Reagents of the University of Michigan

Eliminating Preventable Maternal Mortality in Sub Saharan Africa Highly Ranked

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To learn more about – or provide significant funding to – this project, please contact Lever for Change.

Project Summary

Maternal Mortality is an unresolved global crisis. Most deaths occur in sub-Saharan Africa(SSA) where human/technical capacity with rural reach have yet to integrate to create a total solution. We will apply our expertise to scale a proven, sustainable, high impact paradigm shift to eliminate preventable maternal mortality in SSA. Our consortium pairs major US university centers with 10 African universities/hospitals to build permanent, high impact post-graduate Obstetric/Gynecology/Midwifery training programs, creating a permanent solution integrating human resources, infrastructure and technology. Obstetrics and midwifery care will be integrated with a core curriculum of open source teaching materials available free access through the Global Library of Women’s Medicine. Interdisciplinary training programs will integrate evidence based clinical and surgical care, team-training, communication, certification, quality improvement, and policy work. World Vision will extend our expertise to under-served rural communities, and Civana will create an innovative networking and management platform available beyond our 10 initial sites.

Problem Statement

The death of a woman while pregnant, in childbirth, or postpartum is truly a preventable tragedy that affects a family for generations, and, repeated across time and communities, erodes a nation’s social and economic potential. An unthinkable 830 women die every day from pregnancy related causes such as hemorrhage, infection, obstructed labor and preeclampsia and abortion complications. Most are preventable when proper care is available. The knowledge exists to eliminate this problem, but there is a dearth of expert obstetric and midwifery care in sub-Saharan Africa, and an inadequate educational and policy context to build the national professional capacity to permanently end this problem. The WHO has clearly identified maternal mortality as a dire problem, and defined a human capacity crisis that prevents countries from solving these problems. Many development actions focus on technical solutions that provide relief but are only temporarily effective and remain unsustainable. A higher level of expertise is needed to fill the huge gaps in knowledge, capacity and rural reach so that integration of technical interventions, instead of temporarily filling them, can flourish. If we invest in a training system launched via US strengths, it can sustain itself in-country; the OBGYNs trained in early years become the faculty in years and generations to come. From an ethical and equity perspective, a way to share what we know, to create a complete, sustainable solution is our charge. Structural, institutional strengthening with real long-term impact on women’s lives is the root solution that we are proposing to solve.

Solution Overview

We will eliminate preventable maternal mortality in SSA by creating new OBGYN training programs in 10 sites producing new specialists, coordinating with midwifery and community based programs, to provide each nation with professionals who provide modern, comprehensive obstetric care. The consortium, gathered and supported by University of Michigan, will be networked through Civana, supported with open educational materials from Global Library of Women’s Medicine, and connected with rural communities through World Vision. This structural transformation builds real capacity, in a sustainable program embedded in government policies, with universities and hospitals that already exist. Ghana, our guiding example, certified and retained more than 250 OBGYNs, proved that in-country training leads to retention of providers, sustainable training systems and more rural care. The US partners -experts in the field of OBGYN and Global Health with experience in training innovations -will transfer expertise to their African partners, network with other African partners, and strengthen the US university and NGO partners. This ‘training and learning’ project will stimulate the creation of national contexts that provide the material, human resource, and policy environments for modern obstetric and gynecologic and midwifery care. A common data collection system will be in place in all sites, and a data dashboard will allow real time access to project progress. Community-based surveillance for maternal mortality will monitor progress at the community. We will adopt the SDG goals for Maternal Mortality and aim for a 75% reduction in maternal mortality, and 75% improvement in outcomes by project end.

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Project Funders

  • Flora Family Foundation 2013 - 2015
  • World Bank 2013 - 2014
  • Bill and Melinda Gates Foundation 2013 - 2015

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