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USAID Annual Report to Congress Spotlights URC Work
The U.S. Agency for International Development (USAID) has highlighted URC-managed programs in the agency’s report to the U.S. Congress. “Global Health and Child Survival: Progress Report to Congress 2010–2011" summarizes U.S. global health successes in developing countries from January 2010 to October 2011.
Key Results: Health Systems Strengthening in Niger
The report’s “Key Results” section features our work in Niger, which has the world’s highest maternal mortality rate, largely due to postpartum hemorrhage (PPH). In 2005, we introduced the active management of the third stage of labor (AMTSL), a set of clinical steps to prevent and treat PPH, at the country’s government maternity facilities. Over 33 facilities collaborated intensively with URC guidance to improve maternal care.
Before the intervention, AMTSL provision in participating facilities occurred in less than 5% of births; the rate rose to 98% in two years. At the same time, the PPH rate fell from 2.5% to 0.2%, a 92% decrease. Eight months after program closure in 2009, the sites continued to practice AMTSL at levels achieved during the project. Other countries are replicating these improvements.
Maternal and Newborn Health in Kenya and Tanzania
The report’s section (page 8) on “Maternal Health l Neonatal Health” describes our research into disrespectful care during childbirth. In countries with high maternal and infant mortality, like Kenya and Tanzania, disrespectful and abusive care during pregnancy and childbirth discourages women from delivering in facilities with skilled birth attendants.
Diana Bowser of the Harvard School of Public Health and URC’s Dr. Kathleen Hill called attention to the relative lack of formal research on this topic. As a result, our USAID-funded Translating Research into Action (TRAction) Project has awarded two grants for research studies on disrespectful and abusive care during childbirth at Kenyan and Tanzanian health facilities. The research aims to document the extent of the problem and recommend ways to reduce it, with the ultimate goal of increasing the use of skilled care to ensure safe deliveries and reduce maternal mortality, a Millennium Development Goal.
This section also mentions Helping Babies Breathe (HBB), a global initiative to train skilled health care providers in newborn resuscitation in resource-limited areas. URC is part of the HBB Implementation Advisory Group and works with the group in Afghanistan, Ecuador, El Salvador, Guatemala, Honduras, Nicaragua, and Uganda.
Health Equity Funds in Cambodia
The “Health Systems Strengthening” section references Health Equity Funds in Cambodia. This funding mechanism gives the country’s vulnerable populations financing for health services. URC is one of the organizations working on this type of initiative. Lastly, our USAID-funded Better Health Services (BHS) Project works with Cambodia’s Ministry of Health to increase demand for and equitable access to quality health services. The project is building the capacity of public and private service delivery systems; expanding models for health financing; improving the quality and impact of maternal, neonatal, and child health services; and strengthening the control of infectious diseases.