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Maternal and Newborn Care Sees Vast Improvements in Niger and Mali
Closing the "know-do" gap between interventions and reliable implementation at scale is no easy task, especially in resource-poor countries with some of the worst indicators in the world. In Niger and Mali, two countries with some of the highest maternal and newborn mortality rates worldwide, URC's work has driven some remarkable improvements.
URC recently published an article in BJOG: An International Journal of Obstetrics and Gynecology about our work in these countries: "Improving postpartum care for mothers and newborns in Niger and Mali: a case study of an integrated maternal and newborn improvement programme."
URC has managed the USAID-funded Quality Assurance Project (QAP I, II, III) and its successors, the USAID Health Care Improvement (HCI) and the USAID Applying Science to Strengthen and Improve Systems (ASSIST) projects, from 1990 to the present. These projects have worked with the ministries of health of Niger (from 2006 to 2008) and Mali (from 2009 to the present) to improve the quality of maternal and newborn services in public-sector maternities.
Some of the results from these efforts are truly extraordinary. The percentage of births benefiting from active management of the third stage of labor (AMTSL) increased from 2% at baseline to over 90% in Niger and from 17% in the first month of reporting to 95–97% in Mali. The percentage of births benefiting from essential newborn care increased from 16% at baseline to 96% in Niger and from 25% to 99% in Mali.
The article goes into great depth explaining how these results were achieved. Some key contributions to improvements in quality of care for mothers and newborns relied upon an approach based on common measurable aims, local ownership, and shared learning across multiple sites. This approach can also help strengthen local health system functions such as health information systems, health worker support vehicles, and the like.
This improvement program in Niger and Mali for mothers and newborns is cost-effective and can be efficiently spread to new geographic and technical areas—and is showing promising signs of sustainability, thus far.