Safe motherhood should not be a privilege enjoyed just by those in the global north or in urban centers; it is a part of health as a human right. Maternal deaths are largely preventable, and yet maternal health disparities remain a major challenge across the globe.
After years of steady declines in global maternal mortality rates since 2000, progress stalled in 2015; rates have plateaued for the last decade and even increased in 17 countries. Globally, about 800 women died each day from preventable causes related to pregnancy and childbirth in 2020, the latest year for which there is WHO data. This represents a maternal mortality ratio of 223 deaths per 100,000 live births. This crisis is most acute in sub-Saharan Africa, which accounts for 70% of all maternal deaths in the world. To achieve Sustainable Development Goals for reducing maternal mortality rates to 70 deaths per 100,000 live births by 2030, countries around the world will need to accelerate efforts to improve maternal healthcare.
At the core of Helmsley’s work in sub-Saharan Africa is our goal of helping rural communities build resilience, and such resilience is not possible without strengthening maternal health. Research has found direct connection between maternal health and multiple outcomes that contribute to communities thriving. When mothers die, their infants are more likely to die, children are less likely to stay in school, and economic opportunities decrease for families to name a few.
As part of more than $476 million in total grant commitments since 2013, our Vulnerable Children in Sub-Saharan Africa program has made a concerted effort to invest in maternal health care to increase access to quality healthcare and to address the economic and knowledge barriers that prevent utilization by more women.
Read on to learn about some of the organizations we support that are working to improve maternal health.
Proximity to quality healthcare and availability of this care are important factors in maternal health . Distance prevents many women from accessing the prenatal and postnatal healthcare that they need, as transportation may not be affordable. Distance is an even bigger barrier for patients who need a specialized center for services such as Caesarean sections or anesthesia. Wait times may be long, the expense of care may be too high, and patients may not be comfortable with receiving obstetric healthcare because of cultural preferences.
In Soddo, Ethiopia, St. Luke Health Care Foundation is building the Hope Center for Women and Children at Soddo Christian Hospital. Located in the densely populated Wolaitta region in southwest Ethiopia, Soddo Christian Hospital serves communities that mostly live by subsistence farming. The new Hope Center will increase the capacity of the hospital to serve women and children and provide specialty care services that are otherwise accessible only in Addis Ababa. The center will also help train allied healthcare professionals, who are needed to provide medical care in anesthesia, radiography, and biomedical engineering.
A grant from Helmsley will support the construction of the Hope Center’s two buildings that house pediatrics, obstetrics, gynecology, and surgical suites. The center also includes space for education programs for nurse anesthetists, radiology technicians, biomedical engineers/technicians, and eventually, physician residency programs in family medicine and obstetrics-gynecology – all of which will expand the pipeline of healthcare workers.
In northern Ghana, Ghana Rural Integrated Development built Leyaata Hospital, a 50-bed facility that cares for a population of 200,000 in its catchment area and offers specialized services. Helmsley supported the purchase of medical equipment for the hospital, which launched in 2022, and is also funding the construction of a staff residential village on hospital grounds to house 80 staff members.
In the Ashanti and Bono regions of Ghana, Americares partners with local Ghanaian nonprofit Women’s Health to Wealth to improve the health of women and girls through education and preventative healthcare. The program has established school-based health clubs for adolescent girls to learn about reproductive health, with the aim of lowering school dropout rates attributed to early pregnancy. The program also provides screening for chronic disease at well-women clinics and, for healthcare workers, essential training for neonatal care resuscitation.
In Zambia, Medicines for Humanity’s Mai M’beleki (Safe Delivery for Mothers) pilot project addresses a constellation of out-of-the-hospital factors that affect maternal health outcomes. By focusing on increasing access to health services, improving health behavior through education and peer influencers, and community development for water, sanitation and hygiene (WASH) practices, the project aims to reduce maternal and child mortality rates as well as decrease rates of preventable illness.
The Helmsley-supported pilot, which began in 2020 in the Eastern Province of Zambia, had impressive results, including a 60% increase in mothers completing four prenatal visits in six months, a 75% decrease in home deliveries, a 40% decrease in child deaths, and an 80% decrease in low birth weights in the second year of implementation. The project was so successful that in 2022 Medicines for Humanity expanded the project to new areas in the Northern and Southern Provinces to build the capacity of local healthcare managers, increase the effectiveness and impact of clinic-based interventions for improved access, and to utilize and strengthen community-based interventions for long-term sustainability.
Catholic Relief Services’ Mayi na Mwana Project in Zambia also took a multidisciplinary approach to improve maternal and neonatal health, and in December 2023 reported a 50% reduction in maternal mortality rates during the first phase of the project.
To increase the number of women delivering babies in hospitals, the Mayi na Mwana Project, whose name means “mother and baby” in Chichewa, a widely spoken local language, created a rural emergency health transport system: emergency modified motor tricycles transported women who needed to reach health facilities. The project also worked with community-based volunteers to provide health education to pregnant and breastfeeding women about prenatal and postnatal care, and engaged with community leaders to promote positive maternal health behaviors.
Tens of thousands of women in Ethiopia suffer from obstetric fistula, an injury that occurs during birth, often as a result of prolonged labor without access to adequate medical care. The injury frequently results in stillbirth and causes chronic incontinence, spousal abandonment, and ostracism from communities.
Healing Hands of Joy has trained 3,000 fistula survivors as “Safe Motherhood Ambassadors” to educate pregnant women about safe delivery options, resulting in the safe delivery of more than 28,000 babies. The organization also refers obstetric fistula survivors for surgical treatment so that women can live without shame.
A new documentary short film “Power of Joy,” produced by Healing Hands of Joy and supported by Helmsley, explains the challenges and triumphs of fighting obstetric fistula, and tells the stories of two women as they rebuild their lives.
Rates of obstetric fistula had declined significantly in the Tigray region of Northern Ethiopia after 10 years of work in the area by Healing Hands of Joy. But the recent civil war in Ethiopia has sent obstetric fistula rates skyrocketing, as an estimated 120,000 women were raped during the conflict. Ethiopia has an estimated 40,000 cases of untreated obstetric fistula, and with more than 70 percent of women giving birth at home, there are about 4,000 new cases in the country each year.
In addition to educating women about delivery options, Healing Hands of Joy also trains healthcare workers, engages with male family members and influential members of the community to reduce the incidence of obstetric fistula, and collaborates with local health facilities to prevent and treat the injuries.