At the Christian Alliance for Orphans annual gathering on May 1, 2015, Hope Through Healing Hands hosted a workshop entitled The Mother & Child Project: How to Prevent the Orphan Crisis. While most workshops were providing instructive guidance on the care of orphans and vulnerable children both at home and around the world, ours focused on the prevention side; that is, how can we stop the orphan crisis before it begins? How can we turn the tide over the next two decades?

1. The Mother and Child Project:
How to Prevent the Orphan Crisis

2. About Hope Through Healing Hands
Hope Through Healing Hands
(HTHH) is a Nashville-based
nonprofit 501(c) 3 whose
mission is to promote
improved quality of life for
citizens and communities
around the world using health
as a currency for peace.
Senator Bill Frist, MD is the
founder and chair of the
organization, which was
founded in 2004.

3. • Promote awareness and advocacy for
Maternal, Newborn, and Child Health
(MNCH) and Healthy Timing and Spacing
of Pregnancies (HTSP).
• Encourage faith leaders to learn more
about the successes of HTSP, particularly
to combat maternal mortality and
increase newborn and child survival rates.
• Galvanize leaders to share their interest
with policy makers to enhance
understanding and encourage stronger
support for foreign assistance for MNCH
and HTSP.

4. Maternal, Newborn, and
Child Health
• 1 out of 39 women in Africa will die from childbirth.
• Every year, more than 289,000 women die annually
from complications during pregnancy or childbirth,
and almost all of them —99 percent — in developing
countries.
• 80 percent of all maternal deaths are preventable
through timely prenatal and postnatal care, skilled
birth attendance during delivery, and the availability
of emergency care to deal with complications.
• Every year, more than 1 million children are left
motherless; children who have lost their mothers are
up to 10 times more likely to die prematurely than
those who have not. This means, if we can save the
life of the mother, likely we can reduce infant mortality
rates and orphanhood as well.

5. Healthy Timing of Pregnancies
• Pregnancy & childbirth are the leading cause of
death for girls age 15-19 worldwide.
• Becoming pregnant at age 15-19 creates twice
the risk of death to a mother as becoming
pregnant at age 20-24.
• And if pregnant before age 15, the risk is five-fold
that of women age 20-24
• Even if they survive, they face a high risk of fistula
or other disability.
• In many developing nations, child marriage is a
common practice. For instance, in Ethiopia,
almost half of all young women are married by
age 16.

6. Healthy Spacing of Pregnancies
• With a recommended three to five years of
spacing between birth and pregnancy,
children are more than thrice as likely to survive
to age 5 than those born less than 2 years
apart.
• Children conceived within 2 years of a previous
birth are at dramatically higher risk of:
Prematurity, Stunting, Being stillborn, or dying in
infancy.
• The time between pregnancies allows the
mother to provide the benefits of breastfeeding
longer and spend more time with each child.
This contributes to the child’s physical, mental,
and emotional development.

7. HTSP, as Family Planning
• What is “family planning?” We mean enabling
women and couples to determine the number and
timing of pregnancies, including the voluntary use of
methods for preventing pregnancy, not including
abortion, that are harmonious with their values and
religious beliefs.
• The health benefits of spacing and limiting births for
mothers and children with family planning services
are well known. And this is the crux of family
planning: healthy birth timing and spacing.

8. “Contraception Is a Pro-Life
Cause in Developing World” --
TIME
• More than 222 million around the world who want to
avoid pregnancy do not have access to effective
contraceptives, counseling, or services. The Bill &
Melinda Gates Foundation, along with other
partners of FP2020, are seeking to meet this need for
120 million women by 2020.

9. Why HTSP?
• HTSP is at the nexus of solving other global health
challenges. Family planning is at the center of touching
on all the other health and development goals:
 combating extreme poverty,
 keeping kids in school,
 promoting gender equality,
 reducing child mortality,
 improving maternal health,
 prevention of HIV/AIDS from mother to child, and
 prevention of orphan crisis.

10. It Saves Lives.
• HTSP contributes to the reduction of poverty
and hunger, and it would avert 32% of all
maternal deaths, and nearly 10% of
childhood deaths, if it was available to all who
want it (Lancet, July 2012).
• Prevention of Mother-to-Child (PMTCT)
Transmission of HIV/AIDS: HTSP can aid in
preventing unintended pregnancies among
women already living with HIV and therefore
prevent transmission from prevent mother-to-
child transmission of HIV.

11. Reduction of Abortions
• Every year, there are 210 million pregnancies
worldwide. Of the women with those
pregnancies, it is estimated that 80 million (37%)
do not want to be pregnant. Over half of those
pregnancies, 42 million (or 1 out of 5 of all
pregnancies), end with an induced abortion.
• Abortion-related injuries account for 13% of
maternal deaths worldwide.
• Effective programs could avert 51 million
abortions in the next 10 years.

12. Education
• HTSP results in women that are able to pursue
education and to provide for their needs,
making it one of the most cost-effective and
powerful strategies to empower women and
improve their lives.
• Not only can young women stay in schools, it
also allows her own children—if she already
has a family—to stay in school.
• Women who are empowered to make
choices about childbearing are more likely
to get more education and job experience,
and contribute to the economic health of
their families and communities.

13. Economics
• For every $1 spent on family planning can
save governments up to $6 that can be
spent on improving health, housing, water,
sanitation, and other public services.
• Research has shown that personal savings
and investments increase when working
parents have a number of dependents that
is more manageable, given their means.
• In the case of Ethiopia, we will see a direct
correlation between family planning
contraception prevalence increase and
GDP per capita increase.

14. Case Study: Ethiopia
• Contraception prevalence doubled in 5 years from
2005-2010, 15%-29%.
• Highest unmet need is among young married women
between 15-19, about 25% who lack contraceptives
and want access.
• Currently, they estimate 42% now have access to family
planning services; 59% in urban areas and 38% in rural
areas.

15. How did they do it?
• Health Extension Workers (HEW) Program: A tiered system
managed by the government employing 38,000 HEWs in 5000 new
Health Posts in communities in every region.
• Health Posts: Delivery of antenatal care, family planning, and
primary health care.

16. How did they do it?
• Health Centers: Managing 5 health posts or 25,000 offering ART
services, TB services, family planning, youth friendly services,
and antenatal care including delivery.
• Since 2009, in Tigray, the Health Center estimates that 8% of
women chose to deliver her baby there. By 2013, 95% were
seeking services for delivery.

17. Contraception
• Condoms
• Oral Contraceptions
• Injectables: Depo Provera
• Implants: Implanon
• IUDs

18. New Contraceptive Technology
• Jadelle – Just emerging in Ethiopia. Implant that provides
coverage for 5 years. This was available at some Health
Centers which required special training for the insertion of
the rods.

19. From Family to Nation
With the advent of increased access, and
delivery of contraceptive commodities and
services in Ethiopia…
• Contraceptive prevalence rates increased from 14.7 in
2005 to 28.6 in 20011, or 51%.
• The GDP per capita in Ethiopia increased from 236.1 USD
in 2007 to 453.6 USD in 2012. In other words, it increased
by 217.5 USD, or 52% overall, according to the World
Bank. From 2005-2011, the increase was 47% or 175 USD.
• In other words, a 51% increase in contraceptive
prevalence contributed to a 47% GDP increase per capita
(175 USD).
• From 2005-2012, Ethiopia also saw a 31.3% decrease in
maternal mortality and a 15.7% decrease in total fertility.

20. PRAY
“Lord, Lead Me to the Ones I Need,
And to the One Who’s Needing Me.”
-- Amy Grant, “Greet the Day”

21. Raise Awareness
• Social Networking – Twitter, Facebook
• Blog – Write about the importance of maternal and child
health at the interface of orphanhood in developing nations.
• Op-ed – Write a piece for your hometown newspaper,
church newsletter, or local magazine.
• Sunday School – Lead a class at your church on these issues
with our new curriculum for The Mother & Child Project
coming out in March 2015.
• Book Club – Consider reading The Mother & Child Project and
discussing the various essays.

22. Encourage Family Planning
• Educate– Provide strong counseling and training for healthy
timing and spacing of pregnancies in your community.
• Provide contraceptives– Consider including an array of
contraceptive methods, including natural family planning, for
your community as a resource.
• School for Husbands– Rethink the role of the husband in
planning a family and consider educating husbands to
promote gender equality and create strong argument to
combat maternal/infant mortality with HTSP.

23. Speak Up. Advocate.
• Write/Call your Congressional Representatives and tell them
you care about maternal, newborn, and child health as well
as healthy timing and spacing of pregnancies in developing
nations. You are the experts. You’ve been on the ground
and you know the complications of global health and
development. Your voice and wisdom is so valuable to
convey importance of increased funding for MNCH/HTSP
issues to combat the orphanhood crisis.
• Go to House.gov/Senate.gov to find your Representative or
Senator.

24. Global Health USG Funding:
Perception vs. Reality

25. Global Health USG Funding:
Perception vs. Reality

26. Learn More.
• Go to -
HopeThroughHealingHands.org.