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

Good news about increased IUD use in the US

Here at EngenderHealth, we are encouraged by the recent news that IUD is an increasingly popular contraceptive method in the United States. We know through our work in the field that when correct information about the device and high quality health services are offered, the IUD is a safe, effective, and acceptable form of family planning.

Last month, the Centers for Disease Control and Prevention released the results of its National Survey of Family Growth. The results of the survey, which was conducted from 2006 to 2008, show that IUD use in the US increased from 2 percent in 2002 to 5.5 percent in 2006-2008. Among women with two or more children, the increase was even greater, from 3 to 11 percent. There are now more than 2 million women using IUDs in this country.

As a long-acting contraceptive method, the IUD is one of the most effective forms of birth control. It can be used for medium and long-term planning, preventing pregnancy for up to 12 years, and is reversible.

From 2006-2008, during the same time period as the family growth survey was being conducted U.S., EngenderHealth’s ACQUIRE Project team worked with Kenya’s Ministry of Health to expand IUD use in the country’s Kisii District. In the East African country, as in the U.S., the number of women using an IUD to prevent pregnancy dropped significantly in the past two decades.

In Kisii, EngenderHealth worked with local partners to ensure this convenient and low-cost contraceptive method was more widely available and accepted by improving family planning counseling so Kenyan women could make informed choices and by providing trainings in IUD insertion and removal. In just one year, IUD use in Kisii District tripled.

Read more about how the IUD is saving lives in Ghana in this recent article by EngenderHealth’s Medical Director, Dr. Roy Jacobstein.

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.

New Series of HIV and AIDS Program Briefs

This World AIDS Day, EngenderHealth announces a new series of HIV and AIDS program briefs highlighting promising practices and lessons learned from our work. The briefs explore hallmarks of our programs, including strengthening health systems, developing human resources, engaging communities, and advocating for supportive policies. In nine countries, EngenderHealth partners with local clinics and community-based organizations to provide comprehensive HIV and AIDS prevention, care, and treatment services.

The first in the series is a set of five briefs on the AIDS, Population, and Health Integrated Assistance (APHIA II) Nyanza Project, which is based in Nyanza, Kenya. APHIA II is a holistic project to improve and expand HIV prevention, treatment, care, and support services, along with integrated reproductive health, maternal health, family planning, malaria, tuberculosis, and child health services.

The briefs in this series are:

• Implementation Strategy of the APHIA II Nyanza Project (PDF, 416KB)
  
• Improving Health Facility–Based Services in Nyanza Province, Kenya: The APHIA II Nyanza Project (PDF, 372KB)
• Implementing a Community Strategy within the APHIA II Nyanza Project (PDF, 328KB)
• Community-Based Care and Support within the APHIA II Nyanza Project (PDF, 380KB)
• Strengthening the Kenya Health Management Information System (HMIS) for Monitoring and Evaluation of the APHIA II Nyanza Project (PDF, 372KB)

APHIA II Nyanza is supported by the U.S. Agency for International Development and is managed by EngenderHealth, in collaboration with Kenya’s Ministry of Health. Other partners include: the Academy for Educational Development (AED), the Christian Health Association of Kenya, Inter Diocesan Christian Community Services, and PATH.

For more information about the APHIA II Nyanza Project and EngenderHealth’s HIV and AIDS programs, please visit www.engenderhealth.org/aphia or contact Sharone Beatty at: sbeatty@engenderhealth.org.

Gates foundation funds circumcision

Several media outlets have noted EngenderHealth's participation in the new Male Circumcision Consortium (noted previously), including the News & Observer (quoted below) and First Science.

“Family Health International, a global public health and development organization, has won a five-year, $18.5 million grant from the Bill & Melinda Gates Foundation to boost male circumcision in Kenya. The practice is gaining recognition for limiting the spread of HIV/AIDS across Africa. Durham-based FHI will be working with the Kenyan government, the University of Illinois at Chicago and EngenderHealth, a reproductive health organization.”

Read the rest of the article.

Advancing Male Circumcision to Prevent HIV in Kenya

“Expanding male circumcision services is a great opportunity to engage men to take greater responsibility for HIV prevention. Reaching a population that does not usually access health services, we can maximize chances to educate men about behavior change and the importance of shared sexual decision-making, which would improve health outcomes for both men and women.”
—Feddis Mumba, Country Director, EngenderHealth-Kenya, and Project Director, EngenderHealth–Male Circumcision Consortium

EngenderHealth is pleased to announce that it is partnering with Family Health International and the University of Illinois at Chicago on the Male Circumcision Consortium, which launched November 24 in Kenya. The Consortium will improve and expand access to voluntary medical circumcision services in Kenya as part of an overall strategy to reduce HIV infections in men.

Male circumcision is gaining recognition as an important practice for limiting the spread of HIV across Sub-Saharan Africa. Several studies have shown that being circumcised dramatically reduces a man’s chances of acquiring HIV during sex with a female partner who has the virus. The challenge now is to transform this clinical knowledge into a public health strategy that can save millions of lives.

Working closely with the Kenyan government, the Consortium will focus on Nyanza Province—which has the country’s highest HIV prevalence and low rates of male circumcision. The experience and knowledge the Consortium gains in Kenya will offer positive lessons for similar programs in other countries.

Given the large number of men who are expected to want circumcision and the shortage of skilled health care professionals, EngenderHealth will develop a national training plan to increase the number of medical staff able to provide safe male circumcision services. EngenderHealth will also conduct research to assess the safety, efficacy, and cost of having nonphysicians (e.g., nurses) provide male circumcision, as well as study community outreach models.

The Consortium’s activities complement EngenderHealth’s other work in Nyanza to improve male circumcision services, supported by the APHIA II project.

Read more about the Male Circumcision Consortium.