Perspectives on Monitoring Progress Toward Ending Preventable Maternal Mortality: Highlights from CUGH 2017

By: Meg O’Connor, Project Manager, Maternal Health Task Force, Women and Health Initiative, Harvard T.H. Chan School of Public Health

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

Photo: MHTF

Earlier this month, global health experts (and students aspiring to be experts) from around the world gathered for a series of presentations, panels and posters at the 2017 Consortium of Universities for Global Health (CUGH) Conference in Washington, D.C. The panel titled “Perspectives on Monitoring Progress Toward Ending Preventable Maternal Mortality: What Measures Matter?” provided an opportunity to discuss the monitoring framework developed to accompany the Strategies toward ending preventable maternal mortality (EPMM) report released in 2015. The panel was moderated by Mary Ellen Stanton, Senior Maternal Health Advisor at USAID, and included Rima Jolivet, Maternal Health Technical Director of the Maternal Health Task Force, Elahi Chowdhury of icddr,b (Bangaldesh) and Chibugo Okoli of the Maternal Child Survival Program (MCSP, Nigeria). Representing maternal health monitoring at the global, national and facility-levels respectively, the panelists provided insights from their unique perspectives and highlighted the importance of the EPMM monitoring framework. Continue reading “Perspectives on Monitoring Progress Toward Ending Preventable Maternal Mortality: Highlights from CUGH 2017”

Global Leaders in Maternal Newborn Health: Maria Fernandez Elorriaga (Mexico)

By Kayla McGowan, Project Coordinator, Women and Health Initiative, Harvard T.H. Chan School of Public Health

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

In July 2016, global leaders gathered for the second annual Safe Mothers and Newborns Leadership Workshop (SMNLW) hosted by the Maternal Health Task Force (MHTF) in partnership with the Barcelona Institute for Global Health (ISGlobal) and The Aga Kahn University and sponsored by the Bill & Melinda Gates Foundation. The participants represented 26 countries from five continents.

Maria Fernandez Elorriaga (Mexico)SMNLW participant Maria Fernandez Elorriaga is the principal investigator and technical coordinator of a study investigating the use of the World Health Organization (WHO) Safe Childbirth Checklist to improve the quality of institutional delivery in Mexico. Maria is also co-investigator on two more studies of implementation science in maternal and perinatal care. In addition, Maria has worked as a primary and community care nurse in Spain, as a regional nutrition coordinator in Malawi and as child health and nutrition coordinator in the Sahrawi refugee camps in Tindouf, Algeria. Continue reading “Global Leaders in Maternal Newborn Health: Maria Fernandez Elorriaga (Mexico)”

Global Leaders in Maternal and Newborn Health: Dr. Zulfiqar Bhutta (Canada and Pakistan)

By Kayla McGowan, Project Coordinator, Women and Health Initiative, Harvard T.H. Chan School of Public Health

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

Zulfiqar_BhuttaIn July 2016, 35 global leaders in maternal newborn health gathered for the second annual Safe Mothers and Newborns Leadership Workshop (SMNLW) hosted by the Maternal Health Task Force (MHTF), the Barcelona Institute for Global Health (ISGlobal) and The Aga Kahn University, with support from the Bill & Melinda Gates Foundation. The participants represented 26 countries from five continents.

SMNLW participant Dr. Zulfiqar A. Bhutta is the Robert Harding Inaugural Chair in Global Child Health at The Hospital for Sick Children, Toronto, Co-Director of the SickKids Centre for Global Child Health and the Founding Director of the Center of Excellence in Women and Child Health, at the Aga Khan University, unique joint appointments. He also holds adjunct professorships at several leading Universities globally including the Schools of Public Health at Johns Hopkins (Baltimore), Tufts University (Boston), Boston University School of Public Health, University of Alberta as well as the London School of Hygiene & Tropical Medicine. He is a designated Distinguished National Professor of the Government of Pakistan and was the Founding Chair of the National Research Ethics Committee of the Government of Pakistan from 2003-2014. Continue reading “Global Leaders in Maternal and Newborn Health: Dr. Zulfiqar Bhutta (Canada and Pakistan)”

Global Leaders in Maternal and Newborn Health: Patrick Mwesigye (Uganda)

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

This article originally appeared on the Maternal Health Task Force (MHTF) blog.

In July 2016, global leaders gathered for the second annual Safe Mothers and Newborns Leadership Workshop hosted by the Maternal Health Task Force (MHTF) in partnership with the Barcelona Institute for Global Health (ISGlobal) and The Aga Kahn University and sponsored by the Bill & Melinda Gates Foundation. The participants represented 26 countries from five continents.
Patrick

SMNLW participant Patrick Mwesigye is from Kampala, Uganda. He is the Founder/CEO of the Uganda Youth and Adolescents Health Forum, a community-based organization that aims to empower young women and support youth engagement. He is also the Vice President of the Africa Youth and Adolescents Network on Population and Development and the Chair of the PMNCH advisory group for the adolescent health knowledge summary. Continue reading “Global Leaders in Maternal and Newborn Health: Patrick Mwesigye (Uganda)”

Global Leaders in Maternal and Newborn Health: Dr. Hemant Shah (India)

By Kayla McGowan, Project Coordinator, Women and Health Initiative, Harvard T.H. Chan School of Public Health 

This article originally appeared on the Maternal Health Task Force (MHTF) blog.

In July 2016, global leaders gathered for the second annual Safe Mothers and Newborns Leadership Workshop (SMNLW) hosted by the Maternal Health Task Force (MHTF) in partnership with the Barcelona Institute for Global Health (ISGlobal) and The Aga Kahn University and sponsored by the Bill & Melinda Gates Foundation. The participants represented 26 countries from five continents.

Hemant Shah is Chief of Party, Technical Support Unit for CARE SMNLW participant Hemant Shah is Chief of Party, Technical Support Unit for CARE. He previously worked as the Director of the State reproductive, maternal, newborn, child, adolescent (RMNCH+A) unit in Bihar as well as a maternal health expert in the Integrated Family Health Initiative project and led quality improvement activities in health facilities in Bihar. Continue reading “Global Leaders in Maternal and Newborn Health: Dr. Hemant Shah (India)”

Global Leaders in Maternal and Newborn Health: Dr. Joannie Bewa (Benin)

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

This article originally appeared on the Maternal Health Task Force (MHTF) blog.

In July 2016, global leaders gathered for the second annual Safe Mothers and Newborns Leadership Workshop hosted by the Maternal Health Task Force (MHTF) in partnership with the Barcelona Institute for Global Health (ISGlobal) and The Aga Kahn University and sponsored by the Bill & Melinda Gates Foundation. The participants represented 26 countries from five continents.

Joannie Bewa

SMNLW participant Dr. Joannie Bewa is a medical doctor from Benin and Founder of the Young Beninese Leaders Association (YBLA). She is also a fellow of the US Government International Visitor Leadership Program and Secretary Clinton’s Women in Public Service Project as well as a semi-finalist of the “UN Special Envoy Youth of Courage Award.” Dr. Bewa was recognized as a champion for advancing sexual and reproductive health by Women Deliver in 2015 and is a member of the “Adolescent and Youth Constituency” of the Partnership for Maternal, Newborn and Child Health (PMNCH). She played a pivotal role advocating for the health-related SDGs with the UNFPA Youth Panel in Benin and was featured on Melinda Gates’ list of six influential women on the topic of global access to contraception. Continue reading “Global Leaders in Maternal and Newborn Health: Dr. Joannie Bewa (Benin)”

Global Leaders in Maternal and Newborn Health: Dr. Emmanuel Ugwa (Nigeria)

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

This article originally appeared on the Maternal Health Task Force (MHTF) blog.

In July 2016, 35 global leaders in maternal newborn health gathered for the second annual Safe Mothers and Newborns Leadership Workshop (SMNLW) hosted by the Maternal Health Task Force (MHTF), the Barcelona Institute for Global Health (ISGlobal) and The Aga Kahn University, with support from the Bill & Melinda Gates Foundation. The participants represented 26 countries from five continents.

Emmanuel Ugwa

SMNLW participant Dr. Emmanuel Ugwa is from Nigeria where he has served as a Consultant Obstetrician/Gynecologist at several hospitals. He is a principal investigator on USAID and Gates-funded research projects in Nigeria. Additionally, Dr. Ugwa sits on review committees and editorial boards for multiple scientific journals and has published numerous research articles himself. Continue reading “Global Leaders in Maternal and Newborn Health: Dr. Emmanuel Ugwa (Nigeria)”

Three barriers to delivering maternal health supplies and the solution

By Katharine McCarthy and Saumya RamaRao

Katharine McCarthy is Research Coordinator and Saumya RamaRao is Senior Associate at Population Council. This article originally appeared on the Maternal Health Task Force blog.

This post is part of the blog series “Increasing access to maternal and reproductive health supplies: Leveraging lessons learned in preventing maternal mortality,” hosted by the Maternal Health Task Force, Reproductive Health Supplies Coalition/Maternal Health Supplies Caucus and Family Care International, which discusses the importance and methods of reaching women with lifesaving reproductive and maternal health supplies in the context of the proposed new global target of fewer than 70 maternal deaths per 100,000 births by 2030. To contribute a post, contact Katie Millar.

How can we use the lessons learned by the reproductive health community to advance the maternal health supplies issues?

Each year more than 180,000 women die during pregnancy or childbirth from hemorrhage or pre-eclampsia/eclampsia. Many of these deaths can be prevented with appropriate access to oxytocin, misoprostol and magnesium sulfate. A delivery package containing these medicines is estimated to cost less than US $1.50 per person, and is predicted to save 1.4 million lives over ten years, if available to all women. Current barriers in markets for maternal health drugs, however, cause these drugs to remain largely inaccessible for many women. As the maternal health field refocuses priorities for the SDGs, the importance of building healthy markets for essential medicines is evident.

What are the Major Barriers in Accessing Maternal Health Drugs?

In 2012 the UN Commission on Life Saving Commodities for Women and Children identified key barriers that limit access to lifesaving maternal health drugs:

  1. Market failures leading to an insufficient supply of quality drugs
  2. A weak regulatory environment leading to variability in drug formulation and quality
  3. Lack of provider and consumer awareness of drugs and/or their appropriate use

The interrelated nature of supply and demand challenges makes addressing them difficult. But, there may be a solution. As seen in other health commodity markets, market shaping strategies involving the “total market” may best address these challenges by capitalizing on the potential of all market players to achieve a coordinated approach.

The Solution: What is Market Shaping?

Like many markets, the maternal health drug market is made up of actors from different sectors, including the public (e.g., government), private commercial (e.g., manufacturers, distributors, midwives and oby-gyns), and private non-profit sectors (e.g., faith-based health care providers). Two main reasons for inefficiencies in markets are (1) lack of information and (2) an unbalanced sharing of risk.

Incomplete information or gaps in information flows can be a barrier to market entry. For example, manufacturers and suppliers of drugs may lack information on many aspects of the market such as volume of demand, timing of demand, prices and profitability. Such information gaps can be addressed by high quality demand forecasts, a schedule of when orders are likely to be place, and data on stock-outs, prices, and drug quality. With wider availability of information, new manufacturers and suppliers can be encouraged to enter the market, expanding the supply of available drugs.

To address unbalanced market risk, another strategy is volume guarantees. Unbalanced risk can occur in uncertain markets when a manufacturer or distributor bears the majority of upfront costs with an unforeseeable future profit. A volume guarantee, or an agreement by buyers to purchase of a certain quantity of a product, can offset the risk to suppliers and encourage drug production. Volume guarantees can also aid in negotiations to strengthen the quality and reduce the cost of drugs by achieving purchasing power not previously possible in fragmented developing country markets. Such leverage can also aid in identifying opportunities for innovations in product improvement and financing, further encouraging product purchase and use.

What Else Will it Take?

While capitalizing on market opportunities can facilitate access to drugs and save lives, these strategies alone are likely not sufficient. Complementary programmatic investments are needed to strengthen the supply chain and service delivery, as well as to generate demand by raising awareness on the need and appropriate use of maternal health drugs, and to advocate for the importance of women’s lives. As maternal health researchers, policy planners, advocates and program leaders, we all have our role to play in ensuring women have access to resources for a safe and healthy delivery. We must now turn to moving what we know can work to those in most need.

To learn more about how market shaping lessons from the HIV and reproductive health commodity markets can be applied to scale-up access to maternal health drugs, please see a recent commentary by McCarthy et al., published in Maternal and Child Health Journal.

Resources used in the writing of this post: