Preventing Maternal Death

Worldwide, an estimated 515,000 women die each year due to pregnancy-related complications, most of them in the developing world. Millions of other women sustain serious health problems due to pregnancy and childbirth.

FHI's Work

Family Health International works to reduce maternal mortality and morbidity by:

• developing strategies to improve maternal and neonatal care at all health-system levels
• assisting governments and other health organizations to assess their maternal health needs, plan for solutions and translate their plans into action
• designing, implementing and evaluating innovative interventions
• disseminating information on maternal health to clinicians, consumers, policy-makers and the scientific community

Family Health International can help governments, donor agencies and foundations find answers for policy and programmatic questions, such as:

• how effective are interventions in reducing maternal and neonatal morbidity and mortality?
• how can facilities and their management be improved to respond better to obstetric emergencies?
• what are the costs and benefits of maternal and neonatal health interventions?
• how are family planning services and the treatment and prevention of AIDS and other sexually transmitted diseases best integrated into services for mothers and neonates?
• how can maternal health measures and methodologies be improved?

Our Experience

Family Health International works worldwide to improve reproductive health. Some examples of our maternal health work include the following:

• CONECTA, a five-year Dominican Republic-based service delivery project awarded to FHI by the U.S. Agency for International Development in 2002, focuses on reducing maternal deaths by improving the quality of hospital care. In the Dominican Republic, nearly all births (and deaths) take place in hospitals. CONECTA is working with hospitals in Santo Domingo and in hospitals in the country's southeastern region to improve the technical, managerial, and human rights aspects of obstetric care.

• FHI is a partner in Columbia University's Averting Maternal Death and Disability (AMDD) program, a Gates Foundation global initiative to improve access and quality of Emergency Obstetric Care. 

• Family Health International assisted with research in Uganda that showed a relatively inexpensive drug called nevirapine could effectively reduce HIV transmission between infected pregnant women and their infants.

• Family Health International conducted groundbreaking epidemiological studies of causes of death among women of reproductive age, quantifying the roles of pregnancy and childbirth as leading causes of death in some countries.

• Family Health International was an early leader in documenting the extent of maternal morbidity. Our multicountry survey of chronic or life-threatening morbidity associated with pregnancy and delivery gave health planners valuable insights into needed services.

• Our research has helped reduce mortality and morbidity among infants. Our work has examined the effect of maternal age and birth spacing on infant morbidity and mortality, and the impact of referral on neonatal survival.

• Family Health International's research in Brazil, Ghana, Guatamala and Congo has contributed to understanding the roles played by traditional birth attendents in providing maternal care.

• We have collaborated with the World Health Organization, the United Nations Children's Fund, the U.S. Agency for International Development, the United Kingdom's Department for International Development, Columbia University and others to evaluate the capacity of medical centers to treat obstetric emergencies.

Patricia Bailey, DrPH, has specialized in operations research and evaluation of maternal-child health programs in Latin America and Africa. Related to maternal and infant mortality, she has consulted with the United Nations Population Fund, the World Health Organization, John Snow, Inc.'s MotherCare Project, and the Maternal Neonatal Health Project at Johns Hopkins Program for International Education in Reproductive Health. She is fluent in Spanish and Portuguese.

Judith Fortney, PhD, is a recognized leader in the field of maternal health who has served as advisor and consultant to the World Health Organization, the World Bank, the United Nations Population Fund, the Asian Development Bank and the United Kingdom's Department for International Development. She has worked mainly in Asia and Africa. Dr. Fortney has published more than 90 scientific papers on reproductive health and is a fellow of the American College of Epidemiologists. She is fluent in French.

David A. Grimes, MD, vice president of biomedical affairs, is an obstetrician-gynecologist whose research has focused on fertility regulation, technology assessment, and the application of evidence-based medicine to obstetrics and gynecology. He has taught research methods to scientists in Kenya, Ethiopia, Egypt, India, and Bangladesh. Dr. Grimes has published more than 260 peer-reviewed articles and 40 textbook chapters, and he has received the Distinguished Service Award from the American College of Obstetricians and Gynecologists.

Barbara Janowitz, PhD, is an economist who heads Family Health International's health services research unit. As a widely recognized expert on the costs and cost-effectiveness of reproductive health programs, she has conducted service delivery research for the U.S. Agency for International Development, the United Nations Population Fund, the World Bank and others.

Donna McCarraher, PhD, MPH, is a senior research associate whose work has focused on program evaluation and intimate partner violence and its relationship to contraceptive use and unintended pregnancy. She has worked in several Latin American countries and in Kenya. As a former Peace Corps volunteer, she is fluent in Spanish.

Elizabeth Raymond, MD, an obstetrician-gynecologist, specializes in clinical studies involving reproductive health interventions. She has worked as a staff physician at Planned Parenthood and the Veterans Administration in North Carolina, and Indian Health Service in Arizona. She is a former research fellow at the National Institute of Child Health and Human Development.

Heidi W. Reynolds, PhD, MPH, is a senior research associate whose efforts have focused on maternal morbidity and adolescents. Other areas of interest include program evaluation and measurement issues related to data sources and indicators of maternal health. Dr. Reynolds's geographic region of experience is Africa; she is fluent in French.

Jason Smith, PhD, MPH, is a specialist in health behavior with interests in integrating qualitative and quantitative research. He has served as a consultant to several agencies, including the National Institutes of Health and National Academy of Sciences. Dr. Smith has published more than 40 articles in the areas of maternal health, family planning and HIV/AIDS.

Irina Yacobson, MD, frequently conducts contraceptive technology training. Prior to joining Family Health International, she was a practicing physician in Russia, where she conducted research and was responsible for training nurses. Dr. Yacobson is fluent in Russian and English.

For more information, please contact:

Maternal Health Center

Family Health International

P.O. Box 13950

Research Triangle Park, NC 27709 USA

E-mail: services@fhi.org

Telephone: 919-544-7040

            Fax: 919-544-7261