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How to save mothers and newborns from preventable deaths

May 09, 2023

Nurses taking part in a birth simulation training at Nacala Porto Hospital come together for a group session.

Nurses taking part in a birth simulation training at Nacala Porto Hospital come together for a group session. Photo credit: Mbuto Machili for FHI 360

All people deserve equal access to high-quality, person-centered maternal and newborn health services. But mothers and newborns are dying from preventable causes every day in countries around the world. FHI 360 operates at all levels of health systems, in collaboration with local partners and ministries of health, to create lasting changes that will help mothers and babies live full and healthy lives.

Below, learn how in Mozambique, Zimbabwe and Uganda — by working with health care providers, communities and at the national level — we are putting essential maternal and newborn health services within reach for mothers and babies.

In Mozambique, FHI 360 strengthens providers’ skills and confidence

Through the Alcançar: Achieving Quality Health Services for Women and Children project — which comprises a consortium of partners, led by FHI 360 and funded by the U.S. Agency for International Development (USAID) — FHI 360 is building the skills of health care providers.

Birth simulation trainings — an approach developed by FHI 360’s partner PRONTO International, in which a nurse-turned-actor adopts the role of a woman in labor so that other providers can hone their skills — have been highly successful. Simulations “replicate a real clinical scenario accurately enough to make participants believe and feel that it is real,” says Valeriana Rufino Lemia, deputy chief of party for FHI 360 Mozambique. “Participants feel empowered to ask questions and learn from their mistakes.”

Simulations strengthen providers’ confidence in managing obstetric and neonatal complications, improve their communication and boost their technical skills. In total, nearly 3,000 birth simulation trainings have been conducted in 250 health facilities. And since Alcançar’s inception in 2019, in the 35 health facilities where it first began working, hospital-based maternal mortality has decreased by 64% — a result of several different innovative strategies, including increasing male engagement, supporting pregnant women to begin antenatal (prenatal) care and birth simulations.

“I hope it doesn't stop here,” says Ancha Amade, a maternal and child health nurse who participated in a simulation. “And if there are other places where there is no simulation, [I hope] that they implement it. This is very important for all nurses, for all health staff. I hope it's like this for the whole world.”

In Zimbabwe, FHI 360 brings care to communities

FHI 360’s Mhuri/Imuli project, which is funded by USAID, improves family planning nationally and maternal, newborn and child health in Manicaland province. From 2018 through 2023, Mhuri/Imuli offered mobile outreach services to hard-to-reach populations in rural and urban communities, which included counseling for informed and voluntary choice as well as a range of contraceptives. During this time, teams provided family planning methods to 295,000 people, including over 87,000 adolescent girls and young women ages 15–24.

“My husband didn’t allow me to use any contraceptives, and raising 15 children was not easy,” says Muchaneta*, a 49-year-old mother from an Apostolic community, which objects to the use of modern health care. “But with this Jadelle [a contraceptive implant, which she received after Mhuri/Imuli staff visited her community], I now know that I am safe.”

The project also worked with its partner Family AIDS Caring Trust to implement Family Life Schools, which teach people who are in the same life stage about maternal, newborn and child health and family planning.

Patricia* is a village health worker and Family Life School facilitator who champions women’s and children’s access to services. “I understand these women,” she says. “Many of them now appreciate the benefits of accessing modern health services for their health and [the health of] their babies. But the fear of breaking church doctrines and family religious rules pushes them away from the clinics.”

Patricia connects women and children with services. “Everything we do is for the benefit of the children of this community,” she says.

During the project, Family Life Schools, which have been implemented in conjunction with 48 health facilities, reached over 4,700 participants.

“By addressing the unique needs of these populations, we helped to improve access to maternal and child health care for people who have traditionally been hard to reach,” says Gladwin Muchena, chief of party for Mhuri/Imuli and FHI 360 country representative for Zimbabwe.

In Uganda, FHI 360 works at the national level to reduce birth asphyxia

FHI 360’s Uganda Maternal and Child Health and Nutrition Activity, which is funded by USAID, aims to improve maternal, newborn and child health. “We support the government’s efforts to cascade — from the national level to the district and site levels — policies, guidelines, standards and implementation strategies that improve maternal, newborn and child health and nutrition services,” says Richard Kagimu Musoke, deputy chief of party for the project.

The project worked with the Ministry of Health to establish a national community of practice for maternal and perinatal death surveillance and response. The group, which meets weekly, has over 650 multisectoral partners: health leaders, facility managers, frontline health workers, implementing partners, and civil and corporate societies.

The project shares with the group weekly maternal and perinatal death data analytics disaggregated by region, district and health facility. Reports have highlighted Uganda’s struggle with asphyxia (defined by the World Health Organization as “the failure to establish breathing at birth”) as the leading cause of neonatal deaths.

This knowledge led to action. The Ministry of Health and its partners developed a national framework to reduce perinatal deaths. It worked to improve facilities through additions such as obstetric surgical theaters and newborn care units. And the community of practice also established maternal and newborn care clinical skills mentorships in 131 districts across 14 regions of the country. These holistic actions offer a multifaceted approach to reducing neonatal deaths.

Tackling big challenges through varied approaches

There are just seven years left to meet the Sustainable Development Goals, particularly Target 3.1, which calls for a reduction in the global maternal mortality ratio. But no matter how long it takes, FHI 360 is committed to keep working with health care providers, communities and national bodies and officials until maternal and newborn health care is within reach for all.

*Names have been changed.