By Stefanie Weiland
Mothers and newborns in East Africa lack access to quality healthcare services and suffer from extreme rates of mortality. Every day, 830 women unnecessarily die from pregnancy and childbirth. 99 percent of those deaths occur in developing regions like East Africa. Newborns in this region also disproportionately bear the burden of inadequate access to quality healthcare. Sub-Saharan Africa suffers from one of the highest rates of under-five death in the world, with one-third of those deaths occurring during the first month of life.
International agencies agree that as many as 66 percent of newborn deaths and 74 percent of maternal deaths could be prevented through implementation of known, evidence-based best practices. Hundreds of thousands of maternal and newborn deaths could be prevented every year if health workers in developing regions were trained and equipped to put evidence-based, high-impact interventions into practice at their local health centers.
Trained and equipped health workers are key to improving healthcare outcomes for mothers and newborns. LifeNet International (LN) is one organization working to improve healthcare in East Africa, especially for mothers and babies, from the ground up through its results-oriented partnership network. East African health centers in its network receive a bundle of interventions, including in-person training for medical and management staff, pharmaceutical and equipment supply, and ongoing quality assurance.
In-person training transforms healthcare in East Africa. Evidence-based medical and management trainings are delivered directly to health workers in the network. Trainers provide health center staff with modules of training specifically geared toward reducing the mortality rates of the most vulnerable patients in the region, especially mothers and newborns. Additional modules are used to train health center staff in management best practices and are aimed at improving the financial sustainability of the center. By overlaying its operations onto existing health center operations, LN reduces the overhead costs while strengthening the quality of healthcare available in each clinic.
The LN partnership network provides a framework for rapidly and effectively deploying life-saving initiatives to reach health facilities in underserved regions. This model can make it possible for aid organizations and local governments in East Africa to collaboratively reach last-mile health facilities with packages of training in WASH, proper nutrition, management of non-communicable diseases, HIV prevention and treatment, and more. The model opens the door for life-saving and life-improving collaboration in the region.
The medical results of the model demonstrate its effectiveness. Data gathered from 73 health centers over three years reveal that health worker competency and implementation of evidence-based medical and management best practices have dramatically improved through the health centers’ partnerships with LN. Nurses improved from 44 percent adherence to maternal health best practices and 52 percent adherence to neonatal health best practices to an overall 86 percent adherence to both maternal and neonatal health best practices. These dramatic improvements are due to the implementation of practices that are proven to save and improve the lives of mothers and newborns.
Management improvement results are similarly striking. By following established trainings in pharmacy, management, and administrative best practices, management staff in the partner health centers improved from initial implementation rates of 43 to 52 percent for best management practices to 88 percent post-intervention. This improvement represents the health centers’ improved record keeping, financial management, sustainability, and increased availability of essential medicines.
A results-driven model of training and equipping local health workers is a cost-effective means of building sustainability and capacity in last-mile health centers in East Africa. These newly sustainable and high-capacity centers can, in turn, implement evidence-based best practices in management and in the medical care they offer to mothers and newborns.
Poor health systems are perpetuating extreme rates of death for mothers and newborns in East Africa. The success of health centers in the LN network demonstrates the potential of its model to transform healthcare in East Africa from the ground up. By addressing healthcare needs at the health worker and local health center level, the model places ownership of quality healthcare services back into the hands of East African nurses and managers, building capacity and ensuring long-term improvements in care for mothers and newborns in LN’s health center network.
Stefanie Weiland is the Executive Director of LifeNet International. She is a graduate of the London School of Economics, Georgetown University’s School of Foreign Service, and the Monterey Institute of International Studies, with degrees in development, management and security. Stefanie is passionate about improving healthcare systems in sub-Saharan Africa.
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