Saving Mothers, Giving Life shows what a difference a year can make

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The first year of a program meant to reduce maternal mortality saw deaths from childbirth cut by one-third, according to a report released today. These results were achieved with modest investments, panelists said at an event launching the report.

The report detailed outcomes from the first year of the 5-year Saving Mothers, Giving Life initiative, which began in eight districts in Uganda and Zambia in June 2012. Maternal deaths dropped by 30 percent in Uganda and 35 percent in Zambia, the report said.

Women in resource limited settings are 120 times more likely to die during childbirth than women in the United States, said USAID administrator Dr. Rajiv Shah. He quoted former Secretary of State Clinton who announcing the program in 2012 said, “Every life we save is a step to a more peaceful, prosperous planet.”

Child survival underpins strong economic growth, and reducing maternal mortality is key to ensuring that children have the care they need, he said.

CSIS's Janet Fleischman, Dr. Jane Aceng, and Dr. Caroline Phiri

CSIS’s Janet Fleischman, Dr. Jane Aceng, and Dr. Caroline Phiri

Building on the PEPFAR platform to increase the number of women and newborns tested and treated for life for HIV/AIDS, Uganda has not only seen a 30 percent reduction in maternal mortality in the four districts participating in the Saving Mothers program, but has also seen a 28 percent increase in the number of women who received prevention of mother-to-child transmission of HIV/AIDS services, said Dr. Jane Aceng, Director General of the Uganda Ministry of Health. The districts also saw a 27 percent increase in the number of infants who received HIV prophylaxis.

Uganda’s four districts saw a 62 percent increase in the number of women giving birth in health facilities thanks in part to the program’s emphasis on providing women with transportation to facilities. Dr. Caroline Phiri, Director for Maternal and Child Health at the Zambia Ministry of Community Development and Mother and Child Health, said in Zambia, where most women have to journey at least five hours to reach the nearest health facility, providing transportation is key. Shah said that in Uganda alone, 30,000 transportation vouchers provided by Saving Mothers, were redeemed and used.

Aceng said participating districts in Uganda increased the number of facilities providing basic emergency obstetric and newborn care from 3 to 9, and trained and hired 147 new doctors, nurses, and midwives. With greater access to obstetric care, districts saw huge reductions in cause-specific maternal mortality, such as a 43 percent reduction in deaths from obstetric hemorrhage, and a 54 percent reduction in deaths from obstructed labor. Health workers were also trained to address childbirth-related complications affecting newborns, and saw an 11 percent reduction in institutional perinatal mortality.

In Zambia, 199 health care workers were trained to provide emergency obstetric and newborn care, and the facilities that provided those services increased from 3 to 6. Zambia also saw an 18 percent increase in the number of women who received prophylaxis and ART for HIV prevention, and a 28 percent increase in HIV prophylaxis for infants.

Zambia accomplished this at $12.74 per birth, while the cost in Uganda was $6.93 per birth. That came to $8.1 million in Zambia, and $10.5 million in Uganda.

Continuing a partnership with public and private organization, including Merck, the government of Norway, the American College of Obstetricians and Gynecologists, the U.S. government will continue to roll out the Saving Mothers initiative in more districts in Uganda and Zambia, and at least three more countries, said Shah. “Because it’s clear that this has been succeeding, it can now be taken to scale.”

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