Transcript No Slide Title

MATERNAL DEATH CAN AND
SHOULD BE PREVENTED
By
Francois M. Farah
UNFPA
REDEFINING PREGNANCY AND
CHILDBIRTH FROM A RISK
MANAGEMENT PERSPECTIVE
2001-11-21
UNFPA - Delhi
OBSTACLES TO SAFE
MOTHERHOOD- I
A - LACK OF ACCESS TO HEALTH CARE
NON AVAILABILITY OF HEALTH FACILITIES AND
SERVICES
GEOGRAPHICAL DISTANCE HOME/HEALTH FACILITY
NON-AVAILABILITY OF TRANSPORTATION
TRANSPORT COST
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OBSTACLES TO SAFE
MOTHERHOOD - II
B - POOR QUALITY OF CARE AT HEALTH
FACILITY
FEW, UNSKILLED, NON-MOTIVATED HEALTH PERSONNEL
LACK OF EQUIPMENT
LACK OF SUPPLY (BLOOD)
NON AVAILABILITY OF EOC: REFERRAL SYSTEM,
COMMUNICATION, RECORD KEEPING, ETC.
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UNFPA - Delhi
OBSTACLES TO SAFE
MOTHERHOOD - III
C - HIGH RISK PREGNANCIES
PREDISPPOSING FACTORS SUCH AS MATERNAL AGE,
PREGNANCY ORDER, NARROW BASIN, ETC..
MATERNITY HISTORY
BIRTH INTERVAL
FATALIST HEALTH SEEKING BEHAVIOUR
SOCIAL CULTURAL BARRIERS AND GENDER BIASED
HARMFUL SOCIAL AND HEALTH PRACTICES
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UNFPA - Delhi
PREVIOUS ATTEMPTS AND
LESSONS LEARNED - I
TO REDUCE MATERNAL DEATH AND MORBIDITY:
ACKNOWLEDGE SERIOUSNESS OF COMPLICATIONS
TIMELY DETECTION OF COMPLICATIONS
IMPROVING WOMEN’S ACCESS TO PROMPT,
EFFECTIVE TREATMENT OF OBS. COMPLICATIONS
SUCH SYSTEM SHOULD BUILD UPON EXISTING
CADRES OF HEALTH SERVICE PROVIDERS
IMPROVE QUALITY AND RESPONSIVENESS OF
RH2001CARE
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UNFPA - Delhi
PREVIOUS ATTEMPTS AND
LESSONS LEARNED - II
TO REDUCE MATERNAL DEATH AND MORBIDITY:
SYSTEM MUST BE COST EFFECTIVE AND
SUSTAINABLE TO WORK FOR POOR
COMMUNITIES WITH POOR HUMAN AND
FINANCIAL RESOURCES IN REMOTE AREAS
PROGRAMME MUST WORK WITH
COMMUNITY, CONVINCE FAMILIES,
HUSBANDS, LOCAL AUTHORITIES, RELIGIOUS
AND CULTURAL LEADERS THAT MATERNAL
2001-11-21
UNFPA - Delhi
DEATH
CAN AND SHOULD
BE PREVENTED
CONCRETE PROGRAMME
RESPONSE TO MATERNAL
DEATH
FUNCTIONAL, SUSTAINABLE, COMMUNITY
FRIENDLY REFERRAL SYSTEM: R E S C U E R
(RURAL EXTENDED SERVICES AND CARE FOR ULTIMATE EMERGENCY RELIEF)
A THREE-PRONGED DESIGN:
IDENTIFYING REFERRAL POINTS AND
EQUIPPING THEM FOR CATCHMENT AREAS
COMMUNICATION SYSTEM BETWEEN RP AND
VILLAGES
EFFICIENT, FUNCTIONAL AND SUSTAINABLE
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UNFPA - Delhi
MEANS OF TRANSPORTATION
1
- IDENTIFYING REFERRAL POINTS
MAPPING OF HEALTH FACILITIES
COMPREHENSIVE NEEDS ASSESSMENT
ENSURE MINIMUM REFERRAL CARE AND SERVICES
THROUGH
TRAINING OF DAIs ON REFERRAL, PERSONNEL AT 1st
REFERRAL, AND IN HOSPITAL
LOGISTICS, EQUIPMENT (BASED ON NEEDS
ASSESSMENT)
RENOVATION (BASIC) TO MAKE THE FACILITY
FUNCTIONAL
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UNFPA - Delhi
2 - COMMUNICATION SYSTEM
VHF RADIO COMMUNICATION SYSTEM
TWO WAY COMMUNICATION:
REFERRAL POINT- VILLAGE; 1ST REFERRAL
REFERRAL POINT- HOSPITAL 2ND REFERRAL
IDENTIFY REFERRAL HOSPITAL
A TWO PRONGED TRAINING: EARLY
DETECTION OF COMPLICAITONS SIGNS OF
EMERGENCIES AND USE OF RADIO
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UNFPA - Delhi
3 - TRANSPORTAION
SIMPLE, ECONOMICAL, EASY TO MAINTAIN
AND REPAIR, TRANSPORT DEVICE
THREE WHEELER WITH A SIMPLE
STRUCTURE TO ACCOMMODATE
EXPECTING WOMEN
SIDE SEAT FOR ACCOMPANYING PERSON
(DAI OR RELATIVE)
EMERGENCY DELIVERY KIT
RESCUER BOATS FOR THE TWO ISLANDS
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UNFPA - Delhi
SIMULATION
PRELIMINARY FINDINGS IN PILOT AREA
MARCH 8, 1996 – MARCH 1997
ANTENATAL:
22885 ---- 26078
NORMAL DELIVERIES
5410 ---- 6094
CS
468 ---- 640
REFERRED CASES
342 ---- 1028
MATERNAL DEATHS
48
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UNFPA - Delhi
---- 33
REPLICATION
PRELIMINARY CONSULTATIONS
FEASIBILITY STUDY
SENSITIZATION AND MOBILIZATION OF
COMMUNITY, ADMINISTRATION AND HEALTH
SYSTEM
SELECTION OF HEALTH UNITS/ CATCHMENT AREAS
NEEDS ASSESSEMENT
HUMAN RESOURCE DEVELOPMENT/TRAINING
HEALTH UNIT RENOVATION/PROCUREMENT
IMLEMENTATION
MONITORING,
EVALUATION
INTRODUCTION
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UNFPA - AND
Delhi
OF NECESSARY ADJUSTMENTS
EXAMPLES FROM OTHER CONTEXTS
AMDD: AVERTING MATERNAL DEATH AND
DISABILITY
Multiple Country Project
Preliminary Findings
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UNFPA - Delhi
MATERNAL MORBIDITY AND
MORTALITY CAN AND
SHOULD BE PREVENTED
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UNFPA - Delhi
ONE UNNECESSARY
AND PREVENTABLE
MATERNAL DEATH
IS ONE TOO MANY
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UNFPA - Delhi