Need for a multi-faceted approach to achieve zero maternal mortality
At the Nigeria Heath Watch conference recently held in Abuja on the theme “Evidence for Change – Learnings and Recommendations for Quality Maternal Care”, stakeholders emphasized the need for a multi-pronged approach facets to achieving a world without maternal mortality. Sunday egigiator reports
Ending preventable maternal mortality (EPMM) remains an unfinished agenda and one of the world’s most critical challenges. Maternal health, well-being and survival remain a central goal and investment priority under the Sustainable Development Goals (SDGs).
According to the World Health Organization (WHO), EPMM goals and strategies are grounded in a human rights approach to maternal and newborn health and focus on eliminating significant inequalities that result in disparities in access, quality and outcomes of care within and between countries. .
The SDGs build on the achievements of the Millennium Development Goals (MDGs) with the objective of reducing the maternal mortality rate to less than 70 per 100,000 live births and reducing neonatal mortality to less than 12 to 1 000 live births by 2030.
The Ending Preventable Maternal Mortality (EPMM) target of all countries reducing maternal mortality ratio (MMR) to at least two-thirds of their 2010 baseline levels depends on the provision of available, accessible services , acceptable and of high quality in an enabling environment that respects the principles of human rights.
Similarly, the WHO has posited that attention to maternal mortality must be accompanied by improvements along the continuum of care, including commitments to sexual and reproductive health, family planning and survivorship. newborn and child.
With the high burden of maternal and perinatal mortality (including in health facilities) at 576 per 100,000 live births and 77 per 1,000 live births in 2013, and women suffering life-threatening complications with short to long-term impact on quality of life, according to the National Demographics and Health Survey (NDHS), it becomes critically important to explore a more effective approach to reducing the burden.
In this context, stakeholders at the conference recommended several approaches, including digital technology, capacity building of health facilities through maternal and perinatal database for quality, equity and dignity (DPM–4–CQFD) and empower and equip health providers to deliver better quality maternal care.
Other recommendations include expanding access to better quality maternal care, supporting women’s pregnancy journey through better quality of care, appropriate funding of primary health care centers across the country. and Effective Maternal Medicine Policies in Nigeria.
Earlier, during her welcome address, Nigeria Health Watch Chief Executive Vivianne Ihekweazu said it is possible to achieve a world where no woman dies in childbirth.
According to her, over the past 18 months, Nigeria Health Watch has been working on a maternal health advocacy and communication program to highlight the importance of quality maternal health care in Nigeria through projects funded by MSD for Mothers.
“So over the period, we have been engaging with all of you to shine a light on insights and program evidence from MSD for Mothers collaborators, all to shine a light on interventions that will enable Nigeria to achieve the SDG target of a global maternal-to-maternal ratio of less than 70 maternal deaths per 100,000 live births by 2030”.
Regarding the approach to shed light on the quality of care for women’s maternal health, Ihekweazu said the focus is on six thematic areas, including understanding gaps in quality of care, quality assurance, private sector capacity, affordability, digital support/technology and evidence of change.
She said the goal of this proof of change is “to amplify the collaborators supported by MSD for Mothers, as evidenced by the results and impact of initiatives and innovations in improving maternal health outcomes. in Nigeria; and highlight the importance of adopting a quality of care approach to providing maternal health care in Nigeria through the strategic approaches of MSD for Mothers supported projects in Nigeria.
Also speaking, a WHO representative, Dr. Bosede Ezekwe, in an article titled “How the World Health Organization is improving health facility capacity through the MPD-4-QED program,” said the base of Nigerian Maternal and Perinatal Data for Quality, Equity and Dignity (MPD4QED) aims to address the heavy burden of maternal and perinatal mortality (including in health facilities) at 576 per 100,000 live births and 77 per 1 000 live births in 2013, according to the National Demographics and Health Survey (NDHS).
Ezekwe, whose paper was presented by Director of Policy & Advocacy, Nigeria Health Watch, Ify Babatunde-Yusuf, further said that many women experience life-threatening complications with short or long-term impacts on the quality of life.
She said that among the quality standards that should be available in every health facility is that every mother and every newborn has a complete, accurate and standardized medical record during labour, delivery and the postnatal period. early.
Ezekwe said it is also expected that each health facility will have a mechanism for data collection, analysis and feedback as part of its monitoring and performance improvement activities at the time of delivery. .
Regarding the human resources challenge, Ezekwe said that “the motivation for data collection requires new strategies and innovations, as stipends will no longer be awarded under the FMoH.
“There has been a decrease in motivation for data collection following the cessation of allocations as well as attrition (reassignment/moving of trained data collectors and hospital coordinators). Training required for new personnel coming on board,” she said.
Associate Director, Women’s Wellbeing, moc Healthcare, Chiagoziem Abiakam, in an article titled “Empowering Women Through Digital Technology: Providing Holistic Support Through Virtual Coaching and Digital Nudges,” dwelt on ways in which the organization solves maternal mortality through the digitized process.
She said mDoc optimizes the end-to-end self-care experience for people with regular and chronic health needs by leveraging quality improvement methodologies, behavioral science, data and technology. .
“mDoc is a digital health company, leveraging a high-tech, high-touch approach to optimizing end-to-end care for people living with chronic conditions in Nigeria. They harness behavioral science, quality improvement methodologies, data, and technology to provide an integrated care solution for people with chronic and regular health needs.
“We offer a four-pillar, high-tech, highly tactile approach to integrated self-care: virtual coaches and digital nudges through CompleteHealth TM; In-person Community NudgeHubsTM and Community Ambassadors; Tele-education of MQNTM providers and patients
“We help you find the quality health services you need on NaviHealth.ai, our geocoded directory. Patient reviews can be a powerful tool. They increase the visibility and conﬁdence of existing and potential people to use the installation.
“The NaviHealth.ai patient feedback system is based on the dimensions of quality (safety, timeliness, efficiency, fairness, eﬃciency, and patient-centered care) as established by the National Academy of Medicine.”
She said they used a female-centered QoC model to reduce the risk of indirect MMM related to PE/E.
Regarding capacity building (clinical/quality improvement, IQ), Abraham said the project conducts on-site skills-based training; tele-ECHO virtual sessions to reinforce provider learning/knowledge; supportive supervision and mentoring; and access to job aids and guidelines.
To ensure IQ, she said, the company identifies quality gaps, sets improvement goals, develops QoC metrics; establishes and supports quality improvement teams to test changes (PDSAs) and monitors metrics trends to track progress toward goals. Strengthen the health management information system (HMIS) of non-communicable diseases (NCDs) and use it for decision-making.
The SDGs build on the achievements of the Millennium Development Goals (MDGs) with the objective of reducing the maternal mortality rate to less than 70 per 100,000 live births and reducing neonatal mortality to less than 12 per 1,000 live births by 2030.