Access to Maternal Health Commodities

Tuesday, November 30th, 2010 by Christopher Lindahl

Unlike some other aspects of the development world, maternal health solutions are often straightforward and less controversial. Ask 10 experts how to improve local governance in a given country, and you’ll likely get 10 different answers. However, ask 10 experts how to treat post-partum hemorrhage, and you’ll likely get one answer: treat with misoprostol. This, however, doesn’t mean that maternal health is an issue we can ignore because the challenge is often how to get that knowledge and those supplies to those who need it. The science regarding maternal health is sound, but we still need to figure out how to put that science to use in low-resource settings.

This morning at the Woodrow Wilson center in Washington, D.C., the MHTF and UNFPA hosted “Expanding Access to Essential Maternal Health Commodities.” The discussion focused on methods to ensure that the necessary supplies that we know are essential for maternal health are available in low-resource settings. Elizabeth Leahy Madsen from Population Action International and Melodie Holden from Venture Strategies Innovations (VSI) discussed methods for getting supplies, such as misoprostol, into the hands of health workers and doctors in countries such as Bangladesh and Uganda.

On the Wilson Center’s website, you can view the video from this morning’s presentations and discussion and see the presentations given by the speakers.

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Visualizing Data in Tableau Public

Monday, November 29th, 2010 by Christopher Lindahl

Visualizing data is a useful way to show trends and information that may not be as easily understood or compelling in tables or text. There are many tools available online to visualize maternal health data, such as GapMinder or those available from IHME. Tableau Public is another such tool, but unlike others available, it allows you greater flexibility in terms of the data you use. Data from Access, Excel, text files and many other formats can be used.

It takes some time to learn how to use the tool, but after a little practice you’ll be able to create a chart showing the decreases (and the unfortunate increases) in maternal mortality ratios or a map showing changes in MMRs in Africa.

Looking for data to get started? A number of sources listed on our Statistics page allow you to download data to Excel, which you could then use on Tableau Public.

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Developing a Positive Body Image

Wednesday, November 24th, 2010 by Christopher Lindahl

This blog post was contributed by Ifeyinwa Egwaoje, one of the fifteen Young Champions of Maternal Health chosen by Ashoka and the Maternal Health Task Force at EngenderHealth. She will be blogging about his experience every month, and you can learn more about her, the other Young Champions, and the program here.

 

 

Young Champion of Maternal Health Ifeyinwa Egwaoje presents at the first TED event organized by Tulane University in New Orleans.

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Balancing the Bicycle

Tuesday, November 23rd, 2010 by Christopher Lindahl

This blog post was contributed by Seth Cochran, one of the fifteen Young Champions of Maternal Health chosen by Ashoka and the Maternal Health Task Force at EngenderHealth. He will be blogging about his experience every month, and you can learn more about him, the other Young Champions, and the program here.

Einstein said, “Life is like riding a bicycle – to keep your balance you must keep moving.”

I have never been a poster boy for managing a good Work/Life balance. With a full-time commitment to my project with EHAS and a startup non-profit of my own with OperationOF, I am now facing the challenge of a Work/Work/Life balance. But when I accepted this Young Champion challenge, I expected to grow in unexpected ways.

I have to admit that the Life part of my Work/Life balance is typically my first sacrifice. Normally in a situation like this, I would learn just as much Spanish as necessary (if any) and live as close to work as possible.

Everyone here speaks great English, so necessity demands little. But learning Spanish has become important to me and I am devoting hours of every day studying its intricacies. I also did not choose the path of least resistance in the apartment search. But, being picky paid off. I found a little flat on top of a tall building. With panoramic views in every direction, my terrace is my new refuge. This wide-open, rooftop patio dumps Spain’s enchanting light on me and I honestly can’t get enough. I’m making every day a little longer just by refusing to miss a sunrise. Believe me, I need all the extra time I can get.

View from the Atico

So how can I get the Work/Work done with Life demanding a bigger piece of the pie? I keep moving and try to make sure there is very little wasted motion. It helps that my work with EHAS is contributing to my effort with OperationOF and vice versa. This synergy is driving my growing knowledge not only of maternal health, but also of how I can apply old skills in new ways.

For example, in my first month with EHAS, I did a fair amount of research on telemedicine and ICT (information and communication technologies) for health. This definitely sharpened my research skills and helped me orient myself around the various peer-reviewed resources available. These research skills found immediate use in the investigation of new approaches to preventing obstructed labor and obstetric fistula for an international consultation.

As a member of the Prevention sub-committee in the Société Internationale d’Urologie (SIU) consultation on obstetric fistula, I had the opportunity to present research at the SIU meeting in Marrakesh. My new research skills helped me discover new mechanisms to potentially prevent maternal death. Presenting the findings at the Marrakesh meeting also gave me the opportunity to see one of the world’s leading fistula surgeons: Dr. Steve Arrowsmith. I convinced this thought leader to join OperationOF’s surgical advisory board. So my work with EHAS is not only growing my technical skills, but also helping me strengthen my organization.

Me and Steve Arrowsmith

I am also finding new ways to apply my old private sector skills in my work with EHAS. When I worked in the private equity industry, the application of business development and finance skills translated ideas into profit. As part of my role, I have assisted Andres and Carlos Rey, a member of the EHAS team with broad ICT knowledge, to develop social business strategies for EHAS as part of the Ashoka/Siemens Foundation Social Business Development Group. The strategy sessions and financial forecasting we did this month felt very similar to private sector work, except we sought profit in the form of improved health outcomes. Andres presented the high level strategy at a meeting in Munich and we are now digging deeper into several elements of the plan as well as focusing efforts on maternal and newborn child health.

The breadth of my efforts in this Young Champion experience is most definitely fueling my growth as a maternal health innovator, but I am also growing from interaction with my Young Champion peers. Anna Dion and I are adapting a business planning structure. Martha Fikre Adenew and I are developing a collaboration plan to synergize our project ideas. Ifeyinwa Egwaoje and I have discussed how to reduce volunteer attrition and increase participation. Yeabsira Mehari, who also works on obstetric fistula, has shared a great deal of her experiences and ideas with me. There is truly cross-pollination on every level and in every dimension.

I love how Einstein implied that balance lives in motion. I am “moving” more than I can remember, but am finding incredible balance amidst the flurry of Young Champion experiences. I can’t wait to see where this “bicycle” will take me next.

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Fistula Care in Sierra Leone

Monday, November 22nd, 2010 by Christopher Lindahl

The following post was contributed by the Fistula Care Project and is a part of their Stories from the Field series that documents the experiences of women suffering from obstetric fistula and the people who work on the issue.
 
Dr. Alyona Lewis is the only national fistula surgeon providing routine obstetric fistula repairs in all of Sierra Leone. Based at the Aberdeen Women’s Centre in Freetown, Dr. Lewis and her team transform the lives of hundreds of women each year. Managed by the Gloag Foundation, the Aberdeen Women’s Centre is the fulfillment of Dr. Lewis’s dream to see a freestanding fistula center where women with fistula are welcomed without discrimination.
 
Dr. Lewis first encountered the problem of fistula in 2002. This was just after the war in Sierra Leone, during which rebels frequently abducted and sexually assaulted women. Some women began to leak urine following the trauma; others became pregnant and subsequently experienced obstructed labor. In either case, many women ended up leaking urine uncontrollably, ashamed and stigmatized. At the time of the war, Dr. Lewis worked in a maternity ward. She remembers not having equipment, banked blood, and the freedom to transport patients-sometimes the only thing she could do was to hold a woman’s hand as she died.
 
International relief workers came to Sierra Leone in the war’s terrible wake. One visiting doctor from the International Medical Corps (IMC) saw the young and inquisitive Dr. Lewis on the wards and asked if she would be interested in learning how to screen fistula patients. Dr. Lewis began to assist. Although IMC wanted to train Dr. Lewis in fistula repair surgery, she was initially rejected because she was a resident obstetrician-gynecologist rather than a specialist. With time, however, IMC reconsidered, and Dr. Lewis promised that she would not let them down. She trained first in Nigeria and later under expatriate fistula surgeons who visited Sierra Leone. Most recently, EngenderHealth’s U.S. Agency for International Development-funded Fistula Care project supported Dr. Lewis to hone her skills and learn how to train others to repair fistula onboard Mercy Ships’ floating hospital. Dr. Lewis has been fortunate to work alongside many great fistula surgeons, who passed on not only their technical expertise but also their passion for the job.
 
One of the many women whose lives have been transformed through Dr. Lewis’s commitment to fistula surgery is Jojo. Jojo was waiting for fistula repair at a public hospital at a time when all of that hospital’s cleaners and support staff went on strike. To draw attention to their cause, the workers turned off the water supply. Seeing the need, Jojo organized all of the waiting patients to clean the wards and to fetch water. Dr. Lewis and her colleagues all contributed money and their time to be able to repair Jojo’s fistula. It was a challenging case, but the surgical team tried their best and said a prayer. Dry at last, Jojo regretted that she had no way to pay. She committed to serve however she could and became one of the hospital’s best nurse aides, full of empathy and kindness toward patients. Today, Jojo is finishing nursing school, with plans to learn midwifery. As a midwife, Jojo will be able to keep other Sierra Leonean women from developing the obstetric fistula that she did. Dr. Lewis smiles to think of how Jojo’s life has been transformed: It is stories like these that keep her going.

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Weekend Reading

Friday, November 19th, 2010 by Christopher Lindahl

This week on the MHTF blog:

  1. Tim Thomas wrote about the Partners’ Forum on Women’s and Children’s Health in Delhi.
  2. Raji Mohanam told us about many mobile technologies that have health applications
  3. We heard about the Tamil Nadu Health Systems Project

Some reading for the weekend:

  1. Bill Gates on mHealth
  2. Choices of maternal health services in Egypt
  3. Maternal health in Sierra Leone
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Maternal Mortality, Human Rights and Accountability

Friday, November 19th, 2010 by Christopher Lindahl

In September in Geneva, experts in human rights and maternal health gathered to discuss “good practices regarding maternal death audits, the role of national human rights institutions, and the contribution of judicial procedures.” Participants included staff from Human Rights Watch, the Center for Reproductive Rights, Amnesty International and OHCHR, among others.

The presentations from the roundtable and the meeting report can be found online through the International Initiative on Maternal Mortality and Human Rights.

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Linkages Among Reproductive Health, Maternal Health and Perinatal Outcomes

Friday, November 19th, 2010 by Christopher Lindahl

MHTF Director Ann Blanc published an article in the December 2010 issue of Seminars in Perinatology.

She and her colleagues reviewed about 1,000 studies dealing with reproductive health, maternal health, and perinatal and neonatal outcomes and found:

Our review amply demonstrates that opportunities for assessing outcomes for both mothers and newborns have been poorly realized and documented…This review demonstrates that RHMNH are inextricably linked, and that, therefore, health policies and programs should link them together. Such potential integration of strategies would not only help improve outcomes for millions of mothers and newborns but would also save scant resources. This would also allow for greater efficiency in training, monitoring, and supervision of health care workers and would also help families and communities to access and use services easily.

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C-Sections on GlobalMama and Caesarean Community of Practice

Thursday, November 18th, 2010 by Christopher Lindahl

As we recently mentioned, MHTF also has a blog on Medscape/WebMD and we’ve published a post today on caesarean sections in the United States and throughout the developing world.

Also, we’ve created a page for a community of practice (CoP) working on caesarean indicators. The group met in January 2010 in Baltimore to discuss how to improve measurement of caesarean birth and developed a meeting report with recommendations for moving research forward.

In addition to the caesarean CoP, MHTF has participated in the Clean Birth Kits Community of Practice to investigate the role of clean birth kits in improving maternal health.

These communities of practice serve as a platform for experts in the field of maternal health and its related fields to share knowledge and information to reach consensus on major topics in maternal health that are major areas of debate. As we move forward, the development of additional CoPs around other pressing maternal health issues is likely.

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Call for Abstracts: Global Health Metrics and Evaluation

Thursday, November 18th, 2010 by Christopher Lindahl

The Institute for Health Metrics and Evaluation, The Lancet, the London School of Hygiene & Tropical Medicine, the Harvard School of Public Health, and the University of Queensland School of Population Health invite submission of abstracts for oral or poster presentations at the Global Health Metrics & Evaluation: Controversies, Innovation, Accountability conference, to be held on March 14–16, 2011 in Seattle, WA, USA.

The peer-review process will be organized by The Lancet. Accepted abstracts will be published in a booklet and on The Lancet‘s website.

Topics

A broad range of topics related to health metrics and evaluation will be covered during the conference. Abstracts can be submitted on the following topics:

  • The latest approaches to measuring maternal mortality
  • Transitions in non-communicable diseases in rich and poor countries
  • Controversies in the burden of malaria
  • Trends in health inequalities
  • Integrated surveillance systems
  • Responsible data sharing and strengthening country capacity for analysis
  • New quantitative tools for priority setting
  • The next generation of metrics for health-system performance

Guidelines for abstract submission

  • 250-300 words in length
  • Written in English
  • Abstracts should include the following:
    • Background/introduction
    • Objective
    • Methodology
    • Results
    • Conclusions/recommendations
  • Please indicate whether the abstract is being submitted for consideration as:
    • An oral presentation
    • A poster
    • Either an oral presentation or a poster

The GHME Organizing Committee will cover the registration fee, air travel, and accommodation expenses during the conference dates for all individuals whose abstracts are selected for an oral presentation and for some individuals whose abstracts are selected for a poster session. Students and participants from low-or middle-income countries whose abstracts are accepted for the poster session will be given priority for financial support.

Please submit your abstract as an attached Microsoft Word document to abstracts-ghme@uw.edu no later than December 6, 2010. Participants will be informed of the acceptance of abstracts for oral or poster presentation no later than Jan. 24, 2011. For more information about the GHME 2011 conference, please visit the conference website ghme.org.

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