OUR APPROACH



UGANDA

Uganda

ZAMBIA

Zambia

Maternal and newborn deaths are intertwined. When a mother dies, her newborn has a much greater chance of dying as well. While progress has been made in reducing maternal and newborn deaths, these rates remain unnecessarily high. Women and newborns need a functioning healthcare system to stay alive.


Saving Mothers, Giving Life Primer

Primer

The Saving Mothers, Giving Life Model

The Saving Mothers, Giving Life model employs a health systems approach at the district level to ensure that every pregnant woman has access to clean, safe and normal delivery services and, in the event of an obstetric/newborn complication, life-saving emergency care within two hours. The model strengthens the existing health network (both public and private) in each district to address the delays in seeking appropriate care, reaching care in a timely manner and receiving high-quality care at a health facility. The main focus of the model is on the most vulnerable period for the mother and the baby: labor, delivery and the first 48 hours postpartum. The model further integrates maternal and newborn healthcare with HIV services and postpartum family planning.

Systems Approach

Saving Mothers, Giving Life is designed to help countries ensure the following efforts are in place to provide quality maternal and newborn healthcare services:

  • A functional healthcare system with public and private services available so every pregnant woman can reach a facility that can manage her complications within two hours of the onset of the complication
  • Health facilities (public and private) that are well-equipped and -supplied, and have competent providers who have manageable workloads, are well-compensated and are geographically located to enhance access for all pregnant women—24 hours per day, 7 days a week
  • Managers to provide appropriate supervision and mentoring support to health workers
  • A system that is able to regularly collect, analyze and use the data for decision-making and advocacy
  • Communities that are actively engaged to support women and their newborns to access health services
  • Women and their families who are informed and empowered to plan for and manage access to health services

Results

Saving Mothers, Giving Life was launched in 2012 with high hopes and even loftier goals. Thanks to committed partners, strong leadership from the governments of Uganda and Zambia and effective coordination on the ground, the initiative has achieved remarkable results to date, specifically a 35% reduction of institutional facility maternal mortality. The "proof-of-concept" phase clearly showed that working in support of national strategies and plans can make a significant difference.

Saving Mothers, Giving Life Phase 1 Key Results
Indicator Uganda Zambia
Institutional maternal mortality rate ↓35% ↓35%
Institutional perinatal mortality rate ↓ 17% ↓ 14%
Institutional stillbirth rates ↓ 20% ↓ 19%
Obstetric case fatality rate in facilities providing emergency obstetric and newborn care (EmONC) ↓ 18% ↓ 35%
Availability of 24/7 services provided at health centers ↑ 24% ↑ 44%
Deliveries taking place in a health facility ↑ 62% ↑ 35%
Facilities able to managed basic maternal and newborn complications ↑ 200% ↑ 100%
Cesarean section rate ↑ 23% ↑ 15%
HIV-positive pregnant women receiving antiretroviral treatment ↑ 28% ↑ 18%
Infants receiving HIV prophylaxis ↑ 27% ↑ 29%
Hospitals providing at least one long-acting family planning method ↑ 10% ↑ 50%
Hospitals conducting maternal death audits ↑ 223% ↑ 100%


Way Forward

Building on its year-one success, Saving Mothers, Giving Life is expanding to six new districts in Uganda and 12 new districts in Zambia with a long-term goal of national scale-up to save more women's and newborns' lives. This Phase 2 scale-up includes:

Phase 1:
Proof of Concept
Phase 2:
National Scale-Up
Implemented in 8 districts Expanding to 18 new districts; 11 districts using approach supported by other donors
Used a systems approach to address gaps (3 delays) and mobilize response Using a systematic approach to address gaps (3 delays) and mobilize response
Developed tools and approaches at the community and facility levels Streamlining implementation by clarifying roles and responsibilities, standardizing tools and approaches and simplifying reporting requirements
Outcomes focused monitoring and evaluation Prioritizing program monitoring by strengthening public health surveillance and incorporating short-loop feedback mechanisms and customer perceptions to guide programmatic decisions
Integrated HIV, maternal and newborn health (MNH) services that focused on labor, delivery and the first 24 hours Continuing integration of HIV and MNH services with strengthened newborn component focusing on labor, delivery and the first 48 hours
Built capacity and sustainable systems Increasing ownership and resource mobilization by governments and communities