Deprecated (16384): The ArrayAccess methods will be removed in 4.0.0.Use getParam(), getData() and getQuery() instead. - /home/brlfuser/public_html/src/Controller/ArtileDetailController.php, line: 73
 You can disable deprecation warnings by setting `Error.errorLevel` to `E_ALL & ~E_USER_DEPRECATED` in your config/app.php. [CORE/src/Core/functions.php, line 311]
Deprecated (16384): The ArrayAccess methods will be removed in 4.0.0.Use getParam(), getData() and getQuery() instead. - /home/brlfuser/public_html/src/Controller/ArtileDetailController.php, line: 74
 You can disable deprecation warnings by setting `Error.errorLevel` to `E_ALL & ~E_USER_DEPRECATED` in your config/app.php. [CORE/src/Core/functions.php, line 311]
Warning (512): Unable to emit headers. Headers sent in file=/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Error/Debugger.php line=853 [CORE/src/Http/ResponseEmitter.php, line 48]
Warning (2): Cannot modify header information - headers already sent by (output started at /home/brlfuser/public_html/vendor/cakephp/cakephp/src/Error/Debugger.php:853) [CORE/src/Http/ResponseEmitter.php, line 148]
Warning (2): Cannot modify header information - headers already sent by (output started at /home/brlfuser/public_html/vendor/cakephp/cakephp/src/Error/Debugger.php:853) [CORE/src/Http/ResponseEmitter.php, line 181]
Notice (8): Undefined variable: urlPrefix [APP/Template/Layout/printlayout.ctp, line 8]latest-news-updates/every-birth-every-mother-matters-cyril-engmann-4679110.html"/> LATEST NEWS UPDATES | Every birth, every mother, matters -Cyril Engmann | Im4change.org
Resource centre on India's rural distress
 
 

Every birth, every mother, matters -Cyril Engmann
-The Hindu Business Line

Timely interventions through medical innovations can transform the lives of mothers and children, not simply save them

A couple of years ago, I was in a primary health centre delivery room in Shivgarh and saw a beaming mother with her three-hour-old baby girl happily feeding at the breast. Three hours earlier, this contented baby was born without a cry, still, and blue in colour. Fortunately, the midwife present, immediately provided lifesaving neonatal resuscitation, including the use of a bag and mask — a device to push air into the lungs of the baby. Within a minute, the baby was screaming, moving her limbs furiously, and she had a lovely pink colour, suggesting that oxygen-rich blood was flowing well through her body.

The timely and effective intervention of this midwife, who had recently been trained in neonatal resuscitation, and her use of the bag and mask resulted in the baby surviving.

No less than a miracle

While this situation may well sound like a miracle, and it is, there is robust evidence to back the rapid strides that innovations are making in the reproductive, maternal, newborn, and child health (RMNCH) arena. Innovations matter. Innovations have powerful potential to result in transformative change when tailored to address specific health problems in supportive environments that have sufficient investment, a large and well-trained workforce, opportunities to provide real-time feedback and quality improvement, and that promote advocacy and political will.

A seminal policy paper published in the latest PLOS series, Transformative Innovations in Reproductive, Maternal, Newborn, and Child Health over the Next 20 Years, discusses the concept of a ‘Grand Convergence’ to keep the momentum going. It explains how a dramatic reduction in the global burden of disease can be achieved by 2035 through investing in research and development, and aggressively scaling up delivery of health tools and services.

This paper also examines promising and important innovations that have transformative potential for the survival and well-being of mothers and children in India and elsewhere. Some of these innovations are technologies, others are efforts aimed at improving commodities, increasing demand, and promoting equity in access.

What kind of innovations

Innovations in diagnostics, such as simplified, rapid, multiplexed point-of-care tests, especially those that definitively identify and differentiate bacterial and viral sepsis; and routine use of biomarkers in low-resource settings to identify which women might experience premature labour or predict who might suffer from pre-eclampsia or eclampsia.

Innovative technologies to improve the quality, longevity, and usability of pharmaceuticals and the vaccines for all who need it. For example such technologies are necessary to keep vaccines in the cold chain — from creation of the vaccine, through its storage, transportation, and administration to individuals. Another example is oxytocin, the drug of choice recommended by the World Health Organization to prevent postpartum haemorrhage (women bleeding heavily after delivery of a baby), and the leading cause of maternal death. Innovations in the technologies to prevent this drug from decomposing in high temperatures, such that they can be transported to reach women at the last and furthest mile.

Innovations that attempt to address demand-side issues (barriers that affect women and constrain their ability to seek care), including the use of community health workers, community-based volunteers, peer support groups and electronic health systems within the health system such as laptops, personal digital assistants, mobile phones or patient monitors.

Supply-side innovations, which involve bringing care to women where they are, rather than expecting women to obtain care in a facility. For example, Ghana developed ‘CHPS compounds’ (community-based health planning and services programmes) where an auxiliary nurse trained in basic delivery care is available in a community-based compound. Results suggest that such a model has increased the percentage of women obtaining skilled delivery.

Measurement innovations, that are critical to the success of any RMNCH endeavour. Without it, one is not able to assess the impact of programmatic efforts, care provision, or interventions. Today, virtually all data being examined to inform national and global-level policy change are retrospective, and examined three to seven years after collection. Thus, there is an urgent need for real-time, high-quality data collection and analysis mechanisms, some of which are already under way.

Making change happen

Along with me, the policy paper co-authors, Sadaf Khan, Cheryl A Moyer, Patricia S Coffey, and Zulfiqar A Bhutta, have outlined the many challenges that need to be addressed to ensure that innovations reach their potential.

First, it is essential to maintain a focus that emphasises the end user of health services as the central fulcrum, and that places importance on social and cultural preferences. Other challenges relate to how these innovations can be integrated into existing programmes, and a need for an enabling environment for such interventions to be successful. We believe these challenges can be solved.

India is one of the major contributors to the global burden of mortality and morbidity. For any global health effort to be successful, it has to be successful in India. In India, innovations can inform policies and translate into equitable programmes. Despite many challenges, remarkable progress is being made in the country.

To make every birth count, political and social commitment for the lives and well-being of mothers, newborns, and children will make the difference. Add to that society — politicians, economists, health care administrators, government agencies, civil society, and our own family units — should expect and demand nothing but the best.

The writer is the Global Program Leader/Director, Maternal, Newborn, Child Health & Nutrition Department, PATH, & a professor of paediatrics, University of Washington