Maternal Health
This issue of The Soul Beat contains experiences, evaluations, strategic thinking documents, and resource materials related to maternal health. It looks at: how communication can help create awareness and action around the need for pre-and post natal health care for pregnant women; the provision of adequate maternal and reproductive health information and services; and the need for paternal involvement.
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1. Mabrouk! Initiative - Egypt
The Mabrouk! ("Congratulations!") Initiative was designed to raise awareness and discussion among young married couples in Egypt around antenatal care, safe delivery, postpartum care (maternal and child health and family planning), and infant health. Part of the Communication for Healthy Living (CHL) project, this initiative combined a multimedia campaign with interpersonal and community approaches to reinforce messages.
Contact Ron Hess rhess@jhuhcp-eg.org OR Kim Martin press@jhuccp.org
2. Play your Part - Tanzania
This is a participatory documentary film project on maternal health and childbirth mortality created by the White Ribbon Alliance for Safe Motherhood in Tanzania. Five Tanzanian midwives and one doctor, who all had no previous experience with film, were trained on film-making and editing skills by United Kingdom-based production company, Engine Room. The film deals with different issues around maternal health in Tanzania, including access to health facilities, overcrowding at antenatal clinics, shortages of medical supplies, and the lack of involvement of fathers.
Contact White Ribbon Alliance for Safe Motherhood in Tanzania (WRATZ) wra_tz@yahoo.com OR White Ribbon Alliance for Safe Motherhood - Global Secretariat info@whiteribbonalliance.org
3. Deliver Now for Women and Children
This advocacy drive aims to facilitate greater access to basic health resources as part of the goal of improving the health of women and children around the world. The global effort to eliminate maternal and child deaths is being implemented by a global coalition of governments and organisations. Deliver Now for Women and Children is coordinated by The Partnership for Maternal, Newborn & Child Health, a global alliance of more than 170 partners that is hosted and administered by the World Health Organization (WHO). These partners hope to support the push to achieve the United Nations (UN)'s Millennium Development Goals (MDGs) related to health (MDG #4 and MDG #5). Country-specific programmes are being conducted in India and Tanzania.
Contact pmnch@who.int
4. Ruwan Dare (Midnight Rain) - Nigeria
Launched in July 2007, this is a 2-year radio serial drama being produced by Population Media Center (PMC) in Nigeria. Through character role-models, the drama aims to enhance knowledge and use of existing health services, provide information about reproductive and general health issues, encourage family planning, and promote delaying marriage and childbearing until adulthood. It also aims to promote small family norms, provide information about HIV transmission, and motivate people to take actions to improve their health and the health of their families. One of the storylines is about Azumi, who is pregnant while breastfeeding her four-month-old son. Azumi becomes very sick and nearly dies during the delivery of her son. The couple's story explores the need for birth spacing and contraception in the context of cultural and social demands to have many children quickly.
Contact Katie Elmore elmore@populationmedia.org OR Tony Asangaeneng program@populationmedia.org
5. Fight Fistula! Campaign - Ethiopia
This campaign, initiated under the German Foundation for World Population’s (DSW) Youth-to-Youth programme, intends to reach both men and women in East and West Gojam in Ethiopia. The project uses trained nurses and former fistula sufferers, who are trained as peer educators, to reach people in the region with reproductive heath information and improved health facilities. The project involves home-to-home visits, peer-to-peer learning in youth clubs, and mass edutainment.
Contact Pamela Foster pamela.foster@dsw-hannover.de
6. Campaign to End Fistula
This campaign is an international effort that currently covers some 35 countries in sub-Saharan Africa, South Asia, and some Arab States. The United Nations Population Fund (UNFPA) launched the campaign in 2003 in response to an emerging body of evidence on the negative impact of obstetric fistula on women's lives. UNFPA is motivated by the belief that fistula is an issue of rights and equality and an effective entry point into strengthening women's reproductive health and furthering gender equity, helping support achievement of the Millennium Development Goals. To that end, the Campaign includes interventions to prevent fistula from occurring, to treat women who are affected, and to help women who have undergone treatment return to full and productive lives, with the ultimate goal of making fistula as rare in the developing world as it is in industrialised countries today.
Contact Campaign to End Fistula fistulacampaign@unfpa.org
7. Key Findings from an Evaluation of the Mothers2mothers Program in KwaZulu-Natal, South Africa
by Carolyn Baek, Vuyiswa Mathambo, Sibongile Mkhize,Irwin Friedman, Louis Apicella, and Naomi Rutenberg
This 27-page evaluation report shares findings from an evaluation of mothers2mothers (m2m), a peer support programme designed to provide education and psychosocial support to HIV-positive pregnant women and new mothers, help women access existing health care services to prevent mother-to-child transmission of HIV (PMTCT), and follow up to ensure mothers and babies receive appropriate medical care after delivery. The Horizons Program of the Population Council, in collaboration with Health Systems Trust, completed this first evaluation of m2m, which suggests that m2m plays an important role in providing a continuum of care for HIV-positive women and infants.
8. Participatory Assessment of Gugar Goge, an Entertainment-Education Radio Soap Opera in Nigeria - A Qualitative Assessment Report
by Arvind Singhal, Sarah Hurlburt and Radha Vij
This report documents the results of a participatory assessment exercise conducted in Nigeria to gauge audience reception of Gugar Goge (“Tell It To Me Straight”), an entertainment-education radio soap opera produced by Population Media Center that sought to promote education for girls, the delay of marriage and pregnancies, and the adoption of family planning and maternal health services to both prevent and treat obstetric fistula. The assessment exercise, which used participatory sketching and participatory photography, aimed to assess how frequent listeners engaged with the radio programme, and how they derived personal meanings from its plot, characters, and educational messages.
9. Evaluation of the White Ribbon Alliance for Safe Motherhood 1999-2007
This 50-page evaluation report shares the work of an evaluation team tasked by the United States Agency for International Development (USAID) to examine the growth, influence, and results of the White Ribbon Alliance for Safe Motherhood (WRA) since its inception in 1999. The WRA is described as "a global grassroots movement for safe motherhood that builds alliances, strengthens capacity, influences policies, harnesses resources, and inspires action to save women's lives everywhere." WRA is organising in countries where reducing maternal deaths would significantly accelerate the achievement of the Millennium Development Goal to reduce the maternal mortality ratio by three-quarters by 2015. In India and Tanzania alone, WRA activities are estimated to have reached over three million people.
10. Living Testimony: Obstetric Fistula and Inequities in Maternal Health
This 40-page advocacy booklet, produced by the United Nations Population Fund (UNFPA) and Family Care International (FCI), explores knowledge, attitudes, and perspectives on pregnancy, delivery, and fistula from 31 country-level needs assessments conducted in 29 countries in Africa, Asia, and the Arab States from 2003 to 2006. It also includes detailed findings from 6 countries - Bangladesh, Burkina Faso, Cameroon, Democratic Republic of Congo, Eritrea, and Sudan. In addition, the publication offers recommendations for policymakers, programmers, and researchers to strengthen fistula prevention and treatment programmes based on the findings.
11. Strengthening Postnatal Care Services Including Postpartum Family Planning in Kenya
by Annie Mwangi, Charlotte Warren, Nancy Koskei, and Holly Blanchard
This 48-page report describes and assesses an initiative to develop and introduce a strengthened postnatal care (PNC) package into one hospital and 4 health centres in Embu district, Eastern Province, Kenya. Two United States Agency for International Development (USAID)-funded projects - the Population Council's FRONTIERS project and Jhpiego's ACCESS–FP project - formed a partnership to support Kenya's Department of Reproductive Health (DRH) in its efforts to document the feasibility, acceptability, and quality of care of the endeavour to increase both the recommended timing and content of postnatal services a women and her infant should receive to at least 3 assessments within the first 6 weeks after childbirth. This orientation package, which was introduced and evaluated between 2006 and 2008, also provided opportunities to deliver appropriate family planning (FP) advice and methods at several points in time.
12. Ugandan Love Letters Pull Men to Fetal Heartbeats
by Rachel Scheier
Published by Women's eNews, this article outlines a strategy being used by clinics in the Jinja district of Uganda to encourage men to be involved in the pre-natal care and reproductive health of their wives. When a woman visits a clinic alone, after her consultation she is given a brief letter for her husband, signed by the local district health director, which includes some basic information and a polite request to come to the clinic in person to discuss health matters, such as: HIV testing; what to expect during the delivery; and how to care for a pregnant woman. According to one man interviewed for the article, this letter encouraged him to take the time to come to the clinic to find out what the couple could expect in the time leading up to the birth of their child.
13. Faith-Based Models for Improving Maternal and Newborn Health
by Sarla Chand and Jacqui Patterson
This brief highlights the contribution of faith-based organisations (FBOs) to health care by focusing on 4 FBO programme models that, despite multiple challenges, have been effective in improving maternal and newborn health (MNH) outcomes. The programme models are based on FBO health networks, community health behaviour change programmes, congregation-based health programmes, and comprehensive health care programmes. Using project examples mainly from Africa, the document shows how these models can strengthen and expand health services and contribute to the achievement of the health-related Millennium Development Goals (MDGs). The brief concludes with recommended actions for all stakeholders - FBOs, policy makers, and donors.
14. Antenatal Care in The Gambia: Missed Opportunity for Information, Education, and Communication
by Samuel E Anya, Abba Hydara, and Lamin ES Jaiteh,
This 7-page report, published by BioMed Central (BMC) Pregnancy and Childbirth, is the result of a study conducted to examine the provision of information and education in antenatal clinics from the perspective of pregnant women attending these clinics. The report suggests that information, education, and communication during antenatal care in the largest health division are inadequate. Pregnant women are ill equipped to make appropriate choices especially when they are in danger. This contributes to the persistent high maternal mortality ratios in the country.
15. Maternal Survival Toolkit
This web-based toolkit from the Change Project contains approaches and tools for behaviour change interventions for maternal survival. The Maternal Survival framework in this kit organises behaviour change interventions into 3 areas: seeking skilled care, birth preparedness, and providing skilled care. These are interventions at the household, community, and health facility levels that begin with information gathering on attitudes and beliefs about skilled care, and include lessons learned and global programme experience from a project called the Safe Motherhood Initiative.
16. Awareness, Mobilization and Action for Safe Motherhood: A Field Guide
This Field Guide is intended to provide organisations working in developing countries with practical guidance on how they can be active and involved in the Safe Motherhood Initiative and participate in the White Ribbon Alliance. The Field Guide does not include technical information on how to design, implement, and evaluate safe motherhood programme interventions, but it offers suggestions for bringing a wide range of people and organisations together for awareness and action around the theme of safe motherhood.
17. A Walk to Beautiful
This is a documentary by Engel Entertainment, which tells the stories of five Ethiopian women, who suffer from obstetric fistula, and embark on a journey to reclaim their lost dignity. Rejected by their husbands and ostracised by their communities, these women are left to spend the rest of their lives in loneliness and shame. The trials they endure and their attempts to rebuild their lives, tell a story of hope, courage, and transformation.
For a related previous issue of The Soul Beat see:
The Soul Beat 58 - MDG# 5: Improving Maternal Health
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