For women in the developed world with ready access to medical care, the 24 hours surrounding labor and delivery are an unforgettable mix of anticipation, nervousness, elation, and besotted new-family love. But for women in countries where access to health care is limited, those 24 hours can mean the difference between life and death.
That critical 24-hour window is the primary focus of Saving Mothers, Giving Life, one of two primary initiatives of ACOG’s Office of Global Women’s Health. Launched in 2012 as a partnership between ACOG, the US and Norwegian governments, Every Mother Counts, and Merck for Mothers, Saving Mothers, Giving Life, has begun with pilot projects in two countries with tragically high maternal mortality rates: Uganda and Zambia (145th and 156th out of 180 countries for maternal deaths, respectively).
Saving Mothers works with district and provincial health offices in eight districts within these two countries to train health workers, upgrade health facilities, and encourage more women to give birth in safe locations.
“It’s been really impressive to see the progress made in just one year,” said Erin Thornton, executive director of Every Mother Counts. “The teams on the ground have been able to get many more women to facilitated deliveries, and the result has been that a lot of lives have been saved.”
With technical assistance and clinical guidance from ACOG, Saving Mothers has already trained nearly 4,000 Village Health Team members in Uganda and nearly 800 Safe Motherhood Action Group members in Zambia to promote facility deliveries and preparedness for birth. These workers distributed thousands of “Mama Kits”—small packages that include medical supplies, newborn needs, and other materials for a safe delivery.
The kits also contain a well-made receiving blanket for the newborn. Why is that so important? Many moms in these countries don’t have anything to wrap their babies in and feel ashamed that they must bring their baby home in a scrap of cloth or an old towel. It seems like such a small thing, but the clean, new blanket may be what pushes a woman to give birth in a safe facility rather than at home.
Saving Mothers also trained nearly 60% of the district health workers in Uganda and nearly 50% of those in Zambia to provide emergency obstetric and newborn care. Saving Mothers also built maternity waiting shelters that give women a safe place to stay as they near delivery and provided new ambulances, motorcycles, and bicycles.
Healthy Baby vouchers, which cost just $1.20, entitle pregnant women to four prenatal visits, labor and delivery in a safe environment—including transport to a larger facility if needed—and a postpartum visit.
The results have been dramatic: In just one year, the number of women delivering in facilities in the four Ugandan districts increased by 82%, from 2,585 to 4,707. In Zambia, there was a 44% increase in women delivering in health centers, from 5,475 to 7,863.
Prenatal visits in the Saving Mothers districts in Uganda also increased significantly. Before the program launched, only 20.5% of women in those districts attended four or more prenatal care visits during their pregnancies; a year later, that figure had more than doubled, to 53.5%.
The commitment by the local districts in both countries, as well as the national governments, has been essential to this remarkable progress, said Ms. Thornton. “The health officers are very invested. They’re putting their own offices’ resources in and working closely with their national strategies on maternal and child health.”
Zambian First Lady Christine Mwelwa Kaseba is an ob-gyn and has spoken passionately about Saving Mothers. She also attended ACOG’s Annual Clinical Meeting in May, where she received Honorary Fellowship. “In Uganda, one of the parliamentarians from a western district was so inspired that she held up a vote on the budget until there were resources put in place for health care workers,” said Ms. Thornton. “Local leadership is really critical to what’s happening.”
The work that ACOG is doing with Saving Mothers in these countries isn’t just about saving the lives of individual women—but the futures of entire families. “When a mother dies, you may see a whole family go down the line, where they don’t have a shot at prosperity, they don’t have a shot at education, they don’t have a shot at good health,” said Mark Storella, the US Ambassador to Zambia, in a Saving Mothers video.
Photos courtesy of Saving Mothers, Giving Life
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