ACOG Past President Dr. Douglas Laube, back row, far left, with Survive and Thrive partners and a class of midwife students in Burma.
In the Southeast Asian nation of Burma, nearly 4,000 women die from pregnancy and childbirth complications each year, primarily from postpartum hemorrhage, infection, unsafe abortion, eclampsia, and obstructed labor. That’s about 200 deaths for every 100,000 live births, compared with approximately 9 per 100,000 in the US.
With a historic new global development alliance known as Survive and Thrive, ACOG hopes to help Burma’s Ministry of Health train and mobilize the nation’s own health practitioners to make changes that can prevent many of those deaths, as well as reduce the infant mortality rate, which hovers around 75 deaths during the first year of life for every 1,000 live births.
It’s just one of the countries that can benefit from Survive and Thrive, a global development alliance between ACOG, the US Agency for International Development (USAID), American Academy of Pediatrics, American College of Nurse-Midwives, Laerdal Global Health, Johnson and Johnson, Jhpiego, Maternal Child Health Integrated Program, Save the Children, and Eunice Kennedy Shriver National Institute of Child Health and Human Development. Also contributing to Survive and Thrive are other innovative educational programs and implementing partners to provide training and practical on-the-ground solutions to improve maternal and child health worldwide.
“Burma is a relatively new mission for USAID, but we got a lot of traction there,” said ACOG Past President Douglas W. Laube, MD, MEd, who returned in March from a three-week trip to Burma. “We spent time meeting with the various organizations on the ground, as well as the professional societies represented by our mirror-image colleagues.”
In Burma and in all the countries where it will ultimately work (other representatives from the global development alliance visited Malawi and Mozambique), Survive and Thrive aims to teach lifesaving measures associated with postpartum hemorrhage, newborn care, and post-abortion complications.
“In Burma, we’re going to extend into longer-term newborn care—the first two weeks of newborn life. And on the maternal side, we will add a component of long-acting reversible contraception, which we can implement at the time of post-abortion care. Those are our goals for the first three years,” Dr. Laube said.
The roots of Survive and Thrive date back to 2010, when Dr. Laube spent a year in Washington, DC, on a Jefferson Science Fellowship. The program places tenured academic scientists, engineers, and physicians at the US Department of State and USAID to share their expertise and work in partnership with the agencies.
“One of my main objectives was to create new collaborations between USAID’s maternal health services office and ACOG,” he said. Dr. Laube took on this mission with fervor, helping ACOG set up its Office of Global Women’s Health, which now includes the Survive and Thrive partnership. (For more on what the Office of Global Women’s Health is doing, see “ACOG strives to improve maternal health worldwide.”)
The Burmese Ministry of Health has approved Survive and Thrive’s implementation plan in advance of a series of site visits in September and October that will launch the program in townships selected by the Ministry of Health.
“One has to remember that the backbone of the primary care system in Burma, and in much of the world, is a midwife, and not a midwife trained in the way we know it in the US. They are the GPs of Burma, and many of these townships have only that person as the front-line provider,” Dr. Laube said.
USAID already has other partner organizations working on maternal health in certain parts of the country, and Survive and Thrive aims to collaborate with those groups. “We don’t want to work in parallel, and be 20 miles apart and not know what the other group is doing,” Dr. Laube said. “That can happen a lot in developing countries.”
Beginning in 2014, Survive and Thrive plans to launch a cadre of global health scholars who will work with the senior mentors running the programs. “We want to make this self-sustainable,” Dr. Laube said. “It’s not about sending young doctors somewhere to get experience doing 50 hysterectomies. The name of the game is infrastructure development and sustainability. We want to develop the midwives, the backbone of this country, so that they can provide this care sustainably. Eventually, we will have year-round, on-the-ground oversight and mentorship for the people who are providing this care themselves.”
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