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Project Objective
The goal of this project is to reduce maternal and newborn morbidity and mortality and contribute to the achievement of MDG goals 4 and 5 in a series of low income countries. Specifically, the project will build and sustain the capacity of the ob/gyn and midwifery societies in the participating developing countries to conduct essential projects relevant to the promotion of safe motherhood and the improvement of maternal health. The project will be implemented in a number of countries wherever possible through twinning mechanisms between ob/gyn societies of developed countries with those in the implementing countries. In turn, the ob/gyn societies in the low income countries will partner with the midwifery societies, Ministries of Health, civil society organizations and other relevant stakeholders to ensure harmonization of the project with the health policies and practices in the countries and the proper implementation and sustainability of the tenets of the project
The key innovation of this initiative is to increase women’s access to new, cost-effective and evidence-based technology for the reduction of maternal and newborn mortality in the countries concerned. Thus, the individual projects will consist of staff training and re-training using modules such as the ALARM International program, maternal mortality audits, improvement of antenatal and delivery services, improvement of emergency obstetrics care (EOC) in selected districts, the development and dissemination of obstetric management protocols and algorithms, introduction and dissemination of partogram monitoring of labor and consolidation of the use of essential drugs like misoprostol and uninject for the prevention and treatment of post-partum hemorrhage. The project will also work with communities in the countries to increase awareness on issues related to safe motherhood, and to promote increased utilization of interventions to reduce maternal and newborn morbidity and mortality.
This project, involving major collaborations at the international and local levels and a north to south partnership is critical to addressing the unmet need of maternal mortality reduction in low income countries and will sustain current momentum for achieving the millennium development goals in these countries.
Summary of current FIGO Projects
Haiti
The title of Haiti’s project is “A project for strengthening the Health Centre of Croix Des Bouquets”. The overall objective of the project is to ensure access to skilled birth attendants in the region aided by a functional referral system. The project hopes to achieve the following: Improving the capacity and the quality of reproductive health services, making quality BEOC accessible to all pregnant women and developing collaboration between health staff and the local authority. Additionally, the health centre will be rehabilitated, and be updated to promote the active management of labour for the prevention of PPH.
Kenya
The project titled “Improving quality of antenatal, delivery and postnatal care in Kenya through clinical audit”, has the overall goal to address barriers to the delivery and utilization of antenatal, delivery and postnatal care. Specifically, the project seeks to use clinical audit as a systematic and measurable method to evaluate the quality of care, identify areas of substandard care that need to (and can be) improved and to implement the changes needed to meet agreed standards of care in facilities providing BEOC and CEOC.
Kosovo
The title of Kosovo’s project is: “Reduction of the maternal and newborn mortality in Kosovo”. The goal of the project is to strengthen the capacity and sustainability of professional health associations to participate in improving the quality of maternal and newborn care in Kosovo. Specifically, the project seeks to strengthen the organizational capacity of Kosovo Obstetrics and Gynecology Association (KOGA) and Kosovo Midwifery Association (KMA) with regards to the following: project management skills - communication capacity, development and maintenance of partnerships based on participatory decision making process, and ability to work with the sexual and reproductive health approach. Also, the project will ensure that KOGA and KMA assume leadership roles in the development and implementation of national standards and protocols related to maternal and newborn care in regional and university maternities in Kosovo.
Moldova
The title of the project is “Beyond the numbers: implementation of new approaches for reviewing maternal and perinatal deaths to make pregnancy safer in the Republic of Moldova”. The goal of the project is to contribute to the reduction of perinatal mortality amongst children with a gestational age ≥37 weeks and birth weight ≥2500g in the Republic of Moldova. Specifically, the project seeks to strengthen the capacity of the health system to review perinatal deaths based on a participatory, no blame, confidential and evidence-based approaches and to involve mothers and families in the assessment of the quality of care provided in health institutions. Additionally, the project will help build constructive partnerships between professional associations and fortify the cooperation between the MOH, professional associations, women’s organizations and the decision makers at district level, in order to improve the quality of maternal and perinatal care.
Nigeria
The project is titled “A proposal to build the capacity for improving the quality of emergency obstetric care and prevent maternal morbidity and mortality in Nigeria”. The overall goal of the project is to contribute to the reduction of maternal and neonatal morbidity and mortality, and the attainment of the MDGs in Nigeria. Specifically, it seeks to 1) determine the requirements for improving emergency obstetric services in three states of Nigeria – Anambra, Edo And Kaduna States, (2) strengthen the capacity of professional associations (Society of Gynecology and Obstetrics of Nigeria (SOGON) and the Nigerian Association of Nurses and Midwives (NANM) to design and implement programs for the improvement of emergency obstetric services in the states, and 3) improve the quality of EMOCs in at least one secondary and tertiary hospitals in each of the three states.
Pakistan
The project aims to contribute to the reduction of maternal and perinatal mortality and morbidity in Mirpur Sakro and Thatta Talukas of Thatta District. The basic strategies for the project were to be achieved through upgrading of 7 health facilities in the project area, by raising awareness in the community about maternal and child health to avail skilled care during pregnancy and labour, and by training of skilled and traditional birth attendants, both at the community as well as facility level to carry out preventive antenatal, intra-partum and postnatal care & to improve referral pathways.
Peru
The project is titled: “Comprehensive action to save mothers and newborns in Peru”. The goal of the project is to reduce maternal mortality by at least 50%, in the geographical jurisdiction of the Morropon-Chulucanas (M-C) Health Services Network in Piura. Specifically, the project seeks to improve the organizational and care processes for maternal health in the M-C network, and to increase the use of skilled birth attendants for more than 90% of all births in the community of M-C. Additionally, it will help increase the demand for obstetricians in the most critically poor areas of M-C and strengthen the ability of the Peruvian society of OBGYN to work in alliance with other obstetric associations, the community and the MOH.
Uganda
The title for the project is “Building capacity for the reduction of maternal and newborn mortality and morbidity in 2 poor Ugandan districts through the provision of emergency obstetric and essential newborn care”. The goal of the project is to reduce maternal and newborn morbidity and mortality in Kiboga and Kibale districts of Uganda. Specifically, the project seeks to build the capacity and credibility of professional associations in addressing maternal and newborn health, and to strengthen the provision of emergency obstetric care and essential newborn care through community mobilization, strengthening providers’ skills and facility improvements.
Ukraine
Improving emergency obstetric care in Ukraine: applying the ALARM international program. The ALARM International Program is a training and mobilizing tool designed for health professionals (ob/gyns, midwives, general practitioners, nurses) and administrators involved in delivering essential obstetrical care in low- and middle-resources countries. It focuses on the five 5 main causes of maternal mortality and morbidity: obstructed labour, haemorrhage, sepsis, hypertensive disorders, and complications due to unsafe abortion. Newborn health outcomes are addressed in a component on newborn resuscitation and care. The ALARM International Program further sensitizes the participants to the social, economic, cultural, and legal factors that may impede women’s access to reproductive health services and information, and it advocates for the improvement of women’s reproductive and sexual health as a matter of social justice. Finally, it also exposes health professionals and administrators to those monitoring and evaluation methodologies necessary in all initiatives aimed at increasing access and quality of maternal and newborn health services. It can be offered as Continuing Medical Education (CME) activities or as more comprehensive capacity-building programs within selected health centers or districts.
Uruguay
The title of the project is “To protect the life and health of Uruguayan Women and to reducing abortion under conditions of risk”. The goal of the project is to reduce maternal and newborn mortality and morbidity. Specifically, the project seeks to: (1) reduce the number of abortions performed under conditions of risk in Uruguay, (2) reduce maternal morbidity and mortality associated with abortion, and (3) implement a sustainable model at the national level that is transmissible within similar legal contexts for reducing the number of abortions performed under conditions of risk in Uruguay.
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