Mothers whose babies were born prematurely and who successfully went through Kangaroo Mother Care at the Mtwara District Hospital in Tanzania.
Maternal and Reproductive Health
Save the Children works to improve maternal, newborn, infant and child health (MNCH) and survival in the most vulnerable communities around the world. Through global and local efforts, from 1990 to 2015, the global maternal mortality ratio declined by 44 percent – from 385 deaths to 216 deaths per 100,000 live births (UN inter-agency estimates). In 2017, data showed that contraceptive use prevents 308 million unintended pregnancies every year among women of reproductive age in the developing world. Globally, an estimated 214 million women and girls in the developing world have an unmet need for family planning (FP) services. Fully meeting the unmet need for modern contraception would result in an estimated 76,000 fewer maternal deaths each year. 1
Additionally, 21 million adolescent girls, aged 15 – 19, get pregnant annually and are at a higher risk of adverse outcomes for themselves and their babies than women over 20. Addressing their unmet need by increasing their access to modern methods of contraception and creating a supportive health care system – enabling policies and community environments for safer pregnancies for adolescents – would prevent an additional 79,000 maternal deaths.
Save the Children recognizes the significant contributions maternal health (MH) and family planning (FP) have on the health and development of children. Our work aims to prevent and/or reduce maternal and newborn complications and deaths mainly attributed to preventable causes such as hypertensive disorders of pregnancy, sepsis and post-partum hemorrhage and birth asphyxia, prematurity and neonatal sepsis respectively. We work with local partners, health workers and communities to mobilize resources for health services, promote healthy behaviors and practices, improve access and utilization of quality maternal health through evidence based intervention during antenatal care, providing respective care around time of birth, post-natal and post-partum care. We leverage existing local and national government structures, strengthen health systems both in communities and facilities and ensure availability, access and use of lifesaving basic emergency obstetric and newborn care services. Our FP work focuses on providing FP information and services to help girls delay childbearing, and to help women and couples to plan and space their pregnancies for improved health outcomes.
Maternal and Reproductive Health Program Goals:
- Create a supportive environment for the use of modern contraception for all girls and women who need them.
- Increase access to, improve the quality of and generate demand for family planning FP services, particularly among the hardest to reach communities, including the urban poor, youth, postpartum women and populations in emergency settings and those in transition.
- Strengthen local delivery of FP education and services, especially to adolescents. Examples include training community health workers to provide a wide range of methods including injectable contraception.
- Improve policies, enhance systems and services, and build local capacity for health care providers to provide respectful maternity care to all girls and women.
- Increase access to and improve the quality of antenatal and postnatal care services and skilled attendance at birth.
- Understand and overcome practical and cultural barriers to better reproductive health, breastfeeding and infant care practices by communities and health care providers.
- Improve health systems' capacity to deliver quality family planning FP and maternal newborn health (MNH) programs and policies.
Maternal and Reproductive Health Program Highlights:
- The MaMoni Health Systems Strengthening (MaMoni HSS) Project is a five-year (2013-2018) USAID-funded award aimed at improving utilization of integrated MNCH, FP and nutrition services through a health systems strengthening approach in Bangladesh. MaMoni HSS key activities include improving service-readiness through critical gap management; strengthening health systems at the district level and below; and identifying and reducing barriers to health service accessibility and use. Selected key interventions supported by the project include: antenatal care services; safe childbirth; nationwide scale-up of chlorhexidine (antiseptic) for newborn cord care; essential newborn care including resuscitation; basic and comprehensive obstetric and newborn care; postnatal care for mother and baby; management of sick newborns through “Special Newborn Care Units” and outpatient treatment; Kangaroo Mother Care (KMC); FP including postpartum family planning, maternal, infant and young child nutrition; and strengthened referral linkages between communities and health facilities in six project districts. MaMoni HSS also supports the Ministry of Health and Family Welfare in collaboration with the World Health Organization (WHO) Quality, Equity and Dignity initiative to operationalize and rollout quality improvement processes at clinics and hospitals.
- The Strengthening National Midwifery Programme (SNMP) 2017-2018 works to improve the quality of evidence-based instruction and care in 38 primary clinical sites, in collaboration with UNFPA and the Government of Bangladesh. The program supports midwife-led care, including routine obstetric and newborn care and initial stabilization of emergencies at targeted Upazila Health Complexes prior to referral. In addition, SNMP strengthens evidence-based routine obstetric and newborn care practices at medical colleges and district hospitals that function as primary clinical education sites for midwives.
- The USAID-funded Fertility Awareness for Community Transformation (FACT) Project is a research, intervention, and technical assistance project led by Georgetown University’s Institute for Reproductive Health in partnership with Save the Children and the International Center for Research on Women. The FACT project aims to reduce the high unmet need of youth, postpartum women, and couples for FP in Uganda and Nepal through developing and testing innovative interventions to investigate two primary hypotheses: (1) Increased fertility awareness improves FP use; and (2) Expanded access to fertility awareness-based methods (FAM) increases uptake of FP and reduces unintended pregnancies.
- The USAID Services de Santé à Grand Impact project works in partnership with the Government of Mali, NGOs — both international and local — and communities in several target regions in Mali to reduce the preventable causes of maternal, newborn, and child mortality. Funded by USAID/MALI, this five-year (2014-2019) project is implemented by a consortium of organizations including Jhpiego, Population Services International Management Systems International, Groupe Pivot Santé /Population (GP/SP), and the Fédération Nationale des Associations de Santé Communautaire (FENASCOM) under the leadership of Save the Children. The project aims to increase the long-term use of quality, high-impact health services and practices from households to health facilities. The intervention areas of the project include maternal, newborn, and child health; malaria; reproductive health and FP; HIV/AIDS; nutrition; water, sanitation, and hygiene (WASH); and health systems strengthening.
- The Contraception Without Borders Project, funded by the Bill & Melinda Gates Foundation, works in partnership with the London School of Hygiene and Tropical Medicine and BBC Media Action to increase use of FP among (semi-) nomadic communities, from the standpoints of both supply and demand, in six sub-counties located in Wajir and Mandera in northeastern Kenya. The project will also engage regional stakeholders throughout its four-year duration in sharing lessons on effective, scalable approaches to increase FP use among nomadic populations.
- Save the Children’s My First Baby (MFB) project addresses the reproductive health needs of adolescent first-time mothers and mothers-to-be. In Nepal, where early child marriage is a common practice, most first time mothers are adolescent girls who are forced to leave their schooling and families and have limited access to and information on reproductive healthcare; healthy child care practices; and health facilities for antenatal, delivery, and postpartum care. To reach this often neglected population, Save the Children piloted MFB in Kapilvastu and Pyuthan districts in Nepal to improve married adolescent girls’ reproductive health knowledge, skills, and behaviors. Married Adolescent Girls groups receive counseling through peer-facilitated sessions that cover topics related to nutrition, hygiene, sanitation, fertility, pregnancy, birth preparedness, contraception, breastfeeding, and infant care. The MFB project has since been adapted for First Time Parents in Mozambique, Madagascar, and Nigeria.
- The Household-to-Hospital Continuum of Care (HHCC) project, funded by Atlantic Philanthropies, sought to promote preventive household and community practices and improve the quality, accessibility, and utilization of facility-based maternal and newborn health services in eight provinces in Vietnam. The HHCC approach is a comprehensive model to improve maternal and newborn health through linking households, communities, Community Health Centers, and district and provincial hospitals together. In its third phase of implementation, the project is working to scale-up the model’s best practices and effective interventions to pre-service training countrywide. The HHCC model has informed programming in several other countries including Bangladesh, Malawi, Uganda and Mali.
- The Strengthening Care for Preterm Babies in Urban Hospitals in Kenya project strengthens the skills and capacity of health providers in seven hospitals located in Langata Sub–County, Nairobi, Kenya, so that they can deliver higher quality care to preterm and low-birth-weight babies. The project strengthens Kangaroo Mother Care (KMC) services in the seven hospitals, and reaches surrounding communities with communication on the importance of seeking care for preterm babies.
- Our Johnson & Johnson-funded portfolio of programs focuses on strengthening newborn care in Malawi, Uganda, Ethiopia, Nigeria, and Bangladesh. The Uganda/Malawi project initially worked to reduce neonatal mortality due to birth asphyxia through improving neonatal resuscitation at different health service delivery levels, within the context of integrated MNH services, and eventually expanded the package to include essential newborn care as well as care for small and/or sick babies. Ethiopia and Nigeria are part of the Survive & Thrive Global Development Alliance’s “Saving 100,000 Babies Initiative,” which pledges to save 100,000 babies in the three countries that contribute most to neonatal deaths—Ethiopia, Nigeria, and India. These projects help scale-up quality life-saving interventions for newborns including basic newborn care, newborn resuscitation, management of newborn sepsis, and care for low birth weight babies including preterm births. As the latest addition to the J&J portfolio, the Bangladesh project aims to contribute to ending preventable newborn deaths due to pre-term/small newborns in select hospitals targeting the urban poor in Dhaka.
1: Guttmacher Institute. 2017. Adding it Up: Investing on Contraception and Maternal and Newborn Health, 2017. Accessed at: https://www.guttmacher.org/sites/default/files/factsheet/adding-it-up-contraception-mnh-2017.pdf.
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