Showing posts from category Dot-Mom.
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Emily Puckart, MHTF blog
Maternal Health in Kenya: New Research Unnecessary, Time to Address Existing Gaps
›The original version of this article, by Emily Puckart, appeared on the Maternal Health Task Force blog.
During the recent Wilson Center/African Population and Health Research Center meeting in Nairobi on improving health systems through a maternal health framework, participants focused on knowledge gaps in the Kenyan health system that can negatively affect maternal healthcare. This focus on gaps sparked discussion around research needed (or not needed) in the maternal health field, supply gaps, and gaps between addressing technical, medical issues of maternal health (like preeclampsia or postpartum hemorrhage), and larger society-wide gaps like gender equity. The gaps highlighted by participants at the Nairobi dialogue included:- Gaps in knowledge: During the dialogue, members of the Kenyan maternal health community discussed the possibility of strengthening community health workers as an information delivery platform. Participants wondered about the possibility of using community health workers to distribute information both downward to the end user (patients), and then again to gather information from end users and distribute it upwards through the system to reflect the opinions of the direct users of the healthcare system.
- Supply gaps: Participants argued that while there is a large body of information in terms of maternal health supplies at the national level in Kenya, there is not as much data on supplies at the actual health facility level, where it is much needed and would be very helpful to successfully treat patients.
- Gaps in healthcare delivery: There is a strong need to address inequality in the distribution of health services as there are unequal services in rural and urban areas. Within those broad areas there may be further inequalities, as even in urban areas, slum areas or neighborhoods on the edges of cities may have less access to quality healthcare than populations that live in wealthier areas of the city or closer to the city center. Further there are broader questions of gender and access to care. Where women are not able to control household finances, they may be unable to access and pay for lifesaving care. Participants framed the question in a rights framework, “Do we value the lives of women less than men?”
- Health workforce gaps: There is a mismatch between the supply of health workers and the absorption of those trained health workers in Kenya. Many of them are not incentivized professionally or financially to stay in the system where they are trained. These health workers may leave for other countries or prefer to stay in urban areas depriving rural areas of a surplus of trained health workers.
- Gaps between words and actions: Several of the small working groups pointed to accountability as a serious issue, as there are gaps between the words of politicians on health issues and actual actions. The gap between the government promised funding for health and the actual lower amount of spending was consistently highlighted during the Nairobi dialogue as a serious gap in holding governments accountable for their promises.
The lively conversation provoked by a broad discussion of gaps in the Kenyan health system provided fertile ground to develop action points on maternal healthcare that participants then presented on the second day of the meeting to several Kenyan members of parliament. Ideally, this will be the first discussion of many as maternal health advocates, field workers, and researchers coalesce around ways to address the gaps in maternal healthcare in Nairobi and elsewhere.
Emily Puckart is a senior program assistant at the Maternal Health Task Force (MHTF).
Photo Credit: Jonathan Odhong, African Population and Health Research Center. -
Watch: Ann Blanc on Finding Unique Partnerships to Address Maternal Health Needs
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In the last five years, maternal health has begun to take a front seat within the larger global health agenda, but when it comes to a neutral space for broader focusing and prioritizing efforts there is still a void. In 2008 the Gates Foundation created the Maternal Health Task Force (MHTF) in an effort to fill that void. In this interview with ECSP, former MHTF Director Ann Blanc discusses how collaboration with the Wilson Center and the United Nations Population Fund has created an ideal space for addressing the technical, programmatic, and policy sides of neglected maternal health issues.
“Part of our mandate,” Blanc noted, “is to bring in the perspective of what we call ‘allied fields.’” The Wilson Center’s Advancing Policy Dialogue to Improve Maternal Health series focuses on engaging with neglected and emerging topics and experts, finding connections and encouraging partnerships with other fields, such as those working in water, sanitation, or HIV/AIDS services.
For instance, a two-day conference last year with private meetings and public dialogues focused on the neglected issue of transportation for women seeking maternal health services. The conference brought together non-traditional actors, including transportation engineers and mobile technology experts, to identify common barriers mothers commonly face like lack of infrastructure, poor security, or limited access to emergency communications.
“We’re constantly trying to push those barriers and look for interconnections between different development sectors and maternal health,” Blanc concluded. -
Improving Maternal Health: A Conversation With Kenyan Field Workers and Policymakers
›“The traditional strategies for improving the health system include the horizontal approach, which prioritizes non-communicable diseases, and the vertical approach which prioritizes communicable diseases such as HIV/AIDS,” said John Townsend, vice president of reproductive health programs at Population Council, during a webcast discussion – the second in a series – between the Woodrow Wilson Center in Washington, DC, and maternal health experts in Nairobi, Kenya. [Video Below]
Recently, a third strategy, called the “diagonal approach,” was developed to more clearly define health system priorities and guide general system-wide improvements. Participants in both locations discussed this new approach and other structural improvements that can be made to better integrate maternal health indicators into developing country health systems on October 17.
The meeting was part of the 2011 Advancing Dialogue on Maternal Health series, with the Wilson Center’s Global Health Initiative and the African Population and Health Research Center. Participants in Nairobi were assigned to three topical groups and asked to identify challenges and opportunities related to their themes.
The Role of Policymakers and Funders“We must engage [policymakers and donors] in forums like this one to share findings and share lessons learned,” said participant Sylvia Bushuru of Kenya as she reported back from the policymakers and funders working group. The group focused on steps required to hold politicians accountable to commitments made to maternal health, such as the Abuja Declaration, which requires the Ministry of Finance to dedicate 15 percent of the budget to health. Currently, only 5.5 percent of the Kenya budget is dedicated to the health sector.
Identifying strategic partners will help in reaching ambitious goals, the group agreed; however, they noted that it’s important to ensure that these partnerships and policies extend to an operational level. Besides the overall budget pledge, important steps like ensuring 24-hour emergency health facilities in rural areas and implementing a results-based financing plan based on maternal health indicators have yet to be completed.
A Definition of Priorities through a Diagonal Approach
James Wariero, a regional health advisor with the MDG Centre for East and South Africa, served as the representative for the group discussing the “diagonal approach,” which focused on how maternal health indicators can best set priorities to improve the overall health system. They identified antenatal care visits as a priority because they also serve as an entry point to other health services, including HIV/AIDS treatment.Discussing gender, he said that “male involvement in maternal health will have benefits for child health and other issues…it is an area with little headway here in Kenya and other similar countries in Africa.” Additionally, Wariero discussed how the diagonal approach could be used to link maternal health indicators with other sectors such as technology and information systems.
The group said that improving the health system should start at the district level to ensure the most vulnerable populations at the community level have proper access. However, they said that ideally district-level programming should be evaluated and funded through results-based financing and structured on clear maternal health indicators.
Knowledge Gaps and Research Needed
“We initially began our discussion surrounding the [World Health Organization’s] six health system blocks,” reported Dr. Kristine Kisaka, a program officer with Deutsche Stiftung Weltbevoelkerung and representative from the “knowledge gaps and research needed” group. This group identified access to mobile phones for maternal health data collection as a major resource gap. Instead of calling for additional research they said they would prefer better implementation of existing, evidence-based programming.
Utilizing the World Health Organization’s health system framework, the group identified existing knowledge gaps to improve maternal health in Kenya and six recommendations:- Strengthen community strategies through a national synchronization of information
- Harmonize planning and implementation of the provisioning of supplies and commodities at the community level
- Address inequalities in the distribution and delivery of health services, ensuring distribution to urban and rural centers, including slums
- Centralize health financing in order to reach both national and community levels
- Empower households in financing, including both women and men, so they plan and save for maternal health
- Address the imbalance in supply and demand of healthcare workers
Linkages: Key To Improving Maternal Health Systems
“It’s really about linkages,” said John Townsend, giving closing remarks after the presentations from Nairobi. Maternal health indicators can be a catalyst for change, due to their strong cross-cutting links to other development systems, such as transportation, the economy, and education. “I think the call to action that the Kenyan working groups made is quite valuable,” he said, but the question is, “How do we get intelligent decision alternatives in front of our leaders to figure out what are the best investments given the critical resources?”
“The private sector [presents] an opportunity,” said Townsend. “I think we need to be more explicit about how we want to engage with them and what we would like to see from them.” He pointed out that the national maternal health strategy in Kenya is explicit and promising, but there needs to be stronger links between the national strategy and the operational aspects of actually implementing it.
Event Resources:- Photo gallery
- Presentation: “Improving Health Systems Through a Maternal Health Framework,” African Population and Health Research Center
- Video
Photo Credit: #1 and #3, courtesy of Jonathan Odhong, African Population and Health Research Center; #2 courtesy of David Hawxhurst/Wilson Center. -
Silent Suffering: Maternal Morbidities in Developing Countries
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Maternal morbidities – illnesses and injuries that do not kill but nevertheless seriously affect a woman’s health – are a critical, yet frequently neglected, dimension of safe motherhood. For every woman who dies, many more are affected acutely or chronically by morbidities, said Karen Hardee, president of Hardee Associates at the Global Health Initiative’s September 27 panel discussion, “Silent Suffering: Maternal Morbidities in Developing Countries.” Hardee was joined by Karen Beattie, project director for fistula care at EngenderHealth, and Marge Koblinsky, senior technical advisor at John Snow, Inc., for a discussion moderated by Ann Blanc, director of EngenderHealth’s Maternal Health Task Force.
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Women Leaders Urge Stronger Advocacy on Health and Public Policy
›The original version of this article appeared on the Pan American Health Organization website.
Women have made major strides toward greater equality in Latin America and the Caribbean, but stronger advocacy and leadership are needed to address problems they continue to face in health and other areas, said a group of top women health leaders at an event held at the Woodrow Wilson Center in Washington, D.C. on September 27.
The event was part of a series of activities surrounding the 51st Directing Council meeting of the Pan American Health Organization/World Health Organization (PAHO/WHO), which is being held this week.
Dr. Michelle Bachelet, Executive Director of UN Women, noted that Millennium Development Goal (MDG) five, reduce maternal mortality, “is the one MDG that has advanced the least in our region and around the world.” She said it is now widely accepted that investing in women is not only an issue of human rights, it is also “the intelligent thing to do economically, politically, and socially. So why doesn’t it happen?” She said making it happen is the major leadership challenge facing women in health and public policy today. “We have to empower women to make the strongest case possible that investing in women is the best thing governments can do, and we have to help ministers of health make this same case with their governments.”
WHO Director-General Dr. Margaret Chan said that high levels of maternal mortality reflect “a failure of governments.” “We know how to prevent women from dying while giving birth. It’s a lack of political commitment, policies, and investments in the right areas. We need to get these issues out into the public, and we need to work with men who are enlightened to accomplish this,” she said.
Rocío García Gaytán, President of the Inter-American Commission of Women, said maternal mortality continues to be a major problem in the hemisphere despite the fact that it is almost completely preventable. She said that contrary to common belief, most maternal deaths take place in hospitals and are the result of a lack of proper training of medical personnel. “This problem should not exist in the second decade of this millennium,” she said.
PAHO Director Dr. Mirta Roses urged women to develop a leadership style that will effectively advocate for women’s top concerns, particularly social, economic, and political progress.
“What is different when women lead?” Roses asked. “We need to support each other and identify what we should do that is different from male models. We must all work together – UN Women, the Council of Women World Leaders – to define feminine leadership and promote it.”
Canada’s Minister of International Cooperation, Beverly Oda, said progress on public policies for women “took many years” to develop in Canada. Today, gender reviews of legislation are now mandatory for legislation, and promotion of gender equality is an integral part of Canadian technical cooperation programs.
Vice-Minister of Health Dr. Silva Palma de Ruiz of Guatemala described a number of initiatives in her country that have been successful in improving women’s health and status. They include joint efforts involving the health ministry, the public prosecutor’s office, the national human rights ombudsman, and civil society organizations to reduce sexual violence by empowering women to report violence and by more aggressive prosecution of perpetrators. PAHO/WHO has supported these efforts with technical assistance in developing guides for care of victims of sexual violence. Other efforts include a new family planning law and education of men and women as well as healthcare workers about women’s rights to use contraception.
Minister of Health Ann Peters of Grenada said that women of the Caribbean “are very vocal” and have had considerable success advocating for women’s health. In her own country, this has helped produce a highly effective comprehensive mother-child health program that includes strong community health services with well-trained midwives and good referral systems, breastfeeding-friendly hospitals, and universal voluntary testing of pregnant women for HIV. Thanks to these programs, Grenada has “no mother-to-child transmission of HIV and virtually no maternal mortality.”
Minister of Health Marcella Liburd of Saint Kitts and Nevis noted the importance of addressing the social determinants of women’s health. For example, in her country as elsewhere, the majority of people living in poverty are women. “We need to consider other aspects of women’s well-being,” she said, “including financial, social, and mental health.”
Paraguay’s Minister of Health, Dr. Esperanza Martinez, said it was important to address women’s concerns in an integral way. She described a new platform for discussing policies that affect women involving different government ministries, not just health. “Women need to participate as policymakers and also to influence policies from the outside,” she said.
Dr. Carmen Barroso, Western Hemisphere Director for the International Planned Parenthood Federation, said, “Civil society is ready to partner with ministries of health to advocate for more resources, legislation, and promotion of women’s sexual and reproductive rights.”
The event was organized by the Council on Women World Leaders, PAHO/WHO, the Wilson Center’s Environmental Change and Security Program, Global Health Initiative, and Latin America Program.
Event ResourcesPhoto Credit: David Hawxhurst/Wilson Center. -
The Role of Faith-Based Organizations in Maternal and Newborn Health Care
›Government and nongovernmental organizations have consistently played a key role in addressing maternal mortality. While these initiatives are well documented, the role of faith-based organizations (FBOs) in maternal and newborn health is less well understood.
In November, the Wilson Center’s Advancing Policy Dialogue to Improve Maternal Health series will bring diverse institutions together such as the Pakistan Initiative for Mothers and Newborns (PAIMAN) and Pathfinder International to discuss country experiences and evaluate opportunities for overcoming challenges.
According to the World Health Organization, FBOs own up to 70 percent of the health infrastructure in sub-Saharan African countries and often work in remote regions where government and NGO services are limited. FBO’s are critical to improving maternal health as they fill gaps in the health system – particularly in low-resource settings – and approaching culturally sensitive barriers that often prevent mothers from seeking health care.
The level of trust communities place on their religious leaders explains one of the main reasons why FBOs are attaining success. A study conducted by Pew Charitable Trust found that a vast majority of people in sub-Saharan Africa identify themselves as adherents of Christianity or Islam, and approximately 75 percent trust their religious leaders.
As partnerships with FBO’s increase, it is imperative that organizations share their lessons learned and identify capacity and knowledge gaps in order to improve effectiveness.
Pakistan Initiative for Mothers and Newborns
The Pakistan Initiative for Mothers and Newborns (PAIMAN), which started out as a six-year project funded by USAID and led by JSI Research and Training Institute, is a strong example of a program incorporating faith to improve maternal mortality rates. The project aims to ensure that women have access to skilled birth attendants during and immediately after giving birth. Additionally, the project focused on increasing the quality of care both in the public and health sectors. PAIMAN was able to achieve substantial success by utilizing various communication interventions such as mass media, community media, and advocacy efforts. One of the most successful initiatives PAIMAN organized was reaching out to 1,000 religious scholars, known as ulamas, to deliver frequent messages on maternal and newborn health care. Since its initiation, this project has “saved more than 30,000 newborn lives resulting in a 23 percent decrease in neonatal mortality,” according to their numbers.
Pathfinder International
Pathfinder International is another great example of an organization that has understood the value of FBOs and worked in collaboration with them to achieve results for maternal health. Pathfinder has worked in numerous countries including Nigeria, Ghana, Ethiopia, Egypt, Uganda, Kenya, and Bangladesh to educate religious leaders and communities on communication strategies for improving maternal health behaviors.
In Ethiopia, Pathfinder organized over 250 religious leaders representing the Orthodox Christian, Catholic, Protestant, Seventh Day Adventist, Mekaneyesus Christian, and Muslim faiths to educate them about maternal mortality. At the conclusion of the seminar, the religious leaders agreed to condemn a host of harmful traditional practices, including female genital cutting, marriage by abduction, early marriage, rape, and unsafe abortion and agreed that they are not required by the Bible or Korean. Religious leaders in Egypt also came to similar conclusions after participating in these types of seminars.
“By helping religious leaders see the links between reproductive health and families’ well-being, Pathfinder enables them to become committed advocates for positive reform,” wrote Mary K. Burke, technical communications associate at Pathfinder International in the 2006 report, Advancing Reproductive Health and Family Planning through Religious Leaders.
Challenges: Equipping and Encouraging
Despite the prevalence of success stories among FBOs to improve maternal mortality, challenges do exist. For instance, although religious leaders are highly respected by their communities, their teachings become useless, as pointed out by a USAID-sponsored Extending Service Delivery Project report, unless they are also properly trained and equipped with the latest service delivery systems and scientific information.
The report also describes the importance of cooperation and support from the government and decision-making representatives. If the private, public, and government sectors are fragmented and no formal recognition exists to acknowledge the work of religious leaders for improving maternal mortality, then success may be significantly hampered.
To learn more about the role of faith-based organizations in women’s health, be sure to check out the Global Health Initiative event on FBOs coming in November, with representatives from PAIMAN, Pathfinder International, and others.
Sources: Extending Service Delivery Project, JSI Research and Training Institute, Pathfinder International, Pew Charitable Trust, USAID, World Health Organization.
Photo Credit: “Woolly hats needed,” courtesy of flickr user Church Mission Society (CMS). -
Fistula, Stigmatization, and Development
›Although obstetric fistula may not be as widely recognized as other maternal health issues, the Fistula Foundation estimates that over two million women and girls in developing countries suffer from this condition today. The World Health Organization has labeled it as “the single most dramatic aftermath of neglected childbirth.”
Obstetric fistula is a devastating condition often resulting from obstructed labor that can cause infections, incontinence, and even paralysis. The condition largely afflicts poor, rural, and illiterate women in developing countries who lack resources and access to emergency care and surgery, and sufferers often face an additional burden of social stigma.
Economic Development and Social Standing
Poor infrastructure and poverty significantly increases the occurrence rate of obstetric fistula. Lewis Wall, in an article for The Lancet, writes that “poverty is the breeding-ground where obstetric fistulas thrive.” Wall cites early marriage, low social status of women, malnutrition, inadequately developed social and economic infrastructures, and lack of access to emergency obstetric services as being major contributors of fistulas in developing countries.
Additionally, “postponing the age of marriage and delaying childbirth can significantly reduce the risk of subjecting young women to the arduous labor that induces fistulas,” wrote Sonny Inbaraj of Inter Press Service News Agency (IPS) in an article about how fistula makes social outcasts of child brides.
In most developing societies where child marriage is common, the social standing of women is defined largely in terms of marriage and childbearing. Child marriages are typically arranged without the knowledge or consent of the girls involved. The norms emphasize a girl’s domestic roles and de-emphasize investments such as education.
Stigmatization of Fistula
There is an undeniable link between fistula and social stigmatization. Rather than receiving assistance from their families and communities, women are often ostracized and in many instances exiled from their communities. This is especially true in developing countries where “the role of women is merely limited to providing sexual satisfaction for their husbands, [and] producing children,” said Dr. Catherine Hamlin, founder of the Addis Ababa Fistula Hospital, in an interview with IPS.
“Many women and girls with fistula endure lives of shame, misery, violence, and poverty,” said Agnes Odhiambo, Africa women’s rights researcher and author of ‘I Am Not Dead, But I Am Not Living‘: Barriers to Fistula Prevention and Treatment in Kenya, in a Human Rights Watch article. Human Rights Watch has focused on fistula, recognizing that birth is a human rights issue. Ignoring the issues of women and girls only diminishes progress on human rights and sends a message that says the rights of women do not deserve adequate attention.
Prevention Efforts
Thus far the fight to end fistula has attracted various government agencies and organizations including USAID, UNFPA, EngenderHealth, Maternal Health Task Force, and the Human Rights Watch. Outstanding individuals have also played a key role in fistula prevention efforts, like Drs. Reginald and Catherine Hamlin, Australian gynecologists who came to Addis Ababa in 1959 for temporary medical work, but after hearing heart-breaking stories from fistula patients, they decided to move to Ethiopia permanently and open the Addis Ababa Fistula Hospital. As the only hospital dedicated exclusively to women with obstetric fistula, the hospital provides care free of change, and has done so since 1974.
Although fistula has gotten some support and attention, the need to scale-up the prevention initiatives has never been greater. As a result of the “poverty and the stigma associated with their condition, most women living with fistulas remain invisible to policy makers both in their own countries and abroad,” wrote Inbaraj on IPS.
“Preventing fistula and restoring women’s health and dignity requires more than good policies on paper,” said Odhiambo at Human Rights Watch. Seriously tackling the issue will require much more than traditional medical and public health interventions – prevention efforts must also take into account underlying social issues, food and economic security.
Sources: The Addis Ababa Fistula Hospital, Campaign to End Fistula, The Center for Global Development, The Fistula Foundation, Human Rights Watch, The Lancet, World Health Organization.
Photo Credit: “Hauwa’u, 25, mother from Rogogo community,” courtesy of flicker user DFID-UK Department for International Development. -
Maternal Health Challenges in Kenya: What New Research Evidence Shows
›“Although there have been improvements in the recent past, the status of maternal health care has not met the required international standards,” said Professor at the University of Nairobi Geoffrey Mumia Osaaji during a live video-conference from Nairobi on July 12.
As part of the 2011 Maternal Health Dialogue Series the Woodrow Wilson Center’s Global Health Initiative is partnering with the African Population and Health Research Center to convene a series of technical meetings on improving maternal health in Kenya. The 20 Kenyan experts attending the workshop in Nairobi also shared their strategies and action points with a live audience in Washington, DC during a video conference discussion. [Video Below]
Osaaji was joined by panelists Lawrence Ikamari, director of Population Studies and Research Institute (PSRI), and Catherine Kyobutungi, director of Health Systems and Challenges at the African Population and Research Center to discuss new maternal health research in Kenya. Panelists also shared recommendations for moving the maternal health agenda forward that came out of discussions during the two-day, in-country workshop with Kenyan policymakers, community health workers, program managers, media, and donors. Following the panelists’ presentations, Dr. Nahed Mattta, senior maternal and newborn health advisor at U.S. Agency for International Development (USAID) and John Townsend, vice-president of reproductive health program for Population Council provided reflecting remarks from the Woodrow Wilson Center during the live webcast.
Maternal Health Challenges in Rural Kenya
“Maternal mortality in rural Kenya is still very high,” said Ikamari. “Rural women in Kenya need to have increased access to maternal health services.” Ikamari discussed a number of factors that contribute to high rates of maternal mortality in rural Kenya, including lack of access to quality care and skilled birth attendants, the high burden of HIV/AIDS, and an unmet need for family planning.
Though nearly 90 percent of women in rural Kenya seek antenatal care, according to the UNFPA, many wait until the second or third trimester, limiting the benefits. Additionally, a majority of women in rural Kenya give birth outside of health facilities, oftentimes without the care of a skilled birth attendant, said Ikamari. In a recent survey, many rural women indicated that transportation to often distant health facilities prevented them from seeking adequate maternal health care, he added.
Additionally, “the burden of HIV is really felt in rural Kenya,” said Ikamari. Survey results show that HIV/AIDS prevalence is about seven percent in rural Kenya and because the majority of the Kenyan population lives in rural areas, this adds yet another layer of complications.
“Family planning saves lives,” said Ikamari, stressing the importance of contraception on maternal health outcomes. Only 35 to 40 percent of currently married Kenyan women use family planning, according to the last demographic and health surveys, and unmet need remains particularly high in rural areas. Promoting institutional delivery systems, improving antenatal and postnatal care, and finding other ways to increase access to family planning can help to improve maternal health outcomes and reduce preventable deaths in rural Kenya, concluded Ikamari.
Comparison of Urban and Rural Areas
“The interventions to address maternal health are well known: family planning, increased access to safe abortion services, skilled health workers, health facilities that are accessible, as well as referral systems that work,” said Kyobutungi. “Yet urban averages [of maternal mortality] are becoming either close or worse than rural averages.”
“As much as we appreciate the rural-urban divide that exists for most health indicators, the urban-urban divide (the fact that there are huge intra-urban differences) needs attention”
“Teenage pregnancy is a failure of family planning,” said Kyobutungi. Studies indicate that there are three times more teenagers that are pregnant among the urban poor, compared to the urban rich.
As in rural Kenya, access to quality health facilities and care is also limited in cities. “Health facilities are few and far between and the referral systems are weak,” said Kyobutungi, and “when you remove Nairobi from the numerator, the number of skilled physicians per population is in the decimals.”
Moving forward, there is a need to promote effective integration and improvement of health worker training and monitoring but also development of performance-based incentives to ensure successful programs are properly funded. “It’s not all gloom and doom in urban areas,” concluded Kyobutungi.
Innovative Ideas for Better Results
“By year 2025 there will be 25 percent more people [in Kenya],” said Townsend. “What that means is, when we are planning…we have to think about the scale of solutions that we are proposing in 2025 and 2050.” Therefore, it is essential to acquire new models of data and evidence to better predict future population growth and maternal needs, he suggested.
In addition to expanding services to meet the needs of a growing population, the panelists in Washington emphasized the need to support integration at all levels. Trends are moving in the right direction: Within the Obama administration’s Global Health Initiative, “there is a strong push and recommendation for integration among the health sectors,” said Matta.
But integration is not a magic bullet to improve maternal health, warned the panelists. “Integration is a terrific issue, but when the health sectors are weak, putting more burden on a local community health worker does not usually make sense; we have to think about smart integration,” said Townsend.
Focusing on Kenya’s health sector from all aspects, both at the private and public level, and improving family planning, institutional delivery care, as well as antennal care will help Kenya overcome its maternal health barriers. Additionally, thinking of ways to utilize new models of data and integrating the various sectors will yield substantial benefits, concluded Matta and Townsend.
Following the technical meeting, a public dialogue was held on July 13 in Nairobi to share the recommendations and knowledge gaps identified with members of Kenya’s Parliament, including Hon. Sofia Abdi, parliamentary health committee member; Hon. Ekwee Ethuro, chair of the parliamentary network for population and development; and Hon. Jackson Kiptanui. They joined a group of more than 50 maternal health experts, program managers, members of the media, and donors – such as the UK Department for International Development (DFID) – to identify real solutions and action points for improving maternal health in Kenya.
The formal report from the in-country technical meeting will be available in the near future.
See also the Maternal Health Task Force’s coverage of the event, here and here.
Sources: Kenya National Bureau of Statistics, UNFPA.
Photo Credit: Jonathan Odhong, African Population and Health Research Center.
