Global and national maternal mortality targets for the Sustainable Development Goals

By: Rima Jolivet, Maternal Health Technical Director, Maternal Health Task Force; Sarah Hodin, Project Coordinator II, Women and Health Initiative, Harvard T.H. Chan School of Public Health

This post originally appeared on the MHTF Blog.

There has been some confusion recently about the Sustainable Development Goals (SDG) target for reducing global maternal mortality. The SDG global target is to reduce the global maternal mortality ratio (MMR) to less than 70 per 100,000 live births by 2030. In addition to this global target, there are separate country-level targets: The primary national target is that by 2030, every country should reduce its MMR by at least two-thirds from its 2010 baseline. The secondary target, which applies to countries with the highest maternal mortality burdens, is that no country should have an MMR greater than 140 deaths per 100,000 live births by 2030.

Continue reading “Global and national maternal mortality targets for the Sustainable Development Goals”

Universal health coverage and gender

By Stacy Lu

This interview with Kiley Workman Diop originally appeared on the blog for Systems for Improved Access to Pharmaceuticals and Services (SIAPS), a program funded by USAID and implemented by Management Sciences for Health. This interview has been edited for length. 

Kiley Workman Diop is a Technical Advisor for SIAPS, and Stacy Lu is a Technical Writer for SIAPS.

A pharmacist with a client at the pharmacy for the the Hospital Notre Dame des Palmistes, Ile la Tortue, Haiti  (Photo credit: Jean Jacques Augustin)

How does attention to gender figure into the work SIAPS does in strengthening pharmaceutical systems?
In public health, when you’re designing an intervention you’re trying to think broadly about what’s going to help the whole population. But you also need to pay special attention to vulnerable groups, including groups that derive their vulnerability from their gender. In a broad sense, it’s about equity—if half the population (whether men or women, boys or girls) isn’t being served appropriately by our interventions, that dilutes SIAPS’s success and we miss out on achieving equitable access to medicines and services that help save lives. We have to think about gender to ensure equitable access to quality care.

Continue reading “Universal health coverage and gender”

We are fearless. #FearlessFeb

Photo by Joey O’Loughlin

We are celebrating Fearless February to rally the global community around advocacy for reproductive, maternal, newborn, child and adolescent health!

This month, the FCI Program of MSH will feature stories about fearless champions, powerful evidence, and advocacy wins from the Rights & Realities archive. Follow #FearlessFeb on Twitter and Facebook to read the story of the day.

Join us on Twitter and Facebook, and tell us:
What makes you fearless? What does “fearless” mean to you?
Subscribe to Rights & Realities (on the homepage, right column) to receive emails of new posts.

 

Trump’s global gag rule silences doctors and midwives and harms their patients

By Catharine Taylor

Catharine Taylor is Vice President for health programs at Management Sciences for Health. This post originally appeared on STAT News

Midwifery students in Sierra Leone, which has one of the highest maternal mortality rates in the world. Funding for safe pregnancy and delivery worldwide is threatened by President Trump’s reinstatement of the global gag rule. (Photo by MARCO LONGARI/AFP/Getty Images)

President Trump’s reinstatement of the Mexico City Policy, better known as the global gag rule, came as no surprise to anyone working in the field of global health. We have been through this before — in 1984, when the policy was first put into effect by President Reagan, and then in 1993, 2001, and 2009, when it was repealed, reinstated, and repealed again.

The Mexico City Policy is called a gag rule because it limits not just what organizations and health providers do but what they are permitted to say. It prevents foreign organizations that receive US government funding from performing abortions — even if they are using funds from non-US government sources and even if abortion is completely legal in their countries.

The global gag rule also steps right between a woman and her doctor, nurse, or midwife, preventing these frontline health providers from telling their patients about the full, legal range of health options available to them. It forbids trusted advisers from giving honest, comprehensive health advice and information. I started my career as a nurse-midwife, and then worked in maternal and newborn health programs in Africa and Asia, so I know what this will mean for the lives and health of women and their families. Continue reading “Trump’s global gag rule silences doctors and midwives and harms their patients”

Counting every maternal death: Strengthening maternal mortality surveillance and response in the Caribbean

By Aishling Thurow

Aishling Thurow is a Project Support Associate at Management Sciences for Health. 

Every maternal death must be documented to prevent the next one. In the Caribbean, where 175 women die for every 100,000 live births (WHO, 2015), understanding the reasons they died is essential to preventing more unnecessary maternal deaths in the future.

In 2013, the World Health Organization developed guidelines for maternal death surveillance and response (MDSR) to capture the number and systemic causes of maternal deaths and to strengthen policies and programs that will better respond to maternal health needs.

Delegates and organizers from the Technical Consultation on the Maternal Death Surveillance and Response Guidelines (MDSR): Region of the Americas. Dec. 9, 2016. Montego Bay, Jamaica. Photo by Aishling Thurow/MSH

In December 2016, the Latin America and Caribbean Regional Task Force for the Reduction of Maternal Mortality (GTR for its Spanish acronym), of which MSH is an Executive Committee member, hosted a technical consultation on guidelines for maternal death surveillance and response systems in the Caribbean. Held in Montego Bay, Jamaica, the workshop welcomed 20 delegates−Ministry of Health officials, as well as prominent maternal mortality surveillance experts−from Jamaica, Belize, Suriname, Guyana, and Trinidad and Tobago. The workshop aimed to strengthen maternal mortality surveillance and response systems in the sub-region, to improve maternal mortality data quality, and to strengthen policy development and implementation capacities at the national level.

Continue reading “Counting every maternal death: Strengthening maternal mortality surveillance and response in the Caribbean”

Webinar presentation – Misoprostol for PPH: Innovations for Impact

On December 15, MSH, Gynuity Health Projects and Jhpiego hosted a one-hour webinar to share innovations – interventions, technologies, and distribution approaches – that have the potential to increase access to and use of misoprostol for postpartum hemorrhage (PPH), the leading cause of maternal death. This webinar:

  • Highlighted innovative ways that countries are expanding access to and use of misoprostol for PPH
  • Showed how successful innovations can be scaled up for national impact

PRESENTERS
Esther Azasi
Knowledge Management Specialist & Associate Program Manager, One Million Community Health Workers Campaign-Millennium Promise, Ghana

Holly Anger
Program Associate, Gynuity Health Projects, USA

Gail Webber
Saving Mothers Project, Mara Region, Tanzania and University of Ottawa, Canada

Partamin Manalai
Monitoring, Evaluation and Research Director, Jhpiego, Afghanistan

MODERATOR
Shafia Rashid
Senior Technical Advisor, FCI Program of Management Sciences for Health (MSH)

Listen to the webinar and download the presentation slides here.

Misoprostol for postpartum hemorrhage: Empowering health workers to save lives

Shafia Rashid is a Senior Technical Advisor for the FCI Program of Management Sciences for Health.

In Senegal, approximately 1,800 women lose their lives every year while giving birth. The major cause of these deaths is uncontrolled bleeding after childbirth, or postpartum hemorrhage (PPH). More than half of Senegalese women live in rural areas and have limited access to well-equipped health facilities that can prevent or treat many of these deaths. Many women give birth, attended by matrones or volunteer birth attendants, in maternity huts. Recognized as essential health care providers by their communities, matrones have some formal training and are now registered with the Ministry of Health (MoH).

To effectively prevent or treat PPH, women need access to uterus-contracting drugs, or uterotonics, such as oxytocin or misoprostol. The recommended uterotonic, injectable oxytocin, requires cold storage and technical skill to administer. Misoprostol is a safe and effective alternative where oxytocin isn’t available or feasible; it doesn’t need refrigeration and is easy to use—particularly important features for use in remote, rural areas.

From 2013 to 2014, the Government of Senegal’s Direction of Reproductive Health and Child Survival, in partnership with USAID and Gynuity Health Projects, examined the use of misoprostol (600 mcg oral) or oxytocin (10 UI) via Uniject® for prevention of PPH at the community level. Matrones were trained to assist with deliveries and administer the designated intervention. According to the study, both misoprostol and oxytocin in Uniject® were equally effective and safe in preventing PPH, and matrones  posted at the health huts were capable of administering the medicine they were assigned. Continue reading “Misoprostol for postpartum hemorrhage: Empowering health workers to save lives”

Advocacy success story: Kenya approves misoprostol for PPH

Melissa Wanda Kirowo is advocacy project officer for FCI Program of Management Sciences for Health in Kenya. 

This blog post provides an update to an earlier post.

The Kenya Constitution states that every person has the right to the highest attainable standard of health, including reproductive health. To realize this right, every person must have access to high-quality, life-saving medicines.

Photo credit: Mark Tuschman
Photo credit: Mark Tuschman

Recently, the government achieved great strides toward making this right to health a reality for its citizens. For the first time, the Kenya Essential Medicines List 2016 (KEML) included misoprostol in the oxytocics section, indicating its use for the prevention and treatment of postpartum hemorrhage (PPH), excessive bleeding after childbirth and a leading cause of maternal death. Misoprostol is stable at room temperature, available in pill form, and inexpensive. Because of these advantages and the drug’s wide availability, misoprostol may be a woman’s only chance for surviving PPH in settings with limited infrastructure and a shortage of skilled birth attendants–like many parts of Kenya. Continue reading “Advocacy success story: Kenya approves misoprostol for PPH”

Countdown to 2015 becomes Countdown to 2030

By Sarah Hodin, Project Coordinator II, Women and Health Initiative, Harvard T.H. Chan School of Public Health

This post originally appeared on the Maternal Health Task Force blog. 

CountdownCountdown to 2015 for Maternal, Newborn and Child Survival (“Countdown”) was established in 2005 in response to The Lancet Child Survival Series with the goal of monitoring countries’ progress toward achieving Millennium Development Goals 4 (reduce child mortality) and 5 (improve maternal health) by 2015. Countdown is led by a team of multi-disciplinary leaders in the maternal and child health field, including researchers, governments, international agencies, professional organizations and other stakeholders. Now that the world has adopted the Sustainable Development Goals (SDGs), Countdown has extended its work to monitor progress toward achieving SDG 3 (ensure healthy lives and promote wellbeing for all at all ages) by 2030. Continue reading “Countdown to 2015 becomes Countdown to 2030”