Prevention of Maternal Mortality_
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The Maternal and Child Survival Program (MCSP) is USAID's flagship $500 million, 5-year program aimed at ending preventable child and maternal deaths in 24 priority countries. MCSP works across the continuum of care from household to hospital on technical areas like maternal and newborn health, child health and immunization, family planning, nutrition, and more. It focuses on cross-cutting issues like quality, innovation, gender, and health systems strengthening. The program's goal is to support countries in increasing coverage of reproductive, maternal, newborn and child health interventions and closing innovation gaps to improve health outcomes for vulnerable populations.
Prevention of Maternal Mortality_
- 1. The Maternal and Child Survival Program Acting to End Preventable Maternal Mortality CORE Group Global Health Practitioner Conference April 16, 2015 www.mcsprogram.org
- 2. Vision Statement Self-reliant countries equipped with the analytical tools and effective systems enabling them to be on track to end preventable child and maternal deaths USAID’s flagship Maternal and Child Survival Program
- 3. Awarded: Launched June 2014 Length: 5Years Funding Ceiling: 500 Million AOR: Nahed Matta Alternates: Malia Boggs; Megan Rhodes Technical Advisors: Karen Fogg; Kerry Ross Program Basics
- 4. Maternal & Newborn Health Child Health & Immunization Family Planning Nutrition Malaria Water, Sanitation, & Hygiene (WASH) HIV/TB Technical Areas
- 5. Cross-Cutting Issues Quality Innovation Partnerships (private sector, civil society, etc.) Gender Equity Measurement and Analytics Behavior Change Communication e/mHealth Community Approaches WASH Health Systems Strengthening
- 6. Partners
- 7. Evolution since MCHIP Reflects changing global RMNCH landscape and shifts in USAID priorities Greater emphasis on cross-cutting issues such as quality, equity, and gender Focuses on sustainable scale up, such as strengthening health systems, that will deliver high impact technical interventions 20% of MCSP funds are required to be spent “through local institutions”
- 8. Household to Hospital Continuum of Care Household Clinics/Hospitals Community Referral
- 9. Strategic Objectives Support countries to increase coverage and utilization of evidence-based, high-quality reproductive, maternal, newborn and child health (RMNCH) interventions at the household, community and health facility levels; Close innovation gaps to improve health outcomes among high-burden and vulnerable populations through engagement with a broad range of partners; and Foster effective policy, program learning and accountability for improved RMNCH outcomes across the continuum of care
- 10. IntegratedThemes Scaling up RMNCH coverage in 24 priority countries Maximize potential for public and private sector—including civil society Addressing equity through a community health strengthening approach Strengthening integrated community health platforms Integrating services across the continuum of care Better care on the Day of Birth Maternal newborn health and infectious disease Rigorous focus on monitoring, evaluation, and learning
- 11. 24 Priority USAID Countries Other countries where MCSP works: Burma, Egypt, Guinea, Namibia, South Africa Countries where MCSP works Afghanistan Bangladesh Democratic Republic of Congo Ethiopia Ghana Haiti India Indonesia Kenya Liberia Madagascar Malawi Mali Mozambique Nepal Nigeria Pakistan Rwanda Senegal South Sudan Tanzania Uganda Yemen Zambia
- 13. Translating theVision into Action • Enabling and Mobilizing Individuals and Communities • Improve behaviors and norms, equity • Advancing Quality, Respectful Care • Integration of maternal health and family planning • Scale up quality maternal health care • Address indirect causes of maternal mortality, poor birth outcomes • Increase focus on maternal morbidity and disability • Respectful Maternity Care and improving work environment • Strengthening Health Systems and Continuous Learning • Health systems strengthening, data use, innovation and research
- 14. Enabling and Mobilizing Individuals and Communities • Improve individual, household, and community behaviors and norms • Community engagement, advocacy • Strengthening community-based counseling and empowerment of community health workers • Improve equity of access to and use of services by the most vulnerable • Reaching rural populations with uterotonics for prevention of postpartum hemorrhage
- 15. Integrated Community Health Platforms A flexible system for integrated RMNCH service delivery in the community, spanning common gaps in the continuum of care from household to health facilities CHW Workforce and Community Infrastructure Information for Equity, Learning and Adaptation Institutionalization, Coordination and Partnerships Intervention Package: Preventative, Promotive & Curative Services Support Services and Functions (commodities, supervision, information processes…) National Policy and Support Includes health promotion, disease prevention, care seeking and treatment Not a one- size-fits-all blueprint
- 16. Advancing Quality, Respectful Care • Integration of maternal services & family planning • Postpartum family planning as essential component of both antenatal and postnatal care • Scale up quality care • Comprehensive approach to prevention of postpartum hemorrhage • Address indirect causes of maternal mortality and poor birth outcomes • Infectious disease management as critical component of antenatal care
- 17. Advancing Quality, Respectful Care • Averting and addressing maternal morbidity and disability • Prevention and management of obstetric fistula • Advance choice and respectful maternity care (RMC) • RMC: Bangladesh, Mozambique, South Sudan,Tanzania, Rwanda, Kenya, Ethiopia, Haiti, Indonesia, Madagascar, Burma, Nigeria • Alternative birth positions: Ethiopia, Mozambique, Burma, Pakistan, Rwanda, South Sudan,Tanzania
- 18. Address Gender Issues • Antenatal care (ANC) • Engagement of men in counseling & birth planning • Gender-based violence (GBV): identification, safety planning & harm reduction, counseling re effects on MCH outcomes • Labor and birth • Respectful and gender-sensitive care during birth • Deploying female skilled birth attendants (SBA) • Making services affordable to women • Bringing SBA to women who lack mobility or transport • Participatory women’s groups to foster social support for maternal and neonatal health problems
- 19. Strengthening Health Systems and Continuous Learning • Systems to track stock-outs of life-saving drugs • Human resources for health • Clinical governance and focus on measurement as driver for improving quality and coverage of services • Strengthen maternal death surveillance • Operations research and learning agenda
- 20. Multidimensional Management Antenatal Care DISTRICT FACILITY COMMUNITY HEALTH STRATEGIES COMMUNITY /HOUSEHOLD Intrapartum Care and Emergencies Postpartum and Newborn Care CLINICAL GOVERNANCE BETTER CARE ONTHE DAY OF BIRTH including CEmONC STRENGTHENED ANTENATAL CARE including infectious disease (ID) STRENGTHENED POSTNATAL CARE including FP, nutrition, ID
- 21. Strengthen Maternal Death Surveillance and Response • Technical assistance for capacity-building of key elements of MDSR in 10 countries • Kenya, Ethiopia, Tanzania, Yemen, Nigeria, Malawi, Zambia, Rwanda, Uganda, and Egypt • Engage with global stakeholders developing and integrating MDSR/PDSR Systems • Collaboration with the USAID Africa Bureau and WHO-AFRO
- 22. Support & Study Scale-Up Four high impact technical interventions, each in multiple countries (e.g., misoprostol) Monitor clear outcomes on ongoing basis Use clear implementation strategies Standardized process documentation Active Community of Practice Supporting countries to eliminate preventable deaths: Implementation Research to drive better practice in “real time” Sustainable impact at scale Service expansion / increased coverage Institutionalizationinhealthsystems Short cycle learning to improve practice & achieve scale check adjust learn check adjust learn check adjust learn check adjust learn Adapted from: Institute for Reproductive Health (IRH)
- 25. Acknowledgements • Ali Abdelmegeid • Kate Brickson • Myra Betron • Stephanie Suhowatsky • CicelyThomas
- 26. For more information, please visit www.mcsprogram.org This presentation was made possible by the generous support of the American people through the United States Agency for International Development (USAID), under the terms of the Cooperative Agreement AID-OAA-A-14-00028. The contents are the responsibility of the authors and do not necessarily reflect the views of USAID or the United States Government. facebook.com/MCSPglobal twitter.com/MCSPglobal
- 27. Extra Slides
- 28. Pregnancy Labor & Delivery Newborn Child TECHNICAL APPROACHES ACROSS LIFE CYCLE HEALTHSYSTEMLEVELS CommunityDistrictFacility ACTION-ORIENTED LEARNINGCENTEREDON SYSTEMATICSUPPORT &STUDYOFSCALEUP Integrated Community Platforms Whole Market District Approach ANC/PNC and Day of Birth Integrated Interventions Integrated Child Health Interventions (incl. prevention, immun., nutri.) “PRACTICE – LEARNING FEEDBACK LOOP” Helping Countries Eliminate Preventable Child & Maternal Death, by Achieving Impact at Scale for Women and Children
- 29. What is MDSR? MDSR is a continuous- action cycle to provide real-time, actionable data on MM levels, causes of death, and contributing factors, with focus on using findings to prevent future maternal deaths.