Community Midwifery and Prevention of Postpartum Hemorrhage_Andrea Wlson Cutherell_5.8.14

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  • Major Accomplishments:
    Misoprostol:
    Included in provincial Essential Drug Lists
    clinical protocols developed and endorsed for facilities and communities
    pre-service curriculum endorsed for skilled providers in community settings
    Community Midwifery Strategic Roadmaps developed and endorsed
    Under development:
    Chlorhexidine for newborn care
    Provincial essential drug list inclusion
    Clinical protocols
    Pre-service curriculum
    Inclusion in community healthworker kits
  • Community Midwifery and Prevention of Postpartum Hemorrhage_Andrea Wlson Cutherell_5.8.14

    1. 1. 35 Commercially Viable Community Midwives: Mercy Corps Pakistan CORE Group Spring Meeting 8 May 2014
    2. 2. Mission: Mercy Corps exists to alleviate suffering, poverty and oppression by helping people build secure, productive and just communities. History: Operational in Pakistan since 1986, addressing health (MNCH and infectious disease), emergency response (2005 earthquake and 2010 floods), WASH, economic development, and youth programs Scale: Reaching 50% of Pakistan’s districts in all provinces, through partners Mercy Corps in Pakistan
    3. 3. CONTEXT: Double burden High maternal and newborn mortality Limited economic opportunities for women 132nd out of 134th Pakistan’s rank for ease of starting a business as a woman 1 in 28 babies in Pakistan do not make it past the first month of life
    4. 4. Can Community Midwives (CMWs) reduce maternal and newborn deaths, while generating a viable income? A regional question….
    5. 5. Three tiered solution: Policy, Service Delivery, and Community Policy LEVEL Advocacy INTERVENTION Research Clinical Training Business Training Microloans Mamta Transport Fund Women Support Groups Community Service Delivery OUTCOMES Enabled policy environment for CMWs Increased and sustained availability of quality MNH community-based services through CMWs Increased demand and access to CMW and referral services Reduced maternal and newborn mortality IMPACT Mobile Technology
    6. 6. Policy Interventions Provincial Steering Committees (PSC) and Technical Working Groups (TWGs) to facilitate policy changes in Pakistan’s recently devolved health system • Misoprostol for PPH • Inclusion in provincial Essential Drug Lists • clinical protocols endorsed • pre-service curriculum endorsed • Community Midwifery Strategy Roadmaps endorsed and approved • Chlorhexidine for newborn care (under development)
    7. 7. Results to date: Uptake of CMW services Average # and type of services per month per CMW within five months of deployment
    8. 8. Results to date: Financial Viability of CMWs Average NET income (USD) per month per CMW Within five months of deployment USD 34: Avg. income for women who work outside the home in Quetta* *Source: KPC 30 Cluster Survey, Quetta, MC PRM program, Nov 2013
    9. 9. Long Term Sustainability Average # of service and income per CMW two years after deployment
    10. 10. Case Study
    11. 11. Thank you!

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