Washington — A program designed to save pregnant women from preventable death has yielded "inspiring" results, says Rajiv Shah, administrator of the U.S. Agency for International Development (USAID).
The program -- Saving Mothers, Giving Life -- resulted in 30 percent fewer women dying during childbirth in its eight trial districts in Zambia and Uganda in its first year, Shah reported at a January 9 event at the Washington research institute Center for Strategic and International Studies.
The positive results of the five-year, $200 million program launched in 2012 mean that it can expand to at least three more countries, Shah said. Saving Mothers, Giving Life is a partnership of the United States; the governments of Norway, Zambia and Uganda; Merck for Mothers; the American College of Obstetricians and Gynecologists; Every Mother Counts; and Project Cure.
U.S. partners include USAID, the United States President's Emergency Plan for AIDS Relief (PEPFAR), the Centers for Disease Control and Prevention (CDC), the Peace Corps and the Department of Defense.
Saving Mothers targets the delays that low-income pregnant women face in seeking, reaching and receiving adequate health care, Shah said. "In many cases, something as simple as knowing the danger signs during pregnancy or arranging for transportation to a clinic ahead of time is all it takes to save a mother's life," he said.
Shah said that "it is unacceptable and heartbreaking that nearly 300,000 mothers and almost 3 million newborns continue to die each year from causes we know how to prevent" such as access to a skilled birth attendant. Common causes of maternal death are hemorrhage, infection and obstructed labor, said CSIS Senior Associate Janet Fleischman.
Shah said that to find out how well the Saving Mothers program was working, partners built a strong system to record and measure results. The system showed that in Uganda in 2012, 62 percent more women delivered their babies in a health care facility than in the previous year. In Zambia, the increase was 35 percent.
CDC Director Thomas Frieden said the success of the program rested on key elements. Saving Mothers supplies transportation vouchers to women so they can get to a facility with skilled birth attendants. It helped renovate health facilities to include sleeping quarters for doctors and nurses so they can be available to serve women around the clock. And it equipped the facilities with basic and emergency supplies so that doctors could provide surgical interventions like cesarean sections when needed.
In Uganda, support from Saving Mothers resulted in a 200 percent increase in facilities offering emergency services. In Zambia, support resulted in a 100 percent increase.
Saving Mothers includes communications and referral strategies to inform women of services available. It also registers pregnant women so health care providers can give them regular feedback.
In addition, hundreds of health care providers have received new skills training, empowering them to deliver high quality maternal health care, he said.
Frieden credits PEPFAR with strengthening health care services in the two countries with its integrated approach. He said PEPFAR-supported facilities are recording a decrease in maternal mortality and an increasing numbers of expectant mothers receiving HIV testing.
"When you save the life of a mother you create ripples of change that echo outward, transforming not only the health of her family and the strength of her community, but also the stability and economic prosperity of her society," Shah said.