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Reducing Maternal Mortality through an Integrated Care Approach

When we set out to understand the healthcare needs in Far West, over 95% of deliveries in the region took place at home and maternal mortality rates were some of the highest in the world.

Our first endeavor was to establish a 24/7, safe and free, birthing center. We hired six nurse midwives, despite warnings that this would be a costly investment which the community would not use. Five weeks went by with no patients, while the midwives waited night and day, also questioning the enterprise. One night a woman was carried by her family members for obstructed labor. She arrived at the clinic after experiencing intense bleeding. Our staff jumped into action and safely delivered the child.

This was a turning point.

Community members understood that professionalized staff and equipment could improve outcomes of a child and/or a mother, especially in difficult cases. News spread.

Over time, we realized that our services need to integrated to improve quality. We trained Community Health Workers to deliver care at the home and proactively identify pregnant women. Pregnant women now receive 1:1 counseling and monitoring in their homes, within weeks after conception, in addition to group antenatal sessions that cover nutrition, breastfeeding, and laboratory tests and ultrasounds for high risk pregnancy screening. We built the region’s first operating room for cesarean sections. We expanded treatment for postpartum hemorrhage. Currently, we deliver over 200 babies per month across our two provinces, and areas where the Institutional Birth Rate was less than 5% we now see rates at 95%.

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