Reducing Maternal Deaths in Zambia

A new program is setting out to upgrade entrepreneurial maternity waiting homes to help pregnant women in remote communities reach quality health services. Merck for Mothers,* the Bill & Melinda Gates Foundation, and the ELMA Foundation have partnered to harness the potential of maternity waiting homes to reduce maternal deaths in Zambia. The goal is help pregnant women in remote areas reach timely, quality maternal health care by building and strengthening these waiting homes – residences near health facilities where women can stay in the late stages of their pregnancy as they prepare to give birth and in the critical period immediately following childbirth. Together, the three organizations are contributing $11.4 million.

 

Africare, in collaboration with the University of Michigan School of Nursing (UMSN), and Boston University, in collaboration with the Zambia Center for Applied Health Research and Development, are leading the project in Zambia, supporting local communities to manage the homes. As part of the operations research to determine the effectiveness of maternity waiting homes in increasing access to quality intrapartum care among the most vulnerable women, UMSN Associate Dean for Global Affairs and Director of U-M’s PAHO/WHO Collaborating Center Jody Lori, PhD, CNM, and her team will lead the work in the Lundazi and Mansa districts of Zambia.

 

In Zambia, distance challenges are considered a leading contributor to the country’s high maternal mortality ratio of 224 maternal deaths for every 100,000 live births. Women often have to travel long distances to reach the nearest health facility, making it difficult for them to get the care they need during pregnancy, childbirth and immediately postpartum.

 

Maternity waiting homes can help overcome these distance challenges by enabling women to reside closer to health facilities as they approach the end of their pregnancies. In fact, the government of Zambia has included maternity waiting homes in the country’s efforts to reduce maternal mortality.

 

“It is a tragedy to think that women may die during pregnancy and childbirth simply because they cannot reach a health facility in time,” said Dr. Priya Agrawal, Executive Director, Merck for Mothers. “Our support in combination with that of the Gates Foundation and The ELMA Foundation has the potential to reduce the number of women dying in Zambia by offering pregnant women a place to stay before going into labor and immediately after delivery, and our hope is to help create homes that women and their communities can be proud to use and manage.”

 

Merck for Mothers, the Bill & Melinda Gates Foundation and the ELMA Foundation are each partnering with organizations in Zambia to upgrade 24 maternity waiting homes throughout the country – all of which will be located near high-functioning health facilities equipped to provide quality care and manage life-threatening emergencies that can arise during pregnancy or childbirth. The goal is to create entrepreneurial models of these homes and test a variety of income generating activities to promote their long-term financial sustainability. The program will include an in-depth evaluation to help the maternal health field determine whether maternity waiting homes can be both an effective and sustainable solution to help women overcome distance barriers to quality care. “We are honored and enthusiastic to be part of this dynamic team dedicated to improving the lives of women and infants living in some of the most remote locations in Zambia,” said Dr. Lori.

 

The three-year project will begin in the districts of Kalomo, Choma, Nyimba, Mansa and Lundazi, and it builds on the existing efforts of each organization to lower maternal mortality in sub-Saharan Africa – where more than half of all maternal deaths occur. The project also represents part of Merck for Mothers’ commitment to Saving Mothers, Giving Life, a public-private partnership led by the U.S. Government to reduce maternal deaths in the region.

 

“We hope that our partners can create maternity waiting homes that will benefit families for years to come, giving pregnant women a comfortable place to stay and providing communities a valuable source of income and pride,” said Dr. Agrawal.

 

*Merck for Mothers is Merck’s 10-year, $500 million initiative to help create a world where no woman dies giving life. Merck and Merck for Mothers are known as MSD and MSD for Mothers outside the United States and Canada.