News – Arieli foundation

In Nigeria, wrong perceptions and ignorance fueling malaria in pregnancy

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MATERNAL malaria episode is a common occurrence in pregnancy and one of the concerns of pregnant women in Nigeria is just how best they can prevent or treat malaria. According to guidelines provided by the World Health Organisation, WHO, a pregnant woman should obtain Intermittent Preventive Treatment of Malaria, IPTp, in the form of Sulphadoxine-Pyrimethamine (SP) to reduce maternal and foetal anaemia, prevent placental parasitaemia, low birth weight, and neonatal mortality. Read More

Investing in the health of mothers in Africa: Social hurdles

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Even when maternal health facilities are available, expectant mothers in Africa do not always get timely care. A study by the Africa regional office of the World Health Organization (WHO), Reducing Mortality Rates, reports that sometimes women or birth attendants “fail to recognize danger signals and are not prepared to deal with them.” One answer, argues Dr. Yves Bergevin, senior adviser on reproductive health for the UN Population Fund (UNFPA), is to improve the skills of birth attendants and the knowledge and capacity of women, their families and their communities. Read More

Improving quality of care is the most powerful means to end preventable maternal deaths

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Many would assume that the 45,000 mothers dying in India every year during childbirth is a result of complications that are difficult to manage. It should be rather surprising that these deaths are mostly preventable. In fact, one of the main reasons for losing lives is often due to sub-standard and inconsistent quality of care. Read More

Our entire maternal health care community is aware of this. And yet, improving the quality of maternal health services has been a tough challenge in India, largely due to insufficient tools and incentives for providers to change.

In recent years, considerable efforts to improve the quality of institutional care during the antenatal, delivery and postpartum periods have favored public health care facilities, largely excluding private ones. This has been the case despite the fact that private providers in India account for up to 30% of institutional deliveries in rural areas and up to 52.5% of institutional deliveries in urban areas, and despite evidence suggesting that quality of care is an issue in both sectors. Many such facilities, even those that have been in business for 5 to 10 years and even longer, have been found not to be following recognized, evidence-based quality standards of care in their labor and delivery wards. They do not have the necessary emergency protocols in place to prevent complications.

These challenges persist due to a widespread lack of technical resources, insufficient training and other opportunities for nurses and paramedics to update their skills and knowledge (leading to continued use of outdated, ineffective and sometimes harmful practices); weak incentives for private maternity facilities to invest in quality improvement because efforts typically do not immediately translate into an increased client base; and limited capacity (if not total absence) of systems to measure and monitor the quality of their services.

Greater efforts must be made to bridge the gap between research-supported knowledge and clinical practice. What we need is a large scale streamlined quality improvement initiative, offering a practical and compelling way for private health care facilities to improve their capacities for managing care during labor, delivery and the immediate postpartum period, when risks for life threatening complications are the highestAn intervention which offers all of the above is an important step forward for maternal health in India.