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Breakout session presented at at 2012 Rotary International Convention in Bangkok. Wednesday 9 May 2012
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Reducing Maternal and Newborn
Mortality through collaborative action
(CALMED model) by Future Vision
Global Grant and VTT
Allan O. JaggerDirector Zones 17 and 18a
ProgramRI Director Allan O Jagger – Moderator 5 mins
RI Past President and Trustee John Kenny Maternal and Child Health Area of Focus and VTT 10 min.
Rtn. Dr. Niranjan Bhattacharya Causes of Maternal and New born Mortality 10 min.
PDG Dr. Himansu Basu A strategic approach with VTT – CALMED model 10 min.
Past RI Director Dr. Bill Cadwallader Experience in South America 10 min.
Questions and Answers 45 min.
The Problem
A pregnant woman dies every minute
6 Children die every minute
Most of these deaths are preventable
Maternal Mortality Reduction
Strategies
A realistic solution would have to below cost, low technology, and reproducible in many countries
The strategy should incorporate sustainability and capacity building
Opportunities through Rotary's
Future Vision
Maternal and Child Health is a recognisedArea of Focus
A Vocational Training Team visit , can lead to capacity development and sustainability forthe programme
Future Vision Plan and Vocational
Training Team (VTT)
John Kenny
Trustee, The Rotary Foundation
Past President ,Rotary International
Future Vision Plan Areas
Of Focus1. Peace and Conflict Prevention /
Resolution
2. Disease Prevention and Treatment
3. Water and Sanitation
4. Maternal and Child Health
5. Basic Education and Literacy
6, Economic and Community Development
Humanitarian Programme and
Vocational Service
Vocational Service –adds impact and sustainability to a Global Grant programme
Vocational Training Team (VTT) has a bigger impact on the community than individual hands on vocational service
Vocational Training Team -
VTT1. At least one Rotarian and 3 non-Rotarian
Professional related to one area of focus
2. Training programme is driven by local needs
and priorities
3. Training the Trainer (TTT) is best for capacity
development in resource poor areas
4. VTT is best supported by a Global Grant
Vocational Training Team-VTT
Training Team of Professionals travel to impart
professional training and skills transfer to local
professionals ,generally in a specified area of Focus
Leads to sustainability and capacity building in the
area of Focus
Why Mothers and Babies Die ?
Rtn. Dr. Niranjan Bhattacharya
Vice Chairman
International Fellowship of Rotarian Doctors
Why Mothers and Babies
Die ?
Maternal Mortality Rate is a
Barometer of Women’s
Health and Social Status
Why Mothers and Babies Die ?
Medical Causes –largely preventable
Delays – 3 delay model in resource poor
countries– mostly preventable
Women’s status- lack of empowerment
Why Mothers and Babies Die ?
Medical Causes are largely preventable in resource rich countries
Why Mothers and Babies Die ?
Delays – 3 delay model specially in resource poor countries
delay in recognition by Traditional
Birth Attendant
delay in transport to an Institution
delay at the Institution–mostly
avoidable
Why Mothers and Babies Die ?
Poor Status of Women in resource poor countries
Literacy
Income
Access to health information
Nutrition
Culture and tradition
Reducing Maternal and Newborn
Mortality through collaborative action
(CALMED model)
PDG Dr. Himansu Basu
Past Chairman
RIBI International Committee
International Fellowship of Rotarian Doctors
THE PROBLEM
Reducing Maternal Mortality - MDG 5 A
(Problem in Low Resource Countries) Life time risk of maternal mortality – U.K
– 1 in 9000 ,Ethiopia – 1 in 40
The Problem – Three quarter reduction of MMR ( Maternal Mortality Rate ) by 2015 ,will not be achieved in low resource countries
But there is a Solution – Rotary’s Future Vision Plan Vocational Training Team can assist in low resource countries
THE SOLUTION
How to stop Mothers and Babies
Dying ? Improve skill Standards in Institutional
Delivery
Encourage Institutional Delivery
For women outside the Institution (50 to
70 per cent ) - Three Delay model is the
ultimate killer –reduce the delays
How to stop Mothers and Babies Dying ?
In resource poor countries ,a top down
and a bottoms up approach are needed
Collaboration with Governments,
Communities, Professionals – Rotary
acts as Facilitators for funding,
advocacy, skills transfer
THE TOOLS
CALMED -
Collaborative Action in Lowering
Maternity Encountered Deaths
A FVP Strategy of Collaborative
Action – VTT visit
CALMED MODEL
DataCollection
Emergency Obstetric Training
Village Women’s Groups
Care Pathway Mapping
CALMED MODEL
Emergency Obstetric Training
VTT using the Training the Trainer Model –sustainability and capacity development
It is important to have partnership with the Government, University and the Professions
CALMED MODEL
Care Pathway Mapping
Basic Ambulance, Cell phone,Social Obstetrics ,Mapping
CALMED MODEL
Village Women’s Groups
Saheli Centres, ASHA, Anganwadi etc. health awareness ,family spacing, empowerment and social mobilisation
CALMED MODEL
DataCollection
Signal functions, processes and some outcome indicators
CALMED MODEL
DataCollection
Emergency Obstetric Training
Village Women’s Groups
Care Pathway Mapping
The planSikkim
Mumbai
Site Visits
Meeting with the Government Health officials
Meeting with the Minister
CALMED MODEL – Rotary
shows the wayGlobal Grant VTT – Training the Trainer
Model – FVP Dist 1120,1130,3140 and 3240
Preliminary visit has confirmed the
feasibility for all components
Partnership with District Inner Wheel
Collaboration with Medical Schools,
Governments and professional
organisations (FIGO,FOGSI),GLOWM,
Drexel University
CALMED MODEL
Low cost , low technology method
VTT using the Training the Trainer
model leads to capacity building
Sustainable impact on reducing Three
delays in emergency care
Can be replicated in low resource
countries –empowering women
What can you do ?
You can join us
What can you do ?
You can join us for
- Funding through cash ,DDF
- Advocacy measures
- Professional Hands on
Assistance
Thank You !
drhbasumd@gmail.com
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