Innovations in maternal, newborn and child health

Photo: Lucia Zoro/Save the Children

This blog was written by Franco Wandabwa, Save the Children and Tunde Segun, Evidence for Action. 

Are countries in Africa serious about tackling maternal, newborn and child deaths? Africa has seen maternal mortality decrease by more than 40 percent since 1990 and child mortality by 33 percent. The challenge of addressing maternal, newborn and child survival and health remains a priority as the continent is home to the greatest burden globally of deaths – 57 percent of the world’s maternal deaths and half of the all deaths of children under age five.

African leaders recommitted to improving women’s and children’s health during the African Union’s International Conference on Maternal, Newborn and Child Health (MNCH) in Africa from 1-3 August 2013 in Johannesburg, South Africa. Given that progress for MNCH has been slower in this region than the global average, countries on the continent are looking to innovative solutions to accelerate progress.

To highlight and discuss innovations for MNCH at the African Union conference, Save the Children and Evidence for Action coordinated a plenary panel discussion on innovations chaired by the Honorable Minister of Health of Nigeria, Professor Onyebuchi Chukwu. Other panelists included state actors including the Honorable Minister of Health of Malawi, Mrs. Catherine Gotani, and the Honorable Minister of Health Djibouti, Neima Moussa Ali; Dr. Tunde Segun from Evidence for Action’s MamaYe campaign, Kate Kerber from Save the Children, and Gustav Praekelt from Praekelt Foundation.

Innovation was defined as new ways of working and new ways of thinking about and addressing old problems. Each of the panelists answered questions based on their area of expertise.

How can countries use evidence to adapt innovative solutions and learn from each other?
Evidence for Action’s Dr Tunde Segun presented new ways to use data for decision making include using score cards to track progress in health care coverage, financing and policy change for MNCH. Score cards at sub-national level are being used as a motivator for regional and district health managers in the form of friendly competition between regions. The media also has an important role to play in maintaining real-time accountability. One positive way of promoting accountability is through celebrating health worker heroes who are consistently providing quality care in hard to serve settings. In this vein, the Mama Afrika award – a continent-wide prize for excellence in the field of maternal, newborn and child health – was announced at the conference.

What is the role of innovation in linking families to health facilities and referral care and back again?
Kate Kerber from Save the Children spoke about the opportunities for innovative strategies to address each of the 3 delays faced by families in accessing health care: the delay in identifying the need and taking a decision to seek care; the delay in reaching care once the decision is taken; and the delay in receiving timely and appropriate care once at the health facility. Additionally, there is a strong role for mHealth in addressing the gap in the continuum of care once a woman or child is discharged from the health facility. It is particularly important for first-time parents and those with sick children including preterm babies to stay connected to support services and follow-up care.

What is the role of the private sector in pioneering innovative development solutions?
We are close to the time when every person on the continent will have access to a mobile phone, shared Gustav Prakelt. This presents an unprecedented opportunity to give communities access to services and information which had previously been inaccessible. The MAMA project, currently in South Africa and expanding across the continent, is one example of how this technology is being used to support, inform and empower moms and women of child-bearing age in a broad range of income groups using technologies that many women are already using and already feeling comfortable with.

How can our national governments use innovation to strengthen health systems and address demand related barriers to access to health services?
Honorable Minister Gotani shared successful innovative practices for MNCH in Malawi. One example of this is the use of text messages for communication between women and the health care facilities during late pregnancy and childbirth. Innovative solutions have also been used to shift the role of traditional birth attendants to a birth companion instead of a delivery attendant. By engaging traditional birth attendants in supporting referrals, Malawi has seen a reduction in delays in accessing timely care.

In Djibouti, Honorable Minister Moussa Ali noted that initiatives regarding maternal health especially in identifying women early in pregnancy and supportive birth preparedness planning reduced maternal death by nearly half. The deployment of mobile health team to visit the Northern region twice a month has proven effective at bringing quality care closer to families.

What one innovative approach would have the largest impact on addressing MNCH challenges in countries?
1. Honorable Minister of Djibouti Moussa Ali: The establishment of sustainable financial schemes to assist families in overcoming cost barriers and accessing quality health care
2. Honorable Minister of Malawi Catherine Gotani: Improving communication between health surveillance assistants and traditional birth attendants as the first point of contact for many women and their children.
3. Save the Children’s Kate Kerber: Close the gap between families and the health system for all mothers and children, but particularly for babies born preterm in order to maintain the continuum of care and provide follow up services.
4. Evidence for Action’s Tunde Segun: Institutionalize and digitalize maternal death audit and follow up on action-oriented responses to make a massive difference for the quality of care provided to mothers.
5. Praekelt Foundation’s Gustav Praekelt: Improve access to free information and make this available through mobile technology.

Honorable Minister of Health of Malawi speaks on innovative approaches to address MNCH in Malawi

Panelists for the “Innovations for MNCH” plenary session at the African Union MNCH Conference
(left to right): Honorable Minister of Health Djibouti, Neima Moussa Ali, Honorable Minister of Health of Malawi, Mrs. Catherine Gotani, Kate Kerber from Save the Children, Honorable Minister of Health of Nigeria, Professor Onyebuchi Chukwu, Dr. Tunde Segun from Evidence for Action, and Gustav Praekelt from Praekelt Foundation

Dr. Tunde Segun talks about using score cards

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