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Direct Relief Provides Midwife Kits

Direct Relief finds that

Pregnancy and childbirth are the leading causes of death and disability among women of childbearing age in developing countries. Having a skilled attendant during delivery is considered the single most critical intervention for ensuring safe motherhood.

Therefore they have initiated programs to train midwives in 12 countries (Laos among them) and supple them with kits to ensure clean, safe birthing.

The traditional midwife kits are targeted to areas where more than 50 percent of deliveries happen at home and to providers who have completed basic birth-attendant training programs.

Certified midwife kits have the same materials as a traditional midwife kit, but also include equipment such as stethoscopes, blood pressure cuffs, and instruments appropriate for births at home or in a health or maternity center.

“Laos plan to reverse region’s worst maternal mortality rates”

Here’s more on the new batch of midwives and on-going in Laos. http://www.radioaustralia.net.au/international/radio/onairhighlights/laos-plan-to-reverse-regions-worst-maternal-mortality-rates

This is an interview with: Dr Monir Islam, Director, Family Health and Research Program, World Health Organisation, South-East Asia Regional Office; Della Sherrat, Field Birth Attendant Co-ordinator, United Nations Population Fund (UNFPA), Laos; Boathip Phongsavath, Program Officer for Laos, United Nations Population Fund (UNFPA); Magdalen Drani, International Nurse-midwife Trainer, United Nations

Laos: First Midwives Trained in 22 Years

The first class of new midwives finished their training in Dec 2010 — it had been 22 years since the last midwives were trained.  Read more here: http://www.irinnews.org/Report/91339/LAOS-Midwife-training-resumes-after-20-years

There are 100 midwives nationwide who trained 20 years ago and are still working. Even if the government can continue annual training programmes, reaching an additional 160 health workers every year, it would take another decade to staff each of the country’s 825 health centres and 122 district hospitals with at least one trained midwife, said the deputy general director of health personnel at the Health Ministry, Phouthone Vangkonevilay.

And training is just part of the equation he added. “Our biggest challenges are how to equip centres with enough medical supplies and how to motivate these new workers with incentives to stay in and improve performance in remote areas.”

Hmmm…medical supplies needed.  Wonder how CBKs can contribute to the mission?

Laos: Reducing Maternal Mortality

Another informative article from Dr. Donald Marsden of FRANZCOG– this one about maternal deaths in hospitals in Laos, largely due to hemmorage. http://www.ranzcog.edu.au/publications/oandg-magazine/doc_view/436-vol-11-no-3-spring-2009-complete-issue.html

I found this part of particular interest, as I research how Clean Birth Kits (CBKs) might aid in the effort to lower maternal and infant mortality after birth. It seems that a Australian nurse, Carol Perks of Save the Children, has produced dramatic falls in maternal mortality.

A report published in 2005 shows that the comprehensive  district managed primary healthcare program introduced 12 years earlier resulted in a life expectancy increase of 12 years, a 48 per cent decrease in crude mortality rate, a 30 per cent decrease in crude birth rate, a 70 per cent decrease in infant mortality and a maternal mortality ratio of 110/100,000. The cost of the project was uS$4 million over 12 years, roughly uS$1 per person in the province per year. The reduced maternal mortality in the province was related to increasing use of contraception to space births.  Modern contraceptive use rose from 12 per cent of women in 1997 to 67 per cent in 2003. The proportion of pregnant women attending three or more antenatal visits in Sayaboury province rose from 24 per cent to 58 per cent over the same period. Obviously, even very cheap interventions can have major benefits on health indicators in these poor societies.

Citation for the report:

Perks C, Toole MJ, Phoutonsy K. District health programmes and
health sector reform: case study in the Lao Peoples Democratic
Republic. Bulletin of the World Health Organisation, 2006. 84: 132-
138.

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