Academy for Educational Development

AED Advocacy Models Help Combat Infant and Maternal Mortality

Each day 80 newborns die in Mali.

Every three hours a woman in Mali dies due to complications from pregnancy or childbirth.

These shocking statistics were formulated earlier this year when a multidisciplinary group of concerned Malian professionals met to discuss strategies for improving prenatal and neonatal health care.

Using an advocacy model originally created by AED, a multidisciplinary team of concerned professionals found that Mali stands to lose 34,000 mothers and 340,000 newborns in the next 12 years if nothing is done to improve the country's health care.

Using advocacy models originally created by AED, the 20-person team—including a midwife, pediatrician, statistician, economist, sociologist, and educator—reviewed both local and international surveys, studies, and reports to estimate the cost of inadequate maternal and newborn health services in terms of the number of lives lost and the economic impact on their country.

Waking People Up to the Problem

They found that Mali stands to lose $350 million over the next 12 years  because of the productivity the country loses when women die, or are disabled, from causes related to pregnancy and childbirth. And in the next 12 years, if nothing is done to improve health care, 34,000 mothers and 340,000 newborns will die.

Using this kind of data, which they compiled in their initial meeting, the Malian team created an advocacy plan and a corresponding presentation to show policymakers and community members the devastating impact that maintaining the status quo—that is, not putting additional resources toward improving maternal and neonatal health care—would have on the country’s economy.

“The idea is that in the course of using the advocacy plan, the group will be able to wake people up to the problem by showing them these numbers,” said Elisabeth Sommerfelt, a pediatrician and a maternal and neonatal health specialist for the AED Center for Health Policy and Capacity Development. “And if the number of deaths isn’t shocking enough,” she added, “maybe the group can wake people up by showing them how much money the country stands to lose.” 

“Delays”: A Key Factor in Maternal Mortality

The team used AED’s “Reduce” advocacy model, which focuses on decreasing maternal mortality, morbidity, and disability rates, and the “Alive” advocacy model, which concentrates on saving newborn lives. They developed an advocacy presentation that was shown at the end of the two-week workshop to government officials, donors, and other stakeholders. The presenter, Dr. Zaїnab Maїga, a workshop participant who later became Mali’s Minister of Health,  identified the major delays that lead to mothers dying during labor and delivery:

• Delay on the part of the mother, family, and community in recognizing life-threatening conditions and delay in deciding to seek help;
  
• Delay in reaching a health facility, for example due to lack of transportation;
  
• Delay, after arriving at the health facility, in receiving appropriate care due to inadequate staffing or equipment.

Simple Steps Increase Newborn Viability

The “Alive” model provides a framework in which advocates for better neonatal health care can discuss ways to increase the rate of newborn survival. The actions needed are relatively simple, according to Sommerfelt. For example:

• Ensure clean delivery and cord care;
  
• Dry and wrap the newborn immediately following delivery;
  
• Start breastfeeding as soon as possible. The first milk a mother produces, called colostrum, is rich in antibodies that keep the baby healthy and build up the immune system. In addition, breastfeeding keeps the baby’s body temperature stable.

Perhaps most importantly, communities need to recognize danger signs and know when to seek help.  “That is why it is essential that communities as a whole are educated on what to do and when to act,” said Sommerfelt.

In addition to Mali,  advocacy workshops on reducing maternal and newborn mortality have been held in Ethiopia, Ghana, Mauritania, Mozambique, Nigeria, Senegal, Uganda, and Vietnam. Partners in this effort included national ministries of health, USAID, the Africa Regional Office of WHO, Save the Children, and the World Bank.

• Learn more about AED’s work in maternal health and child health.
• Learn more about AED’s PROFILES model to improve nutrition.