Advocacy & Health Policy: FIGO Roundup: How Can We Improve Maternal Mortality Rates in Sub-Saharan Africa?

During the 21st World Congress of the International Federation of Gynecology and Obstetrics (FIGO) held in Vancouver, Canada, October 4-9, 2015, close to 75 attendees from United States and African institutions, including representatives from Ghana, Ethiopia, Gambia, Malawi, Rwanda, Senegal, Liberia, Zambia, Uganda, Mozambique, and Madagascar, met to share their experiences in training more ob-gyns and expanding opportunities for learning through the 1000+ OBGYN Project to help reduce maternal mortality in Sub-Saharan Africa. 

Representatives from ACOG, Royal College of Obstetricians and Gynaecologists, the Association of Professors of Obstetrics and Gynecology, and the Society of Maternal Fetal Medicine all participated.

The United Nations' Millennium Development Goals (MDGs), recently replaced with the Sustainable Development Goals (SDGs), have been essential in addressing the challenge of preventable maternal and child mortality in the region—child and maternal deaths have dropped 50 percent since 1990. However, there is still a shortage in quality health services and the annual number of maternal deaths is still unacceptably high at nearly 300,000 deaths per year.

One key objective and target of the SDGs is to reduce global maternal mortality to less than 70 per 100,000 live births by 2030. This is a critical challenge for sub-Saharan Africa, which bears the world’s greatest burden of maternal deaths.


Meeting participants at the 1000+ OBGYN meeting
in Accra, Ghana in February 2014

1000+ OBGYN Project to Help

The 1000+ OBGYN Project, created in 2012, addresses the Sub-Sharan maternal mortality issue by advancing the establishment of ob-gyn residency education programs or strengthening existing training programs in the region whose trainees and graduates could provide definitive care for the most severe pregnancy complications. The overall goal is to train 1,000+ ob-gyns in the region over the next 10 years.

Frank Anderson, MD, MPH, FACOG, associate professor in the Department of Obstetrics and Gynecology at the University of Michigan Medical School, and director of the 1000 + OBYGN Project noted, “The FIGO meeting confirmed that people and organizations are ready and willing to contribute their expertise, and the countries are ready and willing to train their health care force and create ob-gyn training programs. We have seen recent success in the Malawi partnership with Baylor University and the University of North Carolina where they now are on their third class of residents based on the Ghanaian model. We are seeing a birth of our specialty in sub-Saharan Africa. The stories we heard at the FIGO meetings are really inspiring.”

Discussion was also held around coordination of funding and technical support that would create a common curriculum, monitoring and evaluation system, and faculty development program, thereby creating a larger community of ob-gyns doing the same work and measuring the same outcomes over the next 10 years. South-to-South collaboration between sub-Saharan African countries was also discussed and is considered crucial to the success of the program in the future.

The 1000+ OBGYN Project introduced the new monitoring and evaluation system designed in partnership with Mountain Labs of Ann Arbor, Michigan. The new system was created to gather data on key maternal and newborn indicators and measurements of ob-gyn “capacity.” Discussion included the type of data that would need to be collected and how the data would be able to create baselines. Initially, the hope is that there will be a voluntary collection of monthly data that will serve as “pre-intervention” baseline data. Baselines will be used to compare outcomes and processes as programs increase the delivery of high impact interventions over time.

Resources for Physicians

The 1000+ OBGYN Project created a resource center that includes free online educational resources and a networking center as well as a robust monitoring system that will allow universities and hospitals across sub-Saharan Africa to access the curriculum models, resources, guidelines and expert advice necessary to create ob-gyn departments that measurably reduce obstetric fistula, stillbirths and maternal and early neonatal deaths. Resources for physicians are also available through the Global Library of Women’s Medicine (GLOWM), and the Open Michigan Initiative.

For more information:

American College of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188
Mailing Address: PO Box 96920, Washington, DC 20024-9998