here: www.maternalhealthtaskforce.org/gmhc2010) He also described many of the lessons learned from the research that led to the Lancet piece–the gaining of ground in the reduction of maternal mortality, an improved picture of what the key drivers of progress really are, the correlation between HIV/AIDS and maternal health outcomes, and the importance of communication with countries and local researchers.
Lale Say, Medical Doctor and Epidemiologist at the World Health Organization, discussed the inter-agency approach of monitoring progress on maternal health–stressing the importance of country level consultations and technical collaboration. While she did not present the latest maternal mortality estimates, she talked in depth about the methodology that the World Health Organization, UNICEF, UNFPA, and the World Bank use to estimate global maternal mortality.
Wendy J. Graham, Principal Investigator with Immpact at the University of Aberdeen, urged the maternal health community to understand that failure is not a bad word. She explained that we often emphasize the successes of our efforts so much so that we neglect to learn from our failures. Wendy also reiterated the importance of context when implementing maternal health programs saying, “context, context, context”–and explaining that because an initiative succeeds in one place, there is no guarantee that it will succeed in the next. We must consider the unique context of each setting where we work.
Saroj Pachauri, Regional Director for South and East Asia at the Population Council, asked a number of thought provoking questions throughout her presentation; We count numbers but do numbers count for policy change? Is there a culture of evidence-based programming? How can we address measurement challenges and improve the use of information? Saroj also noted staggering inequities in maternal deaths between and within countries. She explained that the lifetime risk of maternal death in South Asia is 1 in 43 compared to 1 in 30,000 in Sweden–citing this as an example of a failure to bridge the divide between rich and poor.
For more brief insights from our conference presenters, follow the Maternal Health Task Force and EngenderHealth on Twitter: @MHTF and @EngenderHealth. The conference hashtag is #GMHC2010.
For more posts about the Global Maternal Health Conference, click here.
For the live stream schedule, click here.
Check back soon for the archived videos of the conference presentations.
Global Maternal Health Conference 2010: Empowering the Next Generation
Monday, August 30th, 2010 by Christopher LindahlWritten by Calyn Ostrowski, Woodrow Wilson Center for Scholars
“We do not need new legislation… we need affordable, effective, and scalable solutions,” said Shn Gulamnabi Azad, Minister of Health, India, at the opening ceremony of the first-ever Global Maternal Health Conference in New Delhi.
Co-hosted by the Maternal Health Task Force and the Public Health Institute of India, this three-day technical meeting builds upon the momentum of Women Deliver and the G8 summit by bringing together 700 researchers, program managers, advocates, media, and young people to exchange ideas, share data, develop strategies, and identify solutions for reducing maternal mortality.
In order to reduce India’s maternal mortality rates, Azad called for the repositioning of family planning programs to include maternal and child health and not limit the scope of services to population control as historically executed. Improving family planning and maternal health services must also address the reproductive health needs of adolescent girls and India is currently developing a new ministry that will target gender inequality, poverty, early child marriages, as well as other critical health issues important to young girls such as the dissemination of sanitary napkins.
“Although the legal age of marriage is 18, there are districts in India where 35 percent of the population is married between the ages of 15-18,” said Azad. During the side event Adolescent Girls: Change Agents for Healthy Mother and Child technical experts such as Anil Paranjap of the Indian Institute of Health Management presented scientific evidence that girls who marry between 15-18 are five times more likely to die during childbirth than women in their early 20’s.
“We still have deep-rooted subordination that makes it very difficult for young women to realize their sexual and reproductive health rights,” said Sanam Anwar with the Oman Medical College. Interventions such as the UDAAN project–a private-public partnership between CEDPA and the Government of India–demonstrate promising solutions for empowering young people through the use of existing infrastructure. In collaboration with teachers, parents, principals, and students this project successfully increased leadership skills and improved youth knowledge on menstruation, health, friendship, peer pressure, early marriage, and reproductive health, said Sudipta Mukhopadhyay of CEDPA.
Empowering “young people” to improve maternal health also requires that the community support committed new thinkers and future leaders. The Young Champions of Maternal Health Program is a unique and refreshing group of young professionals from 13 countries dedicated to improving maternal health, and I look forward to learning how this new energy will further the maternal health agenda.
Calyn Ostrowski is the Coordinator of the Maternal Health Dialogue Series in partnership with the Maternal Health Task Force and UNFPA at the Woodrow Wilson International Center for Scholars.
Stay up to date with the conference happenings! Follow the Maternal Health Task Force and EngenderHealth on Twitter: @MHTF and @EngenderHealth. The conference hashtag is #GMHC2010.
For more posts about the Global Maternal Health Conference, click here.
For the live stream schedule, click here.
Check back soon for the archived videos of today’s presentations.
Power to the People: How to Use Policy and Advocacy Tools to Improve Maternal Health
Monday, August 30th, 2010 by KateMitchWritten by Janna Oberdorf, Women Deliver
At today’s session on “Policy and advocacy tools,” panelists presented on web-based and new media options for disseminating maternal health research and messages. Though online technology is an often-untapped resource for the maternal health field, the panelists laid out specific ideas and strategies that have the potential to catalyze policy change.
Panelists discussed:
• Leveraging new and online technology for maternal health advocacy and communication; Mari Tikkanen, M4ID
• An Atlas of Birth: mapping the global challenges and solutions to maternal mortality; Sarah Neal, University of Southampton
• Lives Saved Tool: influencing maternal and child health policy; Koki Agarwal, MCHIP
“Maternal health doesn’t have a global movement,” said Tikkanen. “We need these tools to reach out to a broader audience.”
It was interesting to hear the panel talk about the need to present evidence in ways that capture attention and provoke action among a diverse array of stakeholders. It’s true. Research is incredibly important. But we also need to take scientific research, like the data used in the Lives Saved Tool (LiST), and make it accessible. Data visualization and creative maps, like those created in the Atlas of Birth, are fantastic ways to capture policymakers and express complex issues quickly.
But maps are a natural next step for researchers and academics. What else can we be doing? We can be blogging, updating our Facebook pages, tweeting, downloading iPhone apps, sending text alerts, and more. I am a strong supporter of all new media initiatives, but I think it’s important to remember the difference between awareness-raising and advocacy. Though raising awareness is a step towards advocacy, we should be mindful that our social networking and online tools have an intended impact on policy change. It is not enough to just exist on social networks; we must strategize and use tools that benefit our organizational mission and the broader maternal health cause. And we must tailor our messages to specific audiences.
We also need to work hard to combat those who think online tools are trivial. Betsy McCallon of the White Ribbon Alliance and moderator of the session gave a great example: “In the US, where global development aid support is sliding, policymakers need to hear from their constituents that these issues are important,” she said.
I encourage maternal health organizations who look down on new media, or who fear the rapid pace and inherent transparency, I encourage you to join the movement. Social media and online tools put the power in the hands of the people. It’s our job, as maternal health advocates, to make sure that power is maximized and targeted.
Stay up to date with the conference happenings! Follow the Maternal Health Task Force and EngenderHealth on Twitter: @MHTF and @EngenderHealth. The conference hashtag is #GMHC2010.
For more posts about the Global Maternal Health Conference, click here.
For the live stream schedule, click here.
Check back soon for the archived videos of today’s presentations.
Day One at the GMHC2010: Numbers and their Implications, Quality of Care, and the Role of Abortion in Reducing Maternal Mortality
Monday, August 30th, 2010 by Raji MohanamWritten by Saumya RamaRao, Population Council
It is 6pm in New Delhi on August 30, 2010 and I’ve just come back to my hotel room after attending a whole day of sessions at the Global Maternal Health Conference. As I sit at my computer reliving the events of the day, I am jotting down key points to share with you—points that struck a chord with me.
I attended four sessions today: the inaugural session, the plenary on “Global progress on maternal health: the numbers and their implications”, “Assessing program performance and quality of care,”, and “The role of abortion in reducing maternal mortality”. The inaugural session brought together key stakeholders each of whom representing a different voice and role: elected government representatives, policy makers, academics, advocates, and youth. Each of the technical sessions I attended had interesting presentations and excellent Q&A sessions.
My take away messages from today are:
Failure is not a bad word. Wendy Graham in the plenary made a call that often we emphasize the successes of our efforts to the detriment of lessons that can be learnt from failures. She made a call for participants to “become connoisseurs of failure” as there can be a lot of learning from failure that will be useful for going forward.
The emphasis on quality of care was repeated several times during the day. Several presenters remarked that increased skilled attendance of deliveries in the absence of improvements in quality of care will lead to nought. Sustained declines in maternal morbidity and mortality can be achieved with an emphasis on quality. This is an argument that the reproductive health field has heard before and understands well. One of my favourite comments of the day came during a Q&A session where the commentator indicated that in the initial phases of increased facility deliveries, we should expect to see increases in maternal deaths before declines occur; however there can be pressure on record keepers to present only positive indicators and hence the supportive environment needs to be one of “fact finding” than “fault finding.”
The importance of data was discussed at several times—its importance for advocacy, for monitoring progress towards MDG 5, to monitor quality and process, for evaluation to learn what works and why, for resource allocation, and to aid decision-making. However, it is just as important that these data be of good quality. One of my other favourite comments came during another Q&A session when the commentator suggested that improving the quality of data be included as part of interventions to improve the quality of care.
I was heartened to attend a session on issues related to safe abortion services. Innovative models are being tested in several countries involving communities and health facilities, with technologies such as misoprostol and mifepristone, and advocating for policy and program change. It will be important to begin paying attention to issues of logistics and supplies of medical abortion as these programs scale up.
It is always energizing to be around thoughtful, committed and insightful professionals and looking forward to the next two days at the meetings.
Saumya RamaRao is an economic demographer with research interests in safe motherhood, abortion and postabortion care, and family planning. She has experience in monitoring and evaluation of reproductive health programs, cost analysis, and the use of data for program design and improvement.
Stay up to date with the conference happenings! Follow the Maternal Health Task Force and EngenderHealth on Twitter: @MHTF and @EngenderHealth. The conference hashtag is #GMHC2010.
For more posts about the Global Maternal Health Conference, click here.
For the live stream schedule, click here.
Check back soon for the archived videos of today’s presentations.
Global Maternal Health Conference 2010: Day One Take-Aways from the Young Champions
Tuesday, August 31st, 2010 by Christopher LindahlWritten by Lorraine Thompson, Ashoka
On August 30 at 8:00am, the air was already hot and sticky as Ashoka’s Young Champions and Changemakers boarded an air-conditioned bus. After careening across Delhi’s bumpy streets, the young social entrepreneurs stepped into the bright light of downtown Delhi for their first day at the Global Maternal Health Conference (GMHC).
In the morning they attended the Conference’s inaugural ceremonies. After lunch they absorbed new facts, figures and findings at special conference sessions. Later that evening, I caught up with two Young Champions and a Changemaker to ask a question:
What was your most important takeaway from today’s GMHC sessions? How will it impact your work?
Onikepe Owolabi
“At the first presentation today, I was struck by the obstetric epidemiologist from Aberdeen (Wendy J. Graham from Immpact at the Univeristy of Aberdeen). She kept mentioning context of research. And it struck me that when we look at studies to influence what we do, we should always try to find out about the culture of the people there. And the other things was her idea of ‘failing forward’: learning to maximize our failures—to make them into successes and leverage them for future successes.”
“In the afternoon, I attended a session on the social and economic impacts on maternal health. There was a young man who spoke about a qualitative study done in Nepal. Because of what I heard in the morning, I was a lot more open to qualitative research. Sometimes people think it’s not as scientific as quantitative data collection. He spoke about the cultural things that stopped women from accessing healthcare. He kind of sparked a thought in my heart—that culture is an integral part of people’s lives.”
“I think the aim of our Young Champion projects should be to eliminate the harmful practices of culture. But maybe we will get women to access healthcare better if we can incorporate some good parts of culture. From my cultural context, many people use traditional birth attendants because they want the love, the prayers and the social support. So maybe if we could somehow incorporate those spiritual rituals into hospital birthing and institutional deliveries, women would be more open to using them—as against just insisting that they come to the hospital.”
Seth Cochran
“The partner I work with in Uganda uses these birth kits. She goes around to different women in the villages and shows them a little backpack filled with things that will make a pregnancy safer. Really basic stuff. Like soap to wash your hands. A razor to cut the cord—a sterile razor. A clean blanket.”
“Originally I thought, it was a great idea. But it turns out it’s a pretty controversial idea. A lot of people worry that if you give a woman this kit of clean stuff, it’s going to tell her it’s okay to give birth at home. And that’s not what the institutional players want. They want the women having their babies in hospitals. Which I think is ideal—but in a lot of cases not realistic.”
“Since the Women Deliver Conference, I’ve been thinking I need to better understand this discussion. So today I went to a session on birth kits. It was structured almost like a debate. Like, Here are some of the facts: What do you think?”
“And it became very clear to me what I want to do. With these birth kits, there are all these possibilities, right? It doesn’t have to be a facility birth. If you manage it properly, not only can it make a woman want
At the hospital, they know, if they’ve been trained, how to receive this woman: The woman comes with a little package, they can immediately take every thing out, do the job quicker, more effectively, make sure everything’s there.”
“Today the debate made it very clear in my mind that I’m going to do this as a fundamental part of my program. The specifics of how—I’m not quite sure about yet. But my mind was boiling with possibilities: You could sell these things. You could sell vouchers for additional care. You could give them vouchers for local transport—negotiate with taxis. It’s a physical good, a package that’s not only sellable to the woman in Africa—or donate-able—but it’s also saleable to the donating public. Because it’s tangible. And it’s low cost—probably less than $10 or $15.”
Dr. Minal Singh
“I liked meeting people from the same field, with a similar cause. The best part was I’m coming away with the feeling that I’m not alone—I’m not facing different values in the field of maternal health. The values are shared by people all over the world. So it gives me lots of inspiration to work with new energy when I get back.”
“There are so many synergies. Though we had little time to connect with all the partners, I’m sure we have their contact details and their organization names. Thanks to the World Wide Web, we’ll be able to connect again. I can see much potential—people from whom I can learn and partner.”
“In the afternoon I attended a session on the social and economic and cultural implications of maternal health. It was a very nice talk. And this is actually the problem we are facing—the gap in India between the rural and the urban and also the economic gap. So I hope this will help me implement better.”
Lorraine Thompson is the winner of the Ashoka’s Maternal Health Blogging Contest and is live blogging for the Change Summit and the Global Maternal health Conference.
Stay up to date with the conference happenings! Follow the Maternal Health Task Force and EngenderHealth on Twitter: @MHTF and @EngenderHealth. The conference hashtag is #GMHC2010.
For more posts about the Global Maternal Health Conference, click here.
For the live stream schedule, click here.
Check back soon for the archived videos of the conference presentations.
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Tags: Ashoka, Delhi, Dr. Minal Singh, Global Maternal Health Conference 2010, India, Lorraine Thompson, maternal health, Nepal, Onikepe Owolabi, Seth Cochran, Wendy J. Graham, Women Deliver, Young Champions of Maternal Health
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