Maz & Kilgore

At last! Today I was lucky enough to see an advance version of a much anticipated study on maternal survival. Coming out of UC London (and currently in peer review), the study compares different strategies for treating mothers, using mathematical modeling.

This brilliant work goes straight to the heart of the discussion about “in the meantime” solutions for saving mother’s lives that has been reverberating through the maternal health community all year. We’ve been advocating for drug distribution and treatment at the community level by community health workers and women volunteers as an immediate solution… acknowledging that more than 50% of mothers in the developing world still deliver at home, and facility delivery for all these mothers just cannot realistically be achieved any time soon. (See our previous post “A complimentary approach to saving mother’s lives?”) It’s incredibly exciting to see statistical models that demonstrate how community delivery of medicines could increase maternal survival significantly - particularly in the poorest quintile! A pro-poor solution indeed.

The study compares the impact on maternal survival of 3 approaches - Health facility strengthening alone, Health facility strengthening PLUS antenatal care and community health workers, and both of the above PLUS women volunteers in villages able to provide access to drugs and treatment.

Here’s an excerpt from the study:

“Provision of life-saving drugs to prevent or treat hemorrhage and sepsis might be possible through antenatal clinics, community health workers, or even women community volunteers at the village level, in the same way that child survival has improved through community distribution of anti-malarials and antibiotics.”

Absolutely! And of course - the medicines under consideration are antibiotics and misoprostol… I’ll post a pdf of the study as soon as it’s available.

“The standard recommendation to a woman who needs medical attention is, ‘Go to the hospital’ - but in rural parts of India there are so few doctors that this is like telling her, ‘Do nothing.’ We decided to follow Gandhi’s message to go to the villages. Instead of waiting for people to come to us, we found a way to take the care to the people.“  Abhay Bang, SEARCH

More than 50% of mothers in low-income countries still give birth in the home, far from health facilities, medicines and trained professionals .

Why? These women often live in remote and inaccessible rural areas. And even if health facilities and trained professionals are within reach, many women confront insurmountable cultural and religious obstacles in accessing that healthcare and inevitably give birth at home.  Plus, their governments face significant economic challenges, made worse by the exodus of trained medical staff to rich countries.
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