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      Saving Mothers, Giving Life: A Systems Approach to Reducing Maternal and Perinatal Deaths in Uganda and Zambia

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          Abstract

          The 5-year public-private partnership boldly addressed maternal mortality in Uganda and Zambia using a systems approach at the district level to avoid delays in women seeking, reaching, and receiving timely, quality services. This supplement provides details on the Saving Mothers, Giving Life partnership and approach, including the model, impact, costs, and sustainability.

          Abstract

          The 5-year public-private partnership boldly addressed maternal mortality in Uganda and Zambia using a systems approach at the district level to avoid delays in women seeking, reaching, and receiving timely, quality services. This supplement provides details on the Saving Mothers, Giving Life partnership and approach, including the model, impact, costs, and sustainability.

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          Impact of the Saving Mothers, Giving Life Approach on Decreasing Maternal and Perinatal Deaths in Uganda and Zambia

          Through district system strengthening, integrated services, and community engagement interventions, the Saving Mothers, Giving Life initiative increased emergency obstetric care coverage and access to, and demand for, improved quality of care that led to rapid declines in district maternal and perinatal mortality. Significant reductions in intrapartum stillbirth rate and maternal mortality ratios around the time of birth attest to the success of the initiative.
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            Addressing the First Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Approaches and Results for Increasing Demand for Facility Delivery Services

            The Saving Mothers, Giving Life initiative used 3 coordinated approaches to reduce maternal deaths resulting from a delay in deciding to seek health care, known as the “first delay”: (1) promoting safe motherhood messages and facility delivery using radio, theater, and community engagement; (2) encouraging birth preparedness and increasing demand for facility delivery through community outreach worker visits; and (3) providing clean delivery kits and transportation vouchers to reduce financial barriers for facility delivery. These approaches can be adapted in other low-resource settings to reduce maternal and perinatal mortality.
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              Addressing the Second Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Reaching Appropriate Maternal Care in a Timely Manner

              The Saving Mothers, Giving Life initiative employed 2 key strategies to improve the ability of pregnant women to reach maternal care: (1) increase the number of emergency obstetric and newborn care facilities, including upgrading existing health facilities, and (2) improve accessibility to such facilities by renovating and constructing maternity waiting homes, improving communication and transportation systems, and supporting community-based savings groups. These interventions can be adapted in low-resource settings to improve access to maternity care services.
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                Author and article information

                Journal
                Glob Health Sci Pract
                Glob Health Sci Pract
                ghsp
                ghsp
                Global Health: Science and Practice
                Global Health: Science and Practice
                2169-575X
                11 March 2019
                11 March 2019
                : 7
                : Suppl 1 , Saving Mothers, Giving Life: A Systems Approach to Reducing Maternal and Perinatal Deaths in Uganda and Zambia
                : S1-S5
                Affiliations
                [a ]Director, Global Health Initiative , U.S. Department of State. Now with Pathfinder International , Boston, MA, USA.
                [b ]Principal Deputy Coordinator (acting) , U.S. Department of State. Office of the U.S. Global AIDS Coordinator and Health Diplomacy , Washington, DC, USA.
                [c ]Deputy Assistant Administrator, Bureau for Global Health, U.S. Agency for International Development . Now with Save the Children USA , Washington, DC, USA.
                Author notes
                Correspondence to Angeli Achrekar ( achrekara@ 123456state.gov ).
                Article
                GHSP-D-19-00037
                10.9745/GHSP-D-19-00037
                6519674
                30867206
                7436fa8c-4fc1-45c0-bf63-7b124f5dc845
                © Quam et al.

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit http://creativecommons.org/licenses/by/4.0/. When linking to this article, please use the following permanent link: https://doi.org/10.9745/GHSP-D-19-00037

                History
                : 18 May 2018
                : 21 January 2019
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