Take collaborative strategic action to lower maternal deaths

By Azka Asif, Rotary Service and Engagement staff

In honor of Maternal and Child Health Month, Past District Governor Dr. Himansu Basu, a Rotary Foundation Cadre of Technical Advisors for Maternal and Child Health, shares about his team’s work to save the lives of mothers and babies in partnership with Rotarians, other professional volunteers, and governments.

Azka: Dr. Basu, last year you shared an update on the success of the Calmed (Collaborative Action in Lowering of Maternity Encountered Deaths) programme. Have you had any recent developments?

Dr. Basu:
Calmed, started in 2013, is funded through Rotary Foundation grants, supported by hands-on efforts of volunteer doctors and Rotarians from the United Kingdom and India. Two global grants have supported six vocational training team (VTT) visits to Sikkim, with a target population of 0.7 million, and Gujarat with a target population of 2.5 million.

Our team of 12 Obstetricians has trained 39 master trainers who continue to train professionals (currently just over 250) in emergency care of pregnant women and babies. The team has also trained approximately 100 Accredited Social Health Activists (ASHA) who raise awareness about pregnancy, child care and related issues through community women’s groups.

The programme was recognized with two international awards for excellence in 2016 — Times Sternberg award and Rotary GBI Champion of Change.

AA: Have you achieved your objectives for the programme?

HB: Maternal mortality reduction programmes take time to achieve their goal – zero preventable maternal death. We are on track for improvements in access to effective care. After three years, we see a steady fall in the number of avoidable maternal deaths in all of Sikkim, our first pilot site. We are moving towards our target of zero preventable maternal deaths.

AA: What can Rotarians do to reduce maternal and child mortality?

HB: Maternal mortality is an index of development in any community – an effective project in any of Rotary’s six areas of focus will also decrease maternal and child mortality, albeit slowly. For a more direct measurable response, a comprehensive strategy based on the Calmed template aimed at reducing the shortage of trained professionals while promoting community awareness regarding childbirth and child care issues should be implemented.

AA: What advice can you offer Rotarians planning a global grant project to reduce maternal and child mortality?

HB: Create a strategic programme with vocational training teams being a key component. It’s important to have experienced project committees supported by health professionals, and public health experts. Close collaboration with motivated Rotarians and government in the project host country is essential for impact and sustainability. The Rotary Foundation Cadre of Technical Advisors can be a valuable resource in planning, implementation and the follow-up stages. Expertise is also available from Rotarian Action Groups such as the Population and Development, Health Education and Wellness, and Preconception Care groups.

A planning visit to the project area by the international partner is very important and should focus on identifying local assets and needs, partnership opportunities with local government and professionals.

AA: What advice can you offer for organising a vocational training team aimed at reducing maternal and child mortality?

Himansu: A vocational training team for improving maternal and child health should be structured to meet the needs of the community. Here are examples of scaling a project:

Scenario 1 targets several smaller hospitals or one large hospital. Two to four experienced doctors train a group of 10 to 20 doctors and nurses on emergency care of pregnant women and new-borns.

Scenario 2 targets several larger hospitals or many smaller hospitals. 5-7 experienced doctors train 20 to 25 motivated trainers who then qualify as master trainers. These master trainers go on to train others (30-40 at a time). Two return team visits should be conducted for evaluation and further training.

Scenario 3 targets a community of one million or more. This is a most effective method, but requires close collaboration with local government. A team of 7 to 10 experienced doctors undertake:

  • training cascade as in Scenario 2 (above)
  • training 15 to 20 ASHA trainers to raise community health awareness. The ASHAs then train women’s groups in towns and villages throughout the target area
  • analysing all maternal deaths in the target area to identify preventable causes and facilitate corrective measures in partnership with local government

AA: Which scenario is most effective in your opinion?

HB: Clearly Scenario 3, but it is also the one requiring more time and resources.

AA: Thank you for sharing your knowledge and expertise! What is your vision for the future?

HB: We cannot rest on our laurels. We need to facilitate and provide support for Rotarians in many low resource countries to introduce more strategic programmes for the entire community based on the Calmed VTT template. Please contact me for further information and suggestions. Also, visit the Calmed programme website for more information.

We are in discussion to establish maternal and child health academies in partnership with governments and NGOs to provide academic support, carry out the work of vocational training teams and advocate to develop future programmes and future leaders achieve our goal of zero preventable maternal death.

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Rotary members are dedicated to maternal and child health

By Azka Asif, Rotary Service and Engagement Staff 

According to the World Health Organization, nearly 830 women die every day from preventable causes related to pregnancy and childbirth. 99% of maternal deaths occur in developing countries where nearly half of all mothers and newborns do not receive care during and after birth. The leading causes of death for children under 5 are birth complications, pneumonia, birth asphyxia, diarrhea and malaria. These deaths can be prevented and treated with access to healthcare services.*

Healthcare before, during and after childbirth can save the lives of women and newborn babies. The United Nation’s Sustainable Development Goal 3: Ensure healthy lives and promote well-being for all at all ages, addresses all major health priorities, including reproductive, maternal and child health; access for all to safe, effective, quality and affordable medicines and vaccines.*

Rotary members are working diligently towards this goal through projects that provide education, immunizations, birth kits, mobile health clinics, and much more. Women are taught how to prevent mother-to-infant HIV transmission, how to breast-feed, and how to protect themselves and their children from disease. Here are just a few examples of Rotary projects that are saving mothers and children:

  • Rotary clubs in the Philippines are implementing the Cradle of Hope project which provides cradle boxes for newborn babies. Each box contains postpartum care materials and newborn supplies such as grooming and healthcare kits, and clothing for babies up to 9 months of age.
  • The Rotary Club of Accra East in Ghana conducted a community-wide medical outreach program. More than 300 members of the community, including many women and children, benefited from health screenings and received necessary medical supplies.
  • The Rotary Club of Dhaka North in Bangladesh assists pregnant women who cannot afford the cost of delivery by providing no cost surgeries and other necessary medicine during emergencies.
  • After learning about high mortality rates in India, Past Rotary International Director Ken Collins organized a vocational training team consisting of two gynecologists and two midwives. The team traveled with him from Australia to Raipur, India, to train local health workers on best obstetrical practices aimed at reducing the high mortality rate of mothers and babies due to childbirth.
  • In Nigeria, the Rotary Club of Calabar South-CB partnered with the Rotaract Club of Canaan City CB to educate mothers on how to combat infant mortality, and promote the health of both mother and child during and after birth. Rotary members donated materials to help nursing mothers and babies including diapers, detergents, toilet papers, and baby soaps.

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Throughout the month of April, Rotary Maternal and Child Health Month, take action to support mothers and children. Read more stories about maternal and child health to gain inspiration for club and district service projects. Post your club’s project on Rotary Showcase, find a project to support on Rotary Ideas, or join the conversation in My Rotary’s discussion groups!

*http://www.who.int
https://sustainabledevelopment.un.org

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