New Maternal Health Jobs

Are you interested in working in maternal and newborn health? At the MHTF, we like to encourage knowledgeable and capable people, like yourself, to join the field and pursue new opportunities. Please find a list of some of the current job openings in maternal health below:

  1. Management Sciences for Health: Director of Grants and Contracts in Uganda. See more jobs at MSH.
  2. Pathfinder International: Chief of Party in Kenya
  3. Jhpiego: Program Officer in the US; Senior Monitoring & Evaluation Advisor in the US
  4. World Health Organization: National Consultant, Maternal and Neonatal Health in Ethiopia
  5. Save the Children: Advisor, Newborn MCSP; Coordinator, MCSP
  6. March of Dimes: State Director of Program Services in Alabama, US

Have you or your organization recently posted a job opening? Email us at kmillar@hsph.harvard.edu.

Building Community capacity for maternal health promotion: An important complement to investments in health systems strengthening

By Moustapha Diallo, Country Director, EngenderHealth|Guinea; and Ellen Brazier, Senior Technical Advisor for Community Engagement, EngenderHealth

EngenderHealth’s Fistula Care Plus project recently published the results of two studies in Guinea, one examining factors associated with institutional delivery and another investigating the effect of an intervention to build the capacity of community-level volunteers to promote maternal health care-seeking.

Community empowerment and participation has long been recognized as a fundamental component of good health programming and as a critical strategy for improving access to and use of health services. However, as Susan B. Rifkin notes in a 2014 review of the literature, evidence directly linking community participation to improved health outcomes remains weak.

For maternal health, the evidence gap is particularly acute. A 2014 World Health Organization (WHO) report reviewed a community mobilization approach that involves training and supporting women’s groups to carry out an ongoing process of problem exploration, priority-setting and action planning. The report concluded that, while such participatory approaches appeared to have a strong effect on neonatal mortality, there was no evidence of effects on maternal mortality or on other critical maternal health indicators, such as institutional delivery, delivery with a skilled attendant, or receiving the recommended number of antenatal care visits.

While important questions remain about what types of interventions are effective in improving maternal health, our recent research in Guinea found that women’s use of maternal health services was associated with the existence of strong support systems for maternal health within communities. Our study focused on villages where community volunteers had been trained to raise awareness about obstetric risks, including fistula, to monitor pregnancies, and to promote women’s routine use of maternal heath services. We assessed the extent to which community members were aware of and relied on community-level cadres as a main source of maternal health information and advice.

We also found that women living in communities with a high score on our community capacity index were much more likely to use maternal health services than those living in communities with weak support systems. In fact, women living in villages with a high score on our community capacity index were more than twice as likely to attend at least four antenatal care visits during their pregnancies, to deliver in a health facility, and to seek care for perceived obstetric complications.

Building the capacity of community cadres and volunteers to promote maternal heath and monitor maternal health care-seeking is challenging, and it does not occur overnight. However, our findings suggest that such capacity-building investments are worth it since community-level cadres can be important catalysts for changes in maternal health care-seeking when they have the training, support, and recongiztion they need to serve as a resource in their communities. Such investments are an important complement to ongoing efforts to improve the availability, accessibility, and quality of the continuum of maternal health services.

UNGA week shows maternal and newborn health are central to development challenges

By Amy Boldosser-Boesch, Interim President of Global Advocacy, Family Care International

X00100_9 (2)This year’s UN General Assembly was full of high-profile moments that reinforced the need for investment and action to improve reproductive, maternal, newborn and child health (RMNCH): the launch of a Global Financing Facility to Advance Women’s and Children’s Health; the release of reports tracking stakeholders’ fulfillment of commitments to Every Woman Every Child; new data on maternal, newborn and child survival from Countdown to 2015; and a plethora of side events focusing on strategies and country progress toward MDGs 4 and 5. For Family Care International—which advocates for improved reproductive, maternal, and newborn health—this unprecedented level of attention to women’s and children’s health is a welcome sign that our advocacy is having an impact, and that global commitment to ending all preventable maternal and child deaths is stronger than ever.

RMNCH was a key theme in many other important discussions during the week, demonstrating the centrality of the health of mothers and newborns to a range of development challenges.

  • Events began with a Climate Summit that brought together leaders from more than 120 countries. The Partnership for Maternal, Newborn & Child Health noted during the Summit that “women and children are the most vulnerable to the effects of a changing climate, and those who are more likely to suffer and die from problems such as diarrhoea, undernutrition, malaria, and from the harmful effects of extreme weather events such as floods or drought.”
  • There was a special session to review progress towards achieving the International Conference on Population and Development Programme of Action. The ICPD agenda highlights the importance of ensuring universal access to sexual and reproductive health and rights and the importance of quality and accessible maternal health care, recognizing that healthy girls and women can choose to become healthy moms of healthy babies.
  • The UN Security Council held an emergency meeting where President Obama called for swift action on the Ebola epidemic that is destroying lives and decimating African health systems. This crisis highlights already-fragile health systems that lack sufficient health workers, supplies, and essential medicines; the same failures that contribute to maternal and newborn mortality. A recent news story details how pregnant women who are not infected with Ebola risk dying in West Africa due to lack of access to maternal health services, and the same risk exists for newborns and young children. The loss of skilled healthworkers, particularly midwives, could have enormous long term impacts on the ability of women, newborns and children to access life-saving care.
  • Finally, the UNGA week included high-level meetings on humanitarian crises in Syria, South Sudan and many other countries. According to the State of the World’s Mothers 2014 report, more than half of all maternal and child deaths occur in crisis-affected places. Discussions of humanitarian response in crisis settings included recognition of the disproportionate impact on women and children of violence, including gender-based violence, displacement, lack of access to food and lack of access to crucial maternal health services and early interventions for newborns. These crises and fragile health systems make achieving the Every Newborn Action Plan recommendations on ensuring quality care for mothers and newborns during labor, childbirth and the first week of life more difficult, but also more critical.

While this long list of world crises may seem overwhelming, there is some good news on maternal, newborn and child survival. As the UN Secretary-General reminded us, the world is reducing deaths of children under the age of five faster than at any time in the past two decades and significant declines in maternal mortality have occurred in the past 10 years. As the world works together to shape the post-2015 development goals, these experiences during UNGA show that the new agenda must prioritize continuing to address maternal, newborn and child mortality which is linked to many of the world’s pressing development challenges, including poverty. As a recent editorial in The Lancet says, “As governments slowly come to an agreement about development priorities post-2015, it is clear that maternal and newborn health will be essential foundations of any vision for sustainable development between 2015 and 2030.”

This post original appeared on the Health Newborn Network Blog.

Making a Human-Rights and Socioeconomic Case for Preventing Maternal Mortality

By Katie Millar, Technical Writer, MHTF

Panel at Women's Lives MatterOn October 7, 2014, a panel of experts in maternal health—moderated by Dr. Ana Langer, the Director of the Maternal Health Task Force—gathered at the Harvard School of Public Health to discuss the socioeconomic impact of a maternal death on her family and community. Several studies were summarized and priorities for how to use this research were discussed by the panel and audience at “Women’s Lives Matter: The Impact of Maternal Death on Families and Communities.”

What does the research say?

In many countries around the world, the household is the main economic unit of a society. At the center of this unit is the mother and the work—both productive and reproductive—that she provides for her family. A study in Kenya, led by Aslihan Kes of the International Center for Research on Women (ICRW) and Amy Boldosser-Boesch of Family Care International (FCI), showed great indirect and direct costs of a mother losing her life. This cost is often accompanied by the additional cost and care-taking needs of a newborn. “Once this woman dies the household has to reallocate labor across all surviving members to meet the needs of the household. In many cases that meant giving up other productive work, loss of income, hiring an external laborer, girls and boys dropping out of school or missing school days to contribute [to household work],” shared Kes. In addition, the study done in Kenya determined that families whose mother died used 30% of their annual spending for pregnancy and delivery costs; a proportion categorized by the WHO as catastrophic and a shock to a household.

Similar research was conducted in South Africa, Tanzania, Ethiopia, and Malawi by Ali Yamin and colleagues. In addition to similar socioeconomic findings to those in Kenya, Yamin found that in Tanzania less than 50% of children survived to their fifth birth if their mother died compared to over 90% of children whose mothers lived. An even more dramatic relationship was found in Ethiopia with 81% of children dying by six months of age if their mother had died. In South Africa, mortality rates for children whose mothers had died were 15 times higher compared to children whose mothers survived.

Increasing the visibility of maternal death

While a family is grappling with grief they are also making significant changes in roles and structure to meet familial needs. Dr. Klugman emphasized this point when she said, “Quantifying [the] effects [of maternal death]… and the repercussions down the line—in terms of poverty, dropping out of school, bad nutrition, and future life prospects—I think are all tremendously powerful. [This] additional information [is] very persuasive—to take to the ministries of finance, to take to donors, to take to stakeholders—to help mobilize action for the interventions that are needed.”

Apart from the economic and social costs, is a foundation of human rights violations and gender inequalities. The high rate of preventable maternal mortality is no longer a technical issue, but a social issue. “Maternal mortality it is a global injustice. It is the indicator that shows the most disparities between the North and the developing world in the South. It’s not a technical problem, it’s because women lack voice and agency at household, community, and societal levels and because their lives are not valued. Through this research of showing what happens when those women die, it shows in a way how much they do [and how it] is discounted,” said Dr. Yamin, whose research focuses on the human rights violations in maternal health.

Leveraging this research for improved reproductive, maternal, newborn, and child health

The research findings are clear: prevention of maternal mortality is technically feasible, the right of every woman, and significantly important for the well-being of a family and a community. Boldosser-Boesch provided three reasons why making the case for preventing maternal mortality is critical at this time.

  1. These findings strengthen our messaging globally and in countries with the highest rates on the importance of preventing maternal mortality, by increasing access to quality care, which includes emergency obstetric and newborn care.
  2. This research supports integration across the reproductive, maternal, newborn, and child health (RMNCH) continuum to break down current silos in funding and programs.
  3. “We are at a key moment… for having new information about the centrality of RMNCH to development, because… the countries of the world are working now to define a new development agenda, beyond the MDGS, post-2015. And that agenda will focus a lot on sustainable development… and we see in these findings… , connections to the economic agenda…, questions of gender equality, particularly what this means for surviving girl children, who… may experience earlier marriage or lack of access to education,” shared Boldosser-Boesch.

In order to move the agenda forward on preventing maternal mortality and ensuring gender equality, ministries of health and development partners must be engaged. In addition, donors can fund the action of integration to address a continuum approach and media outlets should be leveraged to disseminate these findings and hold governments accountable for keeping promises and making changes. The prevention of maternal mortality is a human rights-based, personal, and in the socioeconomic interest of a family, community, and a society.

This panel included:

  • Ana Langer, Director of the Maternal Health Task Force
  • Alicia Yamin, Lecturer on Global Health at the Harvard School of Public Health
  • Amy Boldosser-Boesch, Interim President & CEO, Family Care International
  • Jeni Klugman, Senior Adviser at The World Bank Group
  • Aslihan Kes, Economist and Gender Specialist, International Center for Research on Women

Watch the webcast here.

WHO Welcomes Revitalized Interest in Maternal and Newborn Heath Integration

By Severin Ritter von Xylander, WHO

This post is part of the Maternal and Newborn Health Integration Blog SeriesIntegration of Maternal and Newborn Health: In Pursuit of Quality technical meeting.

Philippines: Typhoon RecoveryThe World Health Organization (WHO) welcomes the revitalized interest in integration of maternal and newborn health care as integration is the key to success for both improving maternal health and for ending preventable newborn deaths.

This is the very reason why WHO, together with UNICEF, UNFPA and the World Bank, have been promoting, already since 2000, Integrated Management of Pregnancy and Childbirth (IMPAC). This is the package of guidelines and tools, which respond to key areas of maternal and perinatal health programmes. IMPAC sets standards for integrated maternal and neonatal care. However, integration is not an end in itself, but should serve the purpose of improving quality and efficiency of health care services provided.

One important element of integration of health care services is that they should be centred around the mother-baby dyad, their needs and preferences. It is important that health care services are organized in a way that this will happen. For a normal pregnancy, childbirth and postnatal period this care can and should be provided by midwifery personnel with the necessary skills. Sometimes, however, the mother or the baby needs special attention and services that can only be provided by health care workers with specialized skills. But even in those cases, addressing the needs of the mother and the baby in an integrated way, remains key for success.

For example, early and exclusive breastfeeding is important for the survival, growth and development of the baby and should not be disrupted by separating the baby from her mother, if this is feasible – and in most cases this is feasible. So-called vertical health programmes, such as the expended programme of immunization (EPI) or the prevention of mother-to-child-transmission (PMTCT), have been successful in addressing certain public health priorities as they provide the necessary focus to make things happen. Sometimes they are perceived as disruptive. However, there are good examples how these programme interventions can be successfully integrated into maternal and newborn care services. Again, IMPAC provides guidance on how best to achieve this integration.

Finally, it will be important to promote a truly perinatal approach, which goes beyond highly specialized health care settings, but which will be based on the principles that only good pregnancy and childbirth care will lead to better neonatal outcomes. In conclusion, maternal and newborn health care should be as integrated as possible and as “vertical” as necessary to achieve high coverage and quality of health interventions for the mother and her baby. In the coming months WHO, UNICEF, UNFPA and partners will be working on a Every Mother, Every Newborn initiative to improve the quality of integrated maternal and newborn care.

This post originally appeared on The Healthy Newborn Network Blog