Towards Better Solutions for Reducing Maternal Mortality
To save rural women's lives, we introduced an intensive, innovative social mobilisation intervention that transformed rural apathy into social responsibility and maximized the lifesaving scope of the SBAs. Within 2.5 years, rural communities that participated in the PATHS2 programme in northern Nigeria arranged timely emergency obstetric care referrals for 5,634 women from virtually zero. The prevailing MDG5 approach would have required the SBAs in programme clusters to deliver about 31,000 births to ensure survival of these women.
PRRINN-MNCH survey data for a northern Nigerian programme with the same intervention show a strong correlation requiring further research between knowledge of four maternal danger signs (a proxy for preparing for emergency care) and an impressive 16.7% reduction in maternal mortality within four years from a very high MMR. From a low baseline, women’s knowledge increased 300% in the intervention sites versus 50% in the control sites where the MMR baseline (1271/100,000) remained high and virtually unchanged. The increased number of SBAs cannot explain the significant difference between the endline intervention and control site MMRs; the number of SBA births doubled from 11.2% in both the intervention sites (26.8%) and the control sites (23.6%).
Learning Areas:Advocacy for health and health education
Implementation of health education strategies, interventions and programs
Demonstrate that the worldwide campaign to reduce maternal mortality through skilled birth attendance unnecessarily discriminates against rural women in poor health system environments with high home deliveries, the Nigerian example
Keyword(s): Community Health Workers and Promoters, Women's Health
Qualified on the content I am responsible for because: I was BCC resident adviser for two DfID health systems strengthening programs:Johns Hopkins University Senior Program Officer,PRRINN-MNCH, Kano, Nigeria (January 2007 - March 2011) and Mannion Daniels Ltd Consultant Technical Lead for Informed Citizens Output, Abuja, Nigeria (October 2011 - September 2013), continuing as non-resident adviser through July 31, 2014. My focus is on promoting normative change by empowering community volunteers and members to communicate, reflect together and decide to act on health information.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.