Since 1990, the world has seen a dramatic 44 percent reduction in maternal mortality. Despite this progress maternal mortality remains an urgent health crisis in many low and middle income countries.
Every year, 99 percent of maternal deaths from complications during pregnancy and childbirth, or within 42 days of termination of the pregnancy, occur in developing countries.1 The major causes of death include bleeding, infections, high blood pressure, complications from delivery, and unsafe abortion. Simple interventions and skilled care before, during, and after childbirth can prevent many of these deaths.
USAID’s Health Research Program seeks to reduce maternal mortality by collaborating closely with partner countries, community programs, and health facilities to apply learnings from implementation research that address critical health needs. USAID designs interventions and determines how best to implement them in a given context. The study of the actual implementation process and outcomes – implementation research — forms the core of the Program’s work.
The Health Research Program focuses on implementation research related to illness recognition and care-seeking, respectful maternity care, and performance-based incentives for quality of care. For example, the Program has conducted studies to explore recognition of illnesses and care-seeking and referral patterns for both maternal and newborn complications, ultimately leading to policy changes that improve access to and quality of services. In addition, Afghanistan, India, Kenya, Malawi, Nepal, and Nigeria integrated respectful maternity care (RMC) into national policy standards of maternal care and training of providers to decrease, and eventually eliminate, disrespect and abuse during facility-based childbirth.
Care-seeking
Delayed access to care for maternal complications during or after labor can be a major factor contributing to mortality. In order to address this issue, the Health Research Program conducted studies to explore recognition of illnesses and care-seeking patterns for both maternal and newborn complications. This work is essential to understanding barriers to recognition and care-seeking, identifying the primary decision-makers, and general care-seeking patterns and processes for both maternal and neonatal illness. Ultimately this research will lead to policy changes that improve access to and quality of services for women, leading to generalizable results with global relevance.
Respectful Maternity Care
Emerging evidence indicates that, all too often, women face humiliating and undignified conditions in health facilities. The Health Research Program seeks to decrease, and eventually eliminate, disrespect and abuse during facility-based childbirth. As a result of USAID-funded research, Afghanistan, India, Kenya, Malawi, Nepal, and Nigeria integrated respectful maternity care (RMC) into national policy standards of maternal care and training of providers. This research will lead to better defining, describing, addressing, and advocating for improved facility-based childbirth services and infrastructure.
Performance-Based Incentives for Quality of Care
Performance-Based Incentive programs in developing countries have focused on expanding access and coverage of services and addressing issues of equity. The ultimate goal of this implementation research effort is to anticipate and help program implementers address quality of care in the context of these programs. The vision of this research recognizes that some of the current performance based incentive programs do not yet address quality, but as new programs are developed or refined, quality will be essential to the sustainability of these programs which support maternal and newborn care.
To learn more about efforts to reduce maternal mortality, please visit USAID’s maternal health page.
References:
1WHO Maternal Mortality Fact Sheet, updated November 2016
