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July 18, 2014

What explains the enormous more than 50 fold difference in maternal mortality rates across this river? Both areas of Tajikistan and Afghanistan are "in geographically contiguous poor, post-conflict, highly conservative, mountainous countries." How can the obstetric risks for women be so different? To continue our review of this fascinating study, we take a closer look at the differences between the Tajik and Afghan sides of the river as reported in the study by Kylea Liese.

The Tajik side has a large Soviet era hospital, some basic equipment and some medical personnel. And the Tajik women have a maternal mortality rate 50 times lower than the Afghan women, who have little to no medical care. So it stands to reason that the presence of the emergency obstetric care and medical facility explains the difference, right? Not so fast says our anthropologist/nurse/midwife Kylea Liese. Instead, her observations reveal that the Tajik hospital is large, but poorly equipped. Even the physicians who may be working there do not actually have training in emergency obstetric care. The author says "Expecting a physician to provide emergency obstetric care was like starting to bake a cake with all the right bowls and pans but none of the right ingredients."

Liese makes a bold argument saying:

" I will argue that advanced obstetric care to treat complications is an insufficient strategy to reduce high levels of maternal mortality because it does not address...

maternal mortality | Afghanistan | violence against women
July 03, 2014

“Even on a mountain, there is still a road.”
Pashto proverb

Why are women just over the border of a small 60 foot river, in Tajikistan, about fifty times less likely to die in childbirth as compared to women in Afghanistan?

Words have been spilled generously attempting to describe the difficult terrain (both topological and political) of Afghanistan. Less has been devoted to the deep-boned stubbornness, a defiance, which living in this gnarly terrain has forged in its people. It is stubbornness to outside rulers (whether Alexander the Great or the Soviets), stubbornness with traditions, and stubbornness in both friendships and enmities. Wars have laid waste to a land that was once a geo-economic fixture on the Silk Road and a central post of the Mughal Empire, but stubbornness has allowed a people to survive.

Conflict is an eternal presence. Within this patchwork nation of tribal allegiances of Pashtuns, Tajiks, Uzbeks, and Hazaras. Out of this unending clashes emerged a truly horrifying state of affairs for women, especially under Taliban rule. Today, abuses and subjugation are regular features of nearly every woman’s life. The threat of violence is an everyday reality for those who dare to advocate for the rights of women. 87% experience domestic violence, women earn 25 cents to every man’s dollar, and the life expectancy for women is under 50 years old.

It’s without doubt the worst country on earth for women.

Maternal mortality...

June 25, 2014

Meet Aisha Khadar, Executive Director of Khadarlis Global and nurse by trade. Khadarlis Global works to provide healthcare and sustainable development in Sierra Leone, a country that is known globally as stricken by war and poverty. But Aisha represents a different face of Sierra Leone—a member of the diaspora connected to an ancestral village and with the well-being of her compatriots at the heart of everything she does We at Maternova were blown away by Aisha’s passion and drive when we met with her last week. Having immigrated to the United States, Aisha returned to Sierra Leone after the civil war and used a Médecins Sans Frontières building in Jimmi (Bo district) to enhance a clinic. The clinic is an example of how a health system is built, or rebuilt from scratch. Aisha and her team started shipping goods for the clinic in containers, mostly compromised of donations, from basic medical supplies to the materials used to build the clinic itself. They even sent raw, reclaimed lumber, to be made into furniture for the clinic. Though aid agencies come and go and can make a huge difference while they are present, our bets are on the commitment of people like Aisha to rebuild health systems in Sierra Leone.

In a country where it is difficult to access sterilized medical equipment, non-expired drugs such as Tylenol and Aspirin let alone more advanced life-saving drugs such as oxytocin, vaccines, and condoms, an increase in medical services is critical. Some...

"State of the World's Midwives"
June 06, 2014

A few weeks ago we said that the State of the World's Mothers was in our view the most important global report around. Well, we didn't lie, but a tie for 'most important' would have to include the State of the World' Midwives. This report was launched for the first time in 2011, and this second edition, the 2014 report, saw considerable publicity associated with the Triennial International Conference of Midwives in Prague.

Since 2011, the report does take note of tangible positive changes that have occurred, including the following:

-33 of the 73 countries (45%) report vigorous attempts to improve workforce retention
in remote areas;
-20 countries (28%) have started to increase recruitment and deployment of midwives;
13 countries (18%) have prepared plans to establish regulatory bodies;
-and 14 (20%) have a new code of practice and/or regulatory framework.

What is really starting to emerge is strong quantitative data and evidence on the impact of midwives. If you remember nothing else from this report, remember that the training of a midwife who then is deployed in community health care yields a 16-fold return. How do you measure that return? In c-sections avoided and lives saved. Kudos to the WHO, UNFPA and ICM for quantifying the impact of midwives and getting the messages so clear in this report.

Let's return to the tangible results. So while noting that there is progress, and that is preferable to...

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May 20, 2014

**Reprinted with permission from our friends at the Wellbeing Foundation Africa.

In a unique effort to educate and empower health workers in Kwara State, Nigeria, and in
furtherance of its long-standing commitment to the improvement of maternal, newborn and child
health (MNCH) indices in Africa, the Wellbeing Foundation partnered with the Flight for Every
Mother (FEM) project to facilitate an on-site medical training program aimed at aiding African
countries such as Nigeria to achieve the Millennium Development Goals (MDGs) 4 and 5 before 2015.

Having taken place on the 7th of September 2013 in Ilorin, Kwara State, the Flight for Every Motherproject, spearheaded by Dr. Sophia Webster, successfully impacted both in-service training at theCivil Service Clinic Ilorin and pre-service training at the Kwara State School of Nursing and Midwifery (KWSNM), both of which will inevitably reduce the incidence of maternal mortality and deaths due to post-partum bleeding, sepsis, pre-eclampsia/eclampsia, and neonatal asphyxia.Flight for Every Mother is a maternal health project initiated by U.K. based obstetrician/gynecologist,Dr. Sophia Webster, and endorsed by the Royal College of Obstetricians and Gynecologists (RCOG), the International Federation of Gynecology and Obstetrics (FIGO), and the Federal Ministry of Health. The project is a unique journey by air across Africa to raise awareness about maternal health, particularly in the sub-Saharan...

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May 20, 2014

**Reprinted with permission from our friends at the Wellbeing Foundation Africa.

In a unique effort to educate and empower health workers in Kwara State, Nigeria, and in
furtherance of its long-standing commitment to the improvement of maternal, newborn and child
health (MNCH) indices in Africa, the Wellbeing Foundation partnered with the Flight for Every
Mother (FEM) project to facilitate an on-site medical training program aimed at aiding African
countries such as Nigeria to achieve the Millennium Development Goals (MDGs) 4 and 5 before 2015.

Having taken place on the 7th of September 2013 in Ilorin, Kwara State, the Flight for Every Motherproject, spearheaded by Dr. Sophia Webster, successfully impacted both in-service training at theCivil Service Clinic Ilorin and pre-service training at the Kwara State School of Nursing andMidwifery (KWSNM), both of which will inevitably reduce the incidence of maternal mortality anddeaths due to post-partum bleeding, sepsis, pre-eclampsia/eclampsia, and neonatal asphyxia.Flight for Every Mother is a maternal health project initiated by U.K. based obstetrician/gynaecologist,Dr. Sophia Webster, and endorsed by the Royal College of Obstetricians andGynaecologists (RCOG), the International Federation of Gynaecology and Obstetrics (FIGO), and the Federal Ministry of Health. The project is a unique journey by air across Africa to raise awarenessabout maternal health, particularly in the sub-Saharan...

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May 12, 2014

In the second installment of Maternova's feature on the low-cost highly effective ProntoPack Birth Simulator Kit, join us in learning additional information about where the innovation is helping train birth attendants, midwifes, and healthcare workers in safer birth practices.

We also know that this system has been used at academic institutions in the United States... can you tell us more?

The PRONTOPack and PartoPants are fundamental parts of emergency obstetric and team training at a variety of large US academic institutions and hospitals including the University of Washington, the University of Utah, UCSF and the University of Maryland.

At the University of Washington the PRONTOPack is used for emergency training with ob gynOB/GYN residents and with medical students prior to beginning their internships. It is much easier to set-up and manage than the high-tech birth mannequins. Having a patient actress wear the simulator provides great realism and we can set up the simulations pretty much anywhere. For example, we trained the paramedics and nurses from Airlift Northwest in Seattle who do helicopter and airplane transport throughout the region. We took the kit to the airport and ran the simulations in the helicopter! In Maryland we also trained emergency medical teams who transport patient from the field.

At the University of Utah the PRONTOPack and PartoPants are also being used to orient and train medical, nursing and...