The Maternal Health Task Force Announces New Grants

Innovative Maternal Health Projects to Inform National Policies

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NEW YORK, July 22--The Maternal Health Task Force at EngenderHealth announced today that it has awarded eight new grants supporting innovative maternal health research across Asia, Africa, and Latin America. The research, which will be carried out by local organizations in developing countries, will lead to national policy recommendations for improving maternal health.

Each research project will evaluate an ongoing effort to advance maternal health in places where too many women still die from preventable complications of pregnancy and childbirth. Examples of such projects include integrating maternal health care with HIV prevention and treatment, organizing support groups for pregnant mothers, and outfitting health workers in rural communities with cellular phones to facilitate emergency care for pregnant women. Following are summaries of the new grants:

In Bangladesh, scientists and nonscientists will collaborate at the International Centre for Diarrhoeal Disease Research in Bangladesh (ICDDR,B) in translating new and existing knowledge about maternal health into proposals to improve government policies and practices. They will seek consensus on identifying key questions raised by three recent research programs, ensure access to the findings, reach out to national policymakers, and build ICDDR,B capacity and visibility for future work in knowledge translation.

In India, the Centre for Development and Population Activities (CEDPA) will combat India's high maternal mortality and morbidity rates by demonstrating the value of integrating maternal health programs into HIV and AIDS programs. Using forums, workshops, and consultations, CEDPA will evaluate existing programs of the government's National Rural Health Mission, the National AIDS Control Programme, and the National Health Policy Administration in the Rajasthan area, to compile best practices and build consensus on a set of recommendations for policymakers.

In Malawi, the MaiMwana project will be a pilot effort to strengthen the current inadequate Maternal Death Review (MDR) system with a village-level program of maternal death audits. Kamuzu Central Hospital and the Mchinji District Hospital will support the formation of three-member MDR teams in each village to conduct a verbal autopsy (a structured interview) among relatives and neighbors within two days of every maternal death. Improved data will allow better analysis and service improvements and will contribute to recommendations to the Ministry of Health for a national audit procedure.

In Mexico, the Centro de Investigaciones y Estudios Superiores en Antropologia Social (CIESAS) is conducting an assessment of the Ministry of Health's Advanced Life Support for Obstetrics Program (ALSO), which manages delivery emergencies in Oaxaca. CIESAS will determine whether ALSO courses improve the technical skills and professional morale of health care providers enough to justify expanding the program nationwide.

In Peru, Future Generations, in partnership with the Peruvian Ministry of Health, will field test promising methods of reducing maternal and newborn mortality by organizing groups of pregnant women to share their pregnancy histories and experiences. In a controlled trial involving 500 pregnant women, health workers will guide the discussions, document benefits, develop a training manual and materials for possible nationwide use, hold workshops on the materials, and advocate for policy change.

In South Africa and Kenya, the mothers2mothers program, which offers education and emotional support to pregnant women and new mothers living with HIV, will field test "active client follow-up" to increase the number of HIV-positive pregnant women who return to a health care facility for care after an initial visit. In much of Africa, the return rate is low, posing a major obstacle to preventing mother-to-child transmission of HIV. Mothers2mothers will use peer "mentor mothers" to send text messages or cell phone calls to previously contacted pregnant women to urge them to make return visits. Best practices will be collected for integration into the mothers2mothers standard model used continent-wide.

In Sri Lanka, the Department of Community Medicine at Rajarata University will work to improve the collection of data on the impact of maternal death and postpartum illness, a process that is now limited to hospital reports. University researchers will develop a survey questionnaire for field testing among a sample of expectant mothers in the resource-poor Anuradhapura District, where maternal mortality rates are high. Researchers will analyze the frequency and prevalence of health events and their direct and indirect economic impacts on families, to contribute to national service delivery planning.

In Tanzania, the Ifakara Health Institute (IHI) will seek to improve emergency care for pregnant women and newborns by providing free cellular phones and business-related services for mid-level health care providers, to allow better communication with distant emergency obstetric specialists. Cooperating with district councils and a local telecommunications company IHI will evaluate the cost, feasibility, and implementation issues that arise if health workers at the district level have better access to long-distance counseling, faster referrals and resupply services, and emergency clinical support.

[See the original press release.]

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EngenderHealth is a leading international reproductive health organization working to improve the quality of health care in the world's poorest communities. EngenderHealth empowers people to make informed choices about contraception, trains health care providers to make motherhood safer, promotes gender equity, enhances the quality of HIV and AIDS services, and advocates for positive policy change. The nonprofit organization works in partnership with governments, institutions, communities, and health care professionals in more than 20 countries around the world. For more information, visit www.engenderhealth.org.

The Maternal Health Task Force at EngenderHealth brings together existing maternal health initiatives and engages new organizations to facilitate global coordination of maternal health evidence, programs, and policies. Supported by the Bill & Melinda Gates Foundation, the Maternal Health Task Force convenes stakeholders and creates an inclusive setting to engage in dialogue, build consensus, foster innovation, and share information. For more information, visit www.maternalhealthtaskforce.org.

Contact:
Tim Thomas, Maternal Health Task Force/EngenderHealth
646-436-6555, tthomas@engenderhealth.org

EngenderHealth joins the global health community in celebrating proof-of-concept of microbicides

At the International AIDS Conference in Vienna, there was standing ovation in a packed conference hall for the Caprisa 004 microbicide study. As the New York Times reports:

After two decades in which researchers searched fruitlessly for an effective vaginal microbicide to block H.I.V., South African scientists working in two AIDS-devastated communities of South Africa, one rural and one urban, say they have finally found something that shows real promise.

Women who used a vaginal microbicidal gel containing an antiretroviral medication widely used to treat AIDS, tenofovir, were 39 percent less likely over all to contract H.I.V. than those who used a placebo. Those who used the gel most regularly reduced their chances of infection 54 percent, according to a two-and-a-half year study of 889 women by Caprisa, a Durban-based AIDS research center.

Download the official press release (PDF, 168KB).

South Africa ramps up its response to HIV and AIDS

In a move that United Nations officials say is the biggest and fastest expansion of AIDS services ever attempted, South Africa is opening up a new front in its response to HIV. In the past month, some 500 hospitals and clinics have begun dispensing antiretroviral drugs, and the government has trained hundreds of nurses to prescribe the drugs, work that was formerly the domain of doctors, the New York Times reported yesterday. The plan is to train enough nurses so that all of South Africa’s 4,333 health clinics will be able to dispense antiretroviral medicines.

South Africa is home to an estimated 5.7 million HIV-positive people, the largest number in the world. More than half of South Africans living with HIV are women, and 20 percent of pregnant women accessing public health services in 2008 tested positive for HIV. South Africa also has a high rate of sexual and domestic violence toward women, which increases women’s vulnerability to HIV infection.

Since 1998, EngenderHealth has worked in South Africa to transform men’s attitudes and behaviors to reduce gender-based violence and HIV infection rates. We have also introduced innovative approaches for improving men’s access to HIV counseling and testing and care and treatment services. We applaud South Africa’s increased efforts to respond to HIV and the campaign that was kicked off on Sunday to test 15 million of the country’s 49 million citizens for the virus by next June. We also know from our experiences in places where doctors are scarce that properly trained nurses and midwives can offer high-quality health care.

Read more about EngenderHealth’s work to train nonphysicians to perform male circumcision in Kenya.

Voice of America Highlights EngenderHealth's Men As Partners® Program

Voice of America, a international radio and television broadcasting service funded by the U.S. Government, profiled EngenderHealth's Men As Partners® program in a broadcast titled “South African Men’s Groups Fight to End Violence, Discrimination Against Women.” You can download an MP3 of the radio broadcast, or read it online.

“This month, women's rights advocates are calling on men and women to join together to fight gender discrimination. They're meeting in New York for the 53^rd session of the Committee on the Status of Women [March 2 – 13]. And in South Africa, two NGO's are reaching out to men to help end violence against women. They're also looking at ways to help reduce some of burdens borne by women, like providing almost all of the care for those with HIV/AIDS. From Washington, William Eagle reports.

“Johannesburg community activist Dumisani Rebombo says one out of six men in South Africa commit physical violence against women. Research by Witswatersrand University showed almost one third of sexually experienced women report their first encounter was not consensual.

“Rebombo is an organizer with the Men as Partners outreach group, part of the NGO EngenderHealth.”

Get the rest on Voice of America's web site.

Dumisani has previously appeared on Voice of America's "Healthy Living" television show. You can also hear his story, in his own words, on his digital story on YouTube, along with dozens of other men in our Men As Partners programs around the world.

Turning From Past As Rapist To Advocacy Work

National Public Radio’s News and Notes program recently broadcast a story about South African Men As Partners® advocate Dumisani Rebombo. Listen to it online.

Turning From Past As Rapist To Advocacy Work

National Public Radio’s News and Notes program recently broadcast a story about South African Men As Partners® advocate Dumisani Rebombo. Listen to it online.

Preparing for HPV vaccination in South Africa: Key challenges and opinions.

Mark Barone, Senior Medical Associate, co-authored a paper in the journal Vaccine on preparing for human papillomavirus vaccination in South Africa. The abstract is below.

This article reports on qualitative research investigating key challenges and barriers towards human papillomavirus (HPV) vaccine introduction in the Western Cape Province, South Africa. A total of 50 in-depth interviews and 6 focus groups were conducted at policy, health service and community levels of enquiry. Respondents expressed overall support for the HPV vaccine, underscored by difficulties associated with the current cervical screening programmes and the burgeoning HIV/AIDS epidemic in South Africa. Overall poor community knowledge of cervical cancer and the causal relationship between HPV and cervical cancer suggests the need for continued education around the importance of regular cervical screening. The optimal target populations for HPV vaccination was influenced by the perceived median age of sexual activity in South African girls (9-15 years), with an underlying concern that high levels of sexual abuse had significantly decreased the age of sexual exposure suggesting vaccination should commence as early as 9 years. Vaccination through schools with the involvement of other stakeholders such as sexual and reproductive health and the advanced programme on immunization (EPI) were suggested. Opposition to the HPV vaccine was not anticipated if the vaccine was marketed as preventing cervical cancer rather than a sexually transmitted infection. The findings assist in identifying potential barriers and facilitating factors towards HPV vaccines and will inform the development of policy and programs to support HPV vaccination introduction in South Africa and other African countries.

Video: HIV is Real and It's Around

Mogomotsi "Supreme" Mfalapitsa, a senior transformation agent at EngenderHealth in South Africa, works in our Men As Partners® program to reduce both HIV and gender inequality. He performed this original song about HIV and safe sex at the Mexico YouthForce pre-conference just before the 2008 International AIDS Conference. The video was filmed by Marius Juel Hovland. As Supreme says, “I am passionate about music being used to send positive messages and creating change in people's lives.”

Download a free MP3 version of Supreme's song.

Remorseful father fights to stop rape

Several media outlets have covered the personal transformation of Dumisani Rebombo, Senior Program Coordinator for EngenderHealth’s Men As Partners® program in South Africa, most recently the Toronto Star (quoted below) and the Huffington Post.

“Dumisani Rebombo is protective of his daughters. He wants them to be happy and marry men who treat them well. It's a dream most fathers have, but not an easy one to accomplish in South Africa. According to the country's Commission on Gender Equality, a woman is raped every 17 seconds. Rebombo knows this too well. That's why he wants to make sure his daughters don't meet someone like his younger self. "In my youth, my friends and I, we gang-raped a girl in the village where I was growing up," he says.”

Read the rest of the article.