Index by author
Saving Mothers, Giving Life: A Systems Approach to Reducing Maternal and Perinatal Deaths in Uganda and Zambia
A
Achrekar, Angeli
- Open AccessSaving Mothers, Giving Life: A Systems Approach to Reducing Maternal and Perinatal Deaths in Uganda and ZambiaLois Quam, Angeli Achrekar and Robert ClayGlobal Health: Science and Practice March 2019, 7(Supplement 1):S1-S5; https://doi.org/10.9745/GHSP-D-19-00037
The 5-year public-private partnership boldly addressed maternal mortality in Uganda and Zambia using a systems approach at the district level to avoid delays in women seeking, reaching, and receiving timely, quality services. This supplement provides details on the Saving Mothers, Giving Life partnership and approach, including the model, impact, costs, and sustainability.
Asiimwe, Alice R.
- Open AccessAddressing the Second Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Reaching Appropriate Maternal Care in a Timely MannerThandiwe Ngoma, Alice R. Asiimwe, Joseph Mukasa, Susanna Binzen, Florina Serbanescu, Elizabeth G. Henry, Davidson H. Hamer, Jody R. Lori, Michelle M. Schmitz, Lawrence Marum, Brenda Picho, Anne Naggayi, Gertrude Musonda, Claudia Morrissey Conlon, Patrick Komakech, Vincent Kamara and Nancy A. Scott on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S68-S84; https://doi.org/10.9745/GHSP-D-18-00367
The Saving Mothers, Giving Life initiative employed 2 key strategies to improve the ability of pregnant women to reach maternal care: (1) increase the number of emergency obstetric and newborn care facilities, including upgrading existing health facilities, and (2) improve accessibility to such facilities by renovating and constructing maternity waiting homes, improving communication and transportation systems, and supporting community-based savings groups. These interventions can be adapted in low-resource settings to improve access to maternity care services.
- Open AccessAddressing the First Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Approaches and Results for Increasing Demand for Facility Delivery ServicesFlorina Serbanescu, Mary M. Goodwin, Susanna Binzen, Diane Morof, Alice R. Asiimwe, Laura Kelly, Christina Wakefield, Brenda Picho, Jessica Healey, Agnes Nalutaaya, Leoda Hamomba, Vincent Kamara, Gregory Opio, Frank Kaharuza, Curtis Blanton, Fredrick Luwaga, Mona Steffen and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S48-S67; https://doi.org/10.9745/GHSP-D-18-00343
The Saving Mothers, Giving Life initiative used 3 coordinated approaches to reduce maternal deaths resulting from a delay in deciding to seek health care, known as the “first delay”: (1) promoting safe motherhood messages and facility delivery using radio, theater, and community engagement; (2) encouraging birth preparedness and increasing demand for facility delivery through community outreach worker visits; and (3) providing clean delivery kits and transportation vouchers to reduce financial barriers for facility delivery. These approaches can be adapted in other low-resource settings to reduce maternal and perinatal mortality.
- Open AccessAddressing the Third Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Ensuring Adequate and Appropriate Facility-Based Maternal and Perinatal Health CareDiane Morof, Florina Serbanescu, Mary M. Goodwin, Davidson H. Hamer, Alice R. Asiimwe, Leoda Hamomba, Masuka Musumali, Susanna Binzen, Adeodata Kekitiinwa, Brenda Picho, Frank Kaharuza, Phoebe Monalisa Namukanja, Dan Murokora, Vincent Kamara, Michelle Dynes, Curtis Blanton, Agnes Nalutaaya, Fredrick Luwaga, Michelle M. Schmitz, Jonathan LaBrecque, Claudia Morrissey Conlon, Brian McCarthy, Charlan Kroelinger and Thomas Clark on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S85-S103; https://doi.org/10.9745/GHSP-D-18-00272
Saving Mothers, Giving Life used 6 strategies to address the third delay—receiving adequate health care after reaching a facility—in maternal and newborn health care. The intervention approaches can be adapted in low-resource settings to improve facility-based care and reduce maternal and perinatal mortality.
Atuyambe, Lynn
- Open AccessThe Costs and Cost-Effectiveness of a District-Strengthening Strategy to Mitigate the 3 Delays to Quality Maternal Health Care: Results From Uganda and ZambiaBenjamin Johns, Peter Hangoma, Lynn Atuyambe, Sophie Faye, Mark Tumwine, Collen Zulu, Marta Levitt, Tannia Tembo, Jessica Healey, Rui Li, Christine Mugasha, Florina Serbanescu and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S104-S122; https://doi.org/10.9745/GHSP-D-18-00429
A comprehensive district-strengthening approach to address maternal and newborn health was estimated to cost US$177 per life-year gained in Uganda and $206 per life-year gained in Zambia. The approach represents a very cost-effective health investment compared to GDP per capita.
B
Binzen, Susanna
- Open AccessAddressing the Second Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Reaching Appropriate Maternal Care in a Timely MannerThandiwe Ngoma, Alice R. Asiimwe, Joseph Mukasa, Susanna Binzen, Florina Serbanescu, Elizabeth G. Henry, Davidson H. Hamer, Jody R. Lori, Michelle M. Schmitz, Lawrence Marum, Brenda Picho, Anne Naggayi, Gertrude Musonda, Claudia Morrissey Conlon, Patrick Komakech, Vincent Kamara and Nancy A. Scott on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S68-S84; https://doi.org/10.9745/GHSP-D-18-00367
The Saving Mothers, Giving Life initiative employed 2 key strategies to improve the ability of pregnant women to reach maternal care: (1) increase the number of emergency obstetric and newborn care facilities, including upgrading existing health facilities, and (2) improve accessibility to such facilities by renovating and constructing maternity waiting homes, improving communication and transportation systems, and supporting community-based savings groups. These interventions can be adapted in low-resource settings to improve access to maternity care services.
- Open AccessAddressing the First Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Approaches and Results for Increasing Demand for Facility Delivery ServicesFlorina Serbanescu, Mary M. Goodwin, Susanna Binzen, Diane Morof, Alice R. Asiimwe, Laura Kelly, Christina Wakefield, Brenda Picho, Jessica Healey, Agnes Nalutaaya, Leoda Hamomba, Vincent Kamara, Gregory Opio, Frank Kaharuza, Curtis Blanton, Fredrick Luwaga, Mona Steffen and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S48-S67; https://doi.org/10.9745/GHSP-D-18-00343
The Saving Mothers, Giving Life initiative used 3 coordinated approaches to reduce maternal deaths resulting from a delay in deciding to seek health care, known as the “first delay”: (1) promoting safe motherhood messages and facility delivery using radio, theater, and community engagement; (2) encouraging birth preparedness and increasing demand for facility delivery through community outreach worker visits; and (3) providing clean delivery kits and transportation vouchers to reduce financial barriers for facility delivery. These approaches can be adapted in other low-resource settings to reduce maternal and perinatal mortality.
- Open AccessAddressing the Third Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Ensuring Adequate and Appropriate Facility-Based Maternal and Perinatal Health CareDiane Morof, Florina Serbanescu, Mary M. Goodwin, Davidson H. Hamer, Alice R. Asiimwe, Leoda Hamomba, Masuka Musumali, Susanna Binzen, Adeodata Kekitiinwa, Brenda Picho, Frank Kaharuza, Phoebe Monalisa Namukanja, Dan Murokora, Vincent Kamara, Michelle Dynes, Curtis Blanton, Agnes Nalutaaya, Fredrick Luwaga, Michelle M. Schmitz, Jonathan LaBrecque, Claudia Morrissey Conlon, Brian McCarthy, Charlan Kroelinger and Thomas Clark on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S85-S103; https://doi.org/10.9745/GHSP-D-18-00272
Saving Mothers, Giving Life used 6 strategies to address the third delay—receiving adequate health care after reaching a facility—in maternal and newborn health care. The intervention approaches can be adapted in low-resource settings to improve facility-based care and reduce maternal and perinatal mortality.
Blanton, Curtis
- Open AccessAddressing the First Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Approaches and Results for Increasing Demand for Facility Delivery ServicesFlorina Serbanescu, Mary M. Goodwin, Susanna Binzen, Diane Morof, Alice R. Asiimwe, Laura Kelly, Christina Wakefield, Brenda Picho, Jessica Healey, Agnes Nalutaaya, Leoda Hamomba, Vincent Kamara, Gregory Opio, Frank Kaharuza, Curtis Blanton, Fredrick Luwaga, Mona Steffen and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S48-S67; https://doi.org/10.9745/GHSP-D-18-00343
The Saving Mothers, Giving Life initiative used 3 coordinated approaches to reduce maternal deaths resulting from a delay in deciding to seek health care, known as the “first delay”: (1) promoting safe motherhood messages and facility delivery using radio, theater, and community engagement; (2) encouraging birth preparedness and increasing demand for facility delivery through community outreach worker visits; and (3) providing clean delivery kits and transportation vouchers to reduce financial barriers for facility delivery. These approaches can be adapted in other low-resource settings to reduce maternal and perinatal mortality.
- Open AccessAddressing the Third Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Ensuring Adequate and Appropriate Facility-Based Maternal and Perinatal Health CareDiane Morof, Florina Serbanescu, Mary M. Goodwin, Davidson H. Hamer, Alice R. Asiimwe, Leoda Hamomba, Masuka Musumali, Susanna Binzen, Adeodata Kekitiinwa, Brenda Picho, Frank Kaharuza, Phoebe Monalisa Namukanja, Dan Murokora, Vincent Kamara, Michelle Dynes, Curtis Blanton, Agnes Nalutaaya, Fredrick Luwaga, Michelle M. Schmitz, Jonathan LaBrecque, Claudia Morrissey Conlon, Brian McCarthy, Charlan Kroelinger and Thomas Clark on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S85-S103; https://doi.org/10.9745/GHSP-D-18-00272
Saving Mothers, Giving Life used 6 strategies to address the third delay—receiving adequate health care after reaching a facility—in maternal and newborn health care. The intervention approaches can be adapted in low-resource settings to improve facility-based care and reduce maternal and perinatal mortality.
- Open AccessImpact of the Saving Mothers, Giving Life Approach on Decreasing Maternal and Perinatal Deaths in Uganda and ZambiaFlorina Serbanescu, Thomas A. Clark, Mary M. Goodwin, Lisa J. Nelson, Mary Adetinuke Boyd, Adeodata R. Kekitiinwa, Frank Kaharuza, Brenda Picho, Diane Morof, Curtis Blanton, Maybin Mumba, Patrick Komakech, Fernando Carlosama, Michelle M. Schmitz and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S27-S47; https://doi.org/10.9745/GHSP-D-18-00428
Through district system strengthening, integrated services, and community engagement interventions, the Saving Mothers, Giving Life initiative increased emergency obstetric care coverage and access to, and demand for, improved quality of care that led to rapid declines in district maternal and perinatal mortality. Significant reductions in intrapartum stillbirth rate and maternal mortality ratios around the time of birth attest to the success of the initiative.
Boyd, Mary Adetinuke
- Open AccessImpact of the Saving Mothers, Giving Life Approach on Decreasing Maternal and Perinatal Deaths in Uganda and ZambiaFlorina Serbanescu, Thomas A. Clark, Mary M. Goodwin, Lisa J. Nelson, Mary Adetinuke Boyd, Adeodata R. Kekitiinwa, Frank Kaharuza, Brenda Picho, Diane Morof, Curtis Blanton, Maybin Mumba, Patrick Komakech, Fernando Carlosama, Michelle M. Schmitz and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S27-S47; https://doi.org/10.9745/GHSP-D-18-00428
Through district system strengthening, integrated services, and community engagement interventions, the Saving Mothers, Giving Life initiative increased emergency obstetric care coverage and access to, and demand for, improved quality of care that led to rapid declines in district maternal and perinatal mortality. Significant reductions in intrapartum stillbirth rate and maternal mortality ratios around the time of birth attest to the success of the initiative.
Byabagambi, John
- Open AccessSaving Mothers, Giving Life Approach for Strengthening Health Systems to Reduce Maternal and Newborn Deaths in 7 Scale-up Districts in Northern UgandaSimon Sensalire, Paul Isabirye, Esther Karamagi, John Byabagambi, Mirwais Rahimzai and Jacqueline Calnan on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S168-S187; https://doi.org/10.9745/GHSP-D-18-00263
Saving Mothers, Giving Life (SMGL) strengthened the health system in 7 districts in Northern Uganda through a quality improvement approach. Quality improvement teams removed barriers to delivering maternal and newborn health services and improved emergency care, reducing preventable maternal and newborn deaths in a post-conflict, low-resource setting.
C
Calnan, Jacqueline
- Open AccessSaving Mothers, Giving Life Approach for Strengthening Health Systems to Reduce Maternal and Newborn Deaths in 7 Scale-up Districts in Northern UgandaSimon Sensalire, Paul Isabirye, Esther Karamagi, John Byabagambi, Mirwais Rahimzai and Jacqueline Calnan on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S168-S187; https://doi.org/10.9745/GHSP-D-18-00263
Saving Mothers, Giving Life (SMGL) strengthened the health system in 7 districts in Northern Uganda through a quality improvement approach. Quality improvement teams removed barriers to delivering maternal and newborn health services and improved emergency care, reducing preventable maternal and newborn deaths in a post-conflict, low-resource setting.
Carlosama, Fernando
- Open AccessImpact of the Saving Mothers, Giving Life Approach on Decreasing Maternal and Perinatal Deaths in Uganda and ZambiaFlorina Serbanescu, Thomas A. Clark, Mary M. Goodwin, Lisa J. Nelson, Mary Adetinuke Boyd, Adeodata R. Kekitiinwa, Frank Kaharuza, Brenda Picho, Diane Morof, Curtis Blanton, Maybin Mumba, Patrick Komakech, Fernando Carlosama, Michelle M. Schmitz and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S27-S47; https://doi.org/10.9745/GHSP-D-18-00428
Through district system strengthening, integrated services, and community engagement interventions, the Saving Mothers, Giving Life initiative increased emergency obstetric care coverage and access to, and demand for, improved quality of care that led to rapid declines in district maternal and perinatal mortality. Significant reductions in intrapartum stillbirth rate and maternal mortality ratios around the time of birth attest to the success of the initiative.
Clark, Thomas
- Open AccessAddressing the Third Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Ensuring Adequate and Appropriate Facility-Based Maternal and Perinatal Health CareDiane Morof, Florina Serbanescu, Mary M. Goodwin, Davidson H. Hamer, Alice R. Asiimwe, Leoda Hamomba, Masuka Musumali, Susanna Binzen, Adeodata Kekitiinwa, Brenda Picho, Frank Kaharuza, Phoebe Monalisa Namukanja, Dan Murokora, Vincent Kamara, Michelle Dynes, Curtis Blanton, Agnes Nalutaaya, Fredrick Luwaga, Michelle M. Schmitz, Jonathan LaBrecque, Claudia Morrissey Conlon, Brian McCarthy, Charlan Kroelinger and Thomas Clark on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S85-S103; https://doi.org/10.9745/GHSP-D-18-00272
Saving Mothers, Giving Life used 6 strategies to address the third delay—receiving adequate health care after reaching a facility—in maternal and newborn health care. The intervention approaches can be adapted in low-resource settings to improve facility-based care and reduce maternal and perinatal mortality.
Clark, Thomas A.
- Open AccessImpact of the Saving Mothers, Giving Life Approach on Decreasing Maternal and Perinatal Deaths in Uganda and ZambiaFlorina Serbanescu, Thomas A. Clark, Mary M. Goodwin, Lisa J. Nelson, Mary Adetinuke Boyd, Adeodata R. Kekitiinwa, Frank Kaharuza, Brenda Picho, Diane Morof, Curtis Blanton, Maybin Mumba, Patrick Komakech, Fernando Carlosama, Michelle M. Schmitz and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S27-S47; https://doi.org/10.9745/GHSP-D-18-00428
Through district system strengthening, integrated services, and community engagement interventions, the Saving Mothers, Giving Life initiative increased emergency obstetric care coverage and access to, and demand for, improved quality of care that led to rapid declines in district maternal and perinatal mortality. Significant reductions in intrapartum stillbirth rate and maternal mortality ratios around the time of birth attest to the success of the initiative.
Clay, Robert
- Open AccessSaving Mothers, Giving Life: A Systems Approach to Reducing Maternal and Perinatal Deaths in Uganda and ZambiaLois Quam, Angeli Achrekar and Robert ClayGlobal Health: Science and Practice March 2019, 7(Supplement 1):S1-S5; https://doi.org/10.9745/GHSP-D-19-00037
The 5-year public-private partnership boldly addressed maternal mortality in Uganda and Zambia using a systems approach at the district level to avoid delays in women seeking, reaching, and receiving timely, quality services. This supplement provides details on the Saving Mothers, Giving Life partnership and approach, including the model, impact, costs, and sustainability.
Cohen, Robert
- Open AccessSaving Mothers, Giving Life: It Takes a System to Save a MotherClaudia Morrissey Conlon, Florina Serbanescu, Lawrence Marum, Jessica Healey, Jonathan LaBrecque, Reeti Hobson, Marta Levitt, Adeodata Kekitiinwa, Brenda Picho, Fatma Soud, Lauren Spigel, Mona Steffen, Jorge Velasco, Robert Cohen and William Weiss on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S6-S26; https://doi.org/10.9745/GHSP-D-18-00427
A multi-partner effort in Uganda and Zambia employed a districtwide health systems strengthening approach, with supply- and demand-side interventions, to address timely use of appropriate, quality maternity care. Between 2012 and 2016, maternal mortality declined by approximately 40% in both partnership-supported facilities and districts in each country. This experience has useful lessons for other low-resource settings.
Conlon, Claudia Morrissey
- Open AccessAddressing the Second Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Reaching Appropriate Maternal Care in a Timely MannerThandiwe Ngoma, Alice R. Asiimwe, Joseph Mukasa, Susanna Binzen, Florina Serbanescu, Elizabeth G. Henry, Davidson H. Hamer, Jody R. Lori, Michelle M. Schmitz, Lawrence Marum, Brenda Picho, Anne Naggayi, Gertrude Musonda, Claudia Morrissey Conlon, Patrick Komakech, Vincent Kamara and Nancy A. Scott on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S68-S84; https://doi.org/10.9745/GHSP-D-18-00367
The Saving Mothers, Giving Life initiative employed 2 key strategies to improve the ability of pregnant women to reach maternal care: (1) increase the number of emergency obstetric and newborn care facilities, including upgrading existing health facilities, and (2) improve accessibility to such facilities by renovating and constructing maternity waiting homes, improving communication and transportation systems, and supporting community-based savings groups. These interventions can be adapted in low-resource settings to improve access to maternity care services.
- Open AccessThe Costs and Cost-Effectiveness of a District-Strengthening Strategy to Mitigate the 3 Delays to Quality Maternal Health Care: Results From Uganda and ZambiaBenjamin Johns, Peter Hangoma, Lynn Atuyambe, Sophie Faye, Mark Tumwine, Collen Zulu, Marta Levitt, Tannia Tembo, Jessica Healey, Rui Li, Christine Mugasha, Florina Serbanescu and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S104-S122; https://doi.org/10.9745/GHSP-D-18-00429
A comprehensive district-strengthening approach to address maternal and newborn health was estimated to cost US$177 per life-year gained in Uganda and $206 per life-year gained in Zambia. The approach represents a very cost-effective health investment compared to GDP per capita.
- Open AccessDid Saving Mothers, Giving Life Expand Timely Access to Lifesaving Care in Uganda? A Spatial District-Level Analysis of Travel Time to Emergency Obstetric and Newborn CareMichelle M. Schmitz, Florina Serbanescu, Vincent Kamara, Joan Marie Kraft, Marc Cunningham, Gregory Opio, Patrick Komakech, Claudia Morrissey Conlon and Mary M. Goodwin on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S151-S167; https://doi.org/10.9745/GHSP-D-18-00366
A spatial analysis of facility accessibility, taking into account road networks and environmental constraints on travel, suggests that the Saving Mothers, Giving Life (SMGL) initiative increased access to emergency obstetric and neonatal care in SMGL-supported districts in Uganda. Spatial travel-time analyses can inform policy and program efforts targeting underserved populations in conjunction with the geographic distribution of maternity services.
- Open AccessAddressing the First Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Approaches and Results for Increasing Demand for Facility Delivery ServicesFlorina Serbanescu, Mary M. Goodwin, Susanna Binzen, Diane Morof, Alice R. Asiimwe, Laura Kelly, Christina Wakefield, Brenda Picho, Jessica Healey, Agnes Nalutaaya, Leoda Hamomba, Vincent Kamara, Gregory Opio, Frank Kaharuza, Curtis Blanton, Fredrick Luwaga, Mona Steffen and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S48-S67; https://doi.org/10.9745/GHSP-D-18-00343
The Saving Mothers, Giving Life initiative used 3 coordinated approaches to reduce maternal deaths resulting from a delay in deciding to seek health care, known as the “first delay”: (1) promoting safe motherhood messages and facility delivery using radio, theater, and community engagement; (2) encouraging birth preparedness and increasing demand for facility delivery through community outreach worker visits; and (3) providing clean delivery kits and transportation vouchers to reduce financial barriers for facility delivery. These approaches can be adapted in other low-resource settings to reduce maternal and perinatal mortality.
- Open AccessSustainability and Scale of the Saving Mothers, Giving Life Approach in Uganda and ZambiaJessica Healey, Claudia Morrissey Conlon, Kennedy Malama, Reeti Hobson, Frank Kaharuza, Adeodata Kekitiinwa, Marta Levitt, Davy Wadula Zulu and Lawrence Marum on behalf of the Saving Mothers,Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S188-S206; https://doi.org/10.9745/GHSP-D-18-00265
The Saving Mothers, Giving Life district health systems strengthening approach provides a sustainable model for reducing maternal mortality at scale. Lessons from the learning districts demonstrated increased efficiency in allocation of resources for maternal and newborn health, better use of strategic information, improved management capacities, and increased community engagement.
- Open AccessAddressing the Third Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Ensuring Adequate and Appropriate Facility-Based Maternal and Perinatal Health CareDiane Morof, Florina Serbanescu, Mary M. Goodwin, Davidson H. Hamer, Alice R. Asiimwe, Leoda Hamomba, Masuka Musumali, Susanna Binzen, Adeodata Kekitiinwa, Brenda Picho, Frank Kaharuza, Phoebe Monalisa Namukanja, Dan Murokora, Vincent Kamara, Michelle Dynes, Curtis Blanton, Agnes Nalutaaya, Fredrick Luwaga, Michelle M. Schmitz, Jonathan LaBrecque, Claudia Morrissey Conlon, Brian McCarthy, Charlan Kroelinger and Thomas Clark on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S85-S103; https://doi.org/10.9745/GHSP-D-18-00272
Saving Mothers, Giving Life used 6 strategies to address the third delay—receiving adequate health care after reaching a facility—in maternal and newborn health care. The intervention approaches can be adapted in low-resource settings to improve facility-based care and reduce maternal and perinatal mortality.
- Open AccessImpact of the Saving Mothers, Giving Life Approach on Decreasing Maternal and Perinatal Deaths in Uganda and ZambiaFlorina Serbanescu, Thomas A. Clark, Mary M. Goodwin, Lisa J. Nelson, Mary Adetinuke Boyd, Adeodata R. Kekitiinwa, Frank Kaharuza, Brenda Picho, Diane Morof, Curtis Blanton, Maybin Mumba, Patrick Komakech, Fernando Carlosama, Michelle M. Schmitz and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S27-S47; https://doi.org/10.9745/GHSP-D-18-00428
Through district system strengthening, integrated services, and community engagement interventions, the Saving Mothers, Giving Life initiative increased emergency obstetric care coverage and access to, and demand for, improved quality of care that led to rapid declines in district maternal and perinatal mortality. Significant reductions in intrapartum stillbirth rate and maternal mortality ratios around the time of birth attest to the success of the initiative.
- Open AccessSaving Mothers, Giving Life: It Takes a System to Save a MotherClaudia Morrissey Conlon, Florina Serbanescu, Lawrence Marum, Jessica Healey, Jonathan LaBrecque, Reeti Hobson, Marta Levitt, Adeodata Kekitiinwa, Brenda Picho, Fatma Soud, Lauren Spigel, Mona Steffen, Jorge Velasco, Robert Cohen and William Weiss on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S6-S26; https://doi.org/10.9745/GHSP-D-18-00427
A multi-partner effort in Uganda and Zambia employed a districtwide health systems strengthening approach, with supply- and demand-side interventions, to address timely use of appropriate, quality maternity care. Between 2012 and 2016, maternal mortality declined by approximately 40% in both partnership-supported facilities and districts in each country. This experience has useful lessons for other low-resource settings.
Cunningham, Marc
- Open AccessDid Saving Mothers, Giving Life Expand Timely Access to Lifesaving Care in Uganda? A Spatial District-Level Analysis of Travel Time to Emergency Obstetric and Newborn CareMichelle M. Schmitz, Florina Serbanescu, Vincent Kamara, Joan Marie Kraft, Marc Cunningham, Gregory Opio, Patrick Komakech, Claudia Morrissey Conlon and Mary M. Goodwin on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S151-S167; https://doi.org/10.9745/GHSP-D-18-00366
A spatial analysis of facility accessibility, taking into account road networks and environmental constraints on travel, suggests that the Saving Mothers, Giving Life (SMGL) initiative increased access to emergency obstetric and neonatal care in SMGL-supported districts in Uganda. Spatial travel-time analyses can inform policy and program efforts targeting underserved populations in conjunction with the geographic distribution of maternity services.
- Open AccessSaving Lives Together: A Qualitative Evaluation of the Saving Mothers, Giving Life Public-Private PartnershipAnne Palaia, Lauren Spigel, Marc Cunningham, Ann Yang, Taylor Hooks and Susan Ross on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S123-S138; https://doi.org/10.9745/GHSP-D-18-00264
Overall, the Saving Mothers, Giving Life partnership was praised as a successful model for interagency coordination. Key strengths included diversity in partner expertise, high-quality monitoring and evaluation, strong leadership, and country ownership. Uncertainty about partner roles and responsibilities, perceived power inequities between partners, bureaucratic processes, and limited Ministry of Health representation in the governance structure were some challenges that, if addressed by similar public-private partnerships under development, may improve long-term partnership success.
D
Dynes, Michelle
- Open AccessAddressing the Third Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Ensuring Adequate and Appropriate Facility-Based Maternal and Perinatal Health CareDiane Morof, Florina Serbanescu, Mary M. Goodwin, Davidson H. Hamer, Alice R. Asiimwe, Leoda Hamomba, Masuka Musumali, Susanna Binzen, Adeodata Kekitiinwa, Brenda Picho, Frank Kaharuza, Phoebe Monalisa Namukanja, Dan Murokora, Vincent Kamara, Michelle Dynes, Curtis Blanton, Agnes Nalutaaya, Fredrick Luwaga, Michelle M. Schmitz, Jonathan LaBrecque, Claudia Morrissey Conlon, Brian McCarthy, Charlan Kroelinger and Thomas Clark on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S85-S103; https://doi.org/10.9745/GHSP-D-18-00272
Saving Mothers, Giving Life used 6 strategies to address the third delay—receiving adequate health care after reaching a facility—in maternal and newborn health care. The intervention approaches can be adapted in low-resource settings to improve facility-based care and reduce maternal and perinatal mortality.
F
Faye, Sophie
- Open AccessThe Costs and Cost-Effectiveness of a District-Strengthening Strategy to Mitigate the 3 Delays to Quality Maternal Health Care: Results From Uganda and ZambiaBenjamin Johns, Peter Hangoma, Lynn Atuyambe, Sophie Faye, Mark Tumwine, Collen Zulu, Marta Levitt, Tannia Tembo, Jessica Healey, Rui Li, Christine Mugasha, Florina Serbanescu and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S104-S122; https://doi.org/10.9745/GHSP-D-18-00429
A comprehensive district-strengthening approach to address maternal and newborn health was estimated to cost US$177 per life-year gained in Uganda and $206 per life-year gained in Zambia. The approach represents a very cost-effective health investment compared to GDP per capita.
G
Goodwin, Mary M.
- Open AccessDid Saving Mothers, Giving Life Expand Timely Access to Lifesaving Care in Uganda? A Spatial District-Level Analysis of Travel Time to Emergency Obstetric and Newborn CareMichelle M. Schmitz, Florina Serbanescu, Vincent Kamara, Joan Marie Kraft, Marc Cunningham, Gregory Opio, Patrick Komakech, Claudia Morrissey Conlon and Mary M. Goodwin on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S151-S167; https://doi.org/10.9745/GHSP-D-18-00366
A spatial analysis of facility accessibility, taking into account road networks and environmental constraints on travel, suggests that the Saving Mothers, Giving Life (SMGL) initiative increased access to emergency obstetric and neonatal care in SMGL-supported districts in Uganda. Spatial travel-time analyses can inform policy and program efforts targeting underserved populations in conjunction with the geographic distribution of maternity services.
- Open AccessAddressing the First Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Approaches and Results for Increasing Demand for Facility Delivery ServicesFlorina Serbanescu, Mary M. Goodwin, Susanna Binzen, Diane Morof, Alice R. Asiimwe, Laura Kelly, Christina Wakefield, Brenda Picho, Jessica Healey, Agnes Nalutaaya, Leoda Hamomba, Vincent Kamara, Gregory Opio, Frank Kaharuza, Curtis Blanton, Fredrick Luwaga, Mona Steffen and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S48-S67; https://doi.org/10.9745/GHSP-D-18-00343
The Saving Mothers, Giving Life initiative used 3 coordinated approaches to reduce maternal deaths resulting from a delay in deciding to seek health care, known as the “first delay”: (1) promoting safe motherhood messages and facility delivery using radio, theater, and community engagement; (2) encouraging birth preparedness and increasing demand for facility delivery through community outreach worker visits; and (3) providing clean delivery kits and transportation vouchers to reduce financial barriers for facility delivery. These approaches can be adapted in other low-resource settings to reduce maternal and perinatal mortality.
- Open AccessAddressing the Third Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Ensuring Adequate and Appropriate Facility-Based Maternal and Perinatal Health CareDiane Morof, Florina Serbanescu, Mary M. Goodwin, Davidson H. Hamer, Alice R. Asiimwe, Leoda Hamomba, Masuka Musumali, Susanna Binzen, Adeodata Kekitiinwa, Brenda Picho, Frank Kaharuza, Phoebe Monalisa Namukanja, Dan Murokora, Vincent Kamara, Michelle Dynes, Curtis Blanton, Agnes Nalutaaya, Fredrick Luwaga, Michelle M. Schmitz, Jonathan LaBrecque, Claudia Morrissey Conlon, Brian McCarthy, Charlan Kroelinger and Thomas Clark on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S85-S103; https://doi.org/10.9745/GHSP-D-18-00272
Saving Mothers, Giving Life used 6 strategies to address the third delay—receiving adequate health care after reaching a facility—in maternal and newborn health care. The intervention approaches can be adapted in low-resource settings to improve facility-based care and reduce maternal and perinatal mortality.
- Open AccessImpact of the Saving Mothers, Giving Life Approach on Decreasing Maternal and Perinatal Deaths in Uganda and ZambiaFlorina Serbanescu, Thomas A. Clark, Mary M. Goodwin, Lisa J. Nelson, Mary Adetinuke Boyd, Adeodata R. Kekitiinwa, Frank Kaharuza, Brenda Picho, Diane Morof, Curtis Blanton, Maybin Mumba, Patrick Komakech, Fernando Carlosama, Michelle M. Schmitz and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S27-S47; https://doi.org/10.9745/GHSP-D-18-00428
Through district system strengthening, integrated services, and community engagement interventions, the Saving Mothers, Giving Life initiative increased emergency obstetric care coverage and access to, and demand for, improved quality of care that led to rapid declines in district maternal and perinatal mortality. Significant reductions in intrapartum stillbirth rate and maternal mortality ratios around the time of birth attest to the success of the initiative.
H
Hamer, Davidson H.
- Open AccessAddressing the Second Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Reaching Appropriate Maternal Care in a Timely MannerThandiwe Ngoma, Alice R. Asiimwe, Joseph Mukasa, Susanna Binzen, Florina Serbanescu, Elizabeth G. Henry, Davidson H. Hamer, Jody R. Lori, Michelle M. Schmitz, Lawrence Marum, Brenda Picho, Anne Naggayi, Gertrude Musonda, Claudia Morrissey Conlon, Patrick Komakech, Vincent Kamara and Nancy A. Scott on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S68-S84; https://doi.org/10.9745/GHSP-D-18-00367
The Saving Mothers, Giving Life initiative employed 2 key strategies to improve the ability of pregnant women to reach maternal care: (1) increase the number of emergency obstetric and newborn care facilities, including upgrading existing health facilities, and (2) improve accessibility to such facilities by renovating and constructing maternity waiting homes, improving communication and transportation systems, and supporting community-based savings groups. These interventions can be adapted in low-resource settings to improve access to maternity care services.
- Open AccessAddressing the Third Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Ensuring Adequate and Appropriate Facility-Based Maternal and Perinatal Health CareDiane Morof, Florina Serbanescu, Mary M. Goodwin, Davidson H. Hamer, Alice R. Asiimwe, Leoda Hamomba, Masuka Musumali, Susanna Binzen, Adeodata Kekitiinwa, Brenda Picho, Frank Kaharuza, Phoebe Monalisa Namukanja, Dan Murokora, Vincent Kamara, Michelle Dynes, Curtis Blanton, Agnes Nalutaaya, Fredrick Luwaga, Michelle M. Schmitz, Jonathan LaBrecque, Claudia Morrissey Conlon, Brian McCarthy, Charlan Kroelinger and Thomas Clark on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S85-S103; https://doi.org/10.9745/GHSP-D-18-00272
Saving Mothers, Giving Life used 6 strategies to address the third delay—receiving adequate health care after reaching a facility—in maternal and newborn health care. The intervention approaches can be adapted in low-resource settings to improve facility-based care and reduce maternal and perinatal mortality.
Hamomba, Leoda
- Open AccessCommunity Perspectives of a 3-Delays Model Intervention: A Qualitative Evaluation of Saving Mothers, Giving Life in ZambiaAlice Ngoma-Hazemba, Leoda Hamomba, Adam Silumbwe, Margarate Nzala Munakampe and Fatma Soud on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S139-S150; https://doi.org/10.9745/GHSP-D-18-00287
While the Saving Mothers, Giving Life's health systems strengthening approach reduced maternal mortality, respondents still reported significant barriers accessing maternal health services. More research is needed to understand the necessary intervention package to affect system-wide change.
- Open AccessAddressing the First Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Approaches and Results for Increasing Demand for Facility Delivery ServicesFlorina Serbanescu, Mary M. Goodwin, Susanna Binzen, Diane Morof, Alice R. Asiimwe, Laura Kelly, Christina Wakefield, Brenda Picho, Jessica Healey, Agnes Nalutaaya, Leoda Hamomba, Vincent Kamara, Gregory Opio, Frank Kaharuza, Curtis Blanton, Fredrick Luwaga, Mona Steffen and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S48-S67; https://doi.org/10.9745/GHSP-D-18-00343
The Saving Mothers, Giving Life initiative used 3 coordinated approaches to reduce maternal deaths resulting from a delay in deciding to seek health care, known as the “first delay”: (1) promoting safe motherhood messages and facility delivery using radio, theater, and community engagement; (2) encouraging birth preparedness and increasing demand for facility delivery through community outreach worker visits; and (3) providing clean delivery kits and transportation vouchers to reduce financial barriers for facility delivery. These approaches can be adapted in other low-resource settings to reduce maternal and perinatal mortality.
- Open AccessAddressing the Third Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Ensuring Adequate and Appropriate Facility-Based Maternal and Perinatal Health CareDiane Morof, Florina Serbanescu, Mary M. Goodwin, Davidson H. Hamer, Alice R. Asiimwe, Leoda Hamomba, Masuka Musumali, Susanna Binzen, Adeodata Kekitiinwa, Brenda Picho, Frank Kaharuza, Phoebe Monalisa Namukanja, Dan Murokora, Vincent Kamara, Michelle Dynes, Curtis Blanton, Agnes Nalutaaya, Fredrick Luwaga, Michelle M. Schmitz, Jonathan LaBrecque, Claudia Morrissey Conlon, Brian McCarthy, Charlan Kroelinger and Thomas Clark on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S85-S103; https://doi.org/10.9745/GHSP-D-18-00272
Saving Mothers, Giving Life used 6 strategies to address the third delay—receiving adequate health care after reaching a facility—in maternal and newborn health care. The intervention approaches can be adapted in low-resource settings to improve facility-based care and reduce maternal and perinatal mortality.
Hangoma, Peter
- Open AccessThe Costs and Cost-Effectiveness of a District-Strengthening Strategy to Mitigate the 3 Delays to Quality Maternal Health Care: Results From Uganda and ZambiaBenjamin Johns, Peter Hangoma, Lynn Atuyambe, Sophie Faye, Mark Tumwine, Collen Zulu, Marta Levitt, Tannia Tembo, Jessica Healey, Rui Li, Christine Mugasha, Florina Serbanescu and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S104-S122; https://doi.org/10.9745/GHSP-D-18-00429
A comprehensive district-strengthening approach to address maternal and newborn health was estimated to cost US$177 per life-year gained in Uganda and $206 per life-year gained in Zambia. The approach represents a very cost-effective health investment compared to GDP per capita.
Healey, Jessica
- Open AccessThe Costs and Cost-Effectiveness of a District-Strengthening Strategy to Mitigate the 3 Delays to Quality Maternal Health Care: Results From Uganda and ZambiaBenjamin Johns, Peter Hangoma, Lynn Atuyambe, Sophie Faye, Mark Tumwine, Collen Zulu, Marta Levitt, Tannia Tembo, Jessica Healey, Rui Li, Christine Mugasha, Florina Serbanescu and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S104-S122; https://doi.org/10.9745/GHSP-D-18-00429
A comprehensive district-strengthening approach to address maternal and newborn health was estimated to cost US$177 per life-year gained in Uganda and $206 per life-year gained in Zambia. The approach represents a very cost-effective health investment compared to GDP per capita.
- Open AccessAddressing the First Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Approaches and Results for Increasing Demand for Facility Delivery ServicesFlorina Serbanescu, Mary M. Goodwin, Susanna Binzen, Diane Morof, Alice R. Asiimwe, Laura Kelly, Christina Wakefield, Brenda Picho, Jessica Healey, Agnes Nalutaaya, Leoda Hamomba, Vincent Kamara, Gregory Opio, Frank Kaharuza, Curtis Blanton, Fredrick Luwaga, Mona Steffen and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S48-S67; https://doi.org/10.9745/GHSP-D-18-00343
The Saving Mothers, Giving Life initiative used 3 coordinated approaches to reduce maternal deaths resulting from a delay in deciding to seek health care, known as the “first delay”: (1) promoting safe motherhood messages and facility delivery using radio, theater, and community engagement; (2) encouraging birth preparedness and increasing demand for facility delivery through community outreach worker visits; and (3) providing clean delivery kits and transportation vouchers to reduce financial barriers for facility delivery. These approaches can be adapted in other low-resource settings to reduce maternal and perinatal mortality.
- Open AccessSustainability and Scale of the Saving Mothers, Giving Life Approach in Uganda and ZambiaJessica Healey, Claudia Morrissey Conlon, Kennedy Malama, Reeti Hobson, Frank Kaharuza, Adeodata Kekitiinwa, Marta Levitt, Davy Wadula Zulu and Lawrence Marum on behalf of the Saving Mothers,Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S188-S206; https://doi.org/10.9745/GHSP-D-18-00265
The Saving Mothers, Giving Life district health systems strengthening approach provides a sustainable model for reducing maternal mortality at scale. Lessons from the learning districts demonstrated increased efficiency in allocation of resources for maternal and newborn health, better use of strategic information, improved management capacities, and increased community engagement.
- Open AccessSaving Mothers, Giving Life: It Takes a System to Save a MotherClaudia Morrissey Conlon, Florina Serbanescu, Lawrence Marum, Jessica Healey, Jonathan LaBrecque, Reeti Hobson, Marta Levitt, Adeodata Kekitiinwa, Brenda Picho, Fatma Soud, Lauren Spigel, Mona Steffen, Jorge Velasco, Robert Cohen and William Weiss on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S6-S26; https://doi.org/10.9745/GHSP-D-18-00427
A multi-partner effort in Uganda and Zambia employed a districtwide health systems strengthening approach, with supply- and demand-side interventions, to address timely use of appropriate, quality maternity care. Between 2012 and 2016, maternal mortality declined by approximately 40% in both partnership-supported facilities and districts in each country. This experience has useful lessons for other low-resource settings.
Henry, Elizabeth G.
- Open AccessAddressing the Second Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Reaching Appropriate Maternal Care in a Timely MannerThandiwe Ngoma, Alice R. Asiimwe, Joseph Mukasa, Susanna Binzen, Florina Serbanescu, Elizabeth G. Henry, Davidson H. Hamer, Jody R. Lori, Michelle M. Schmitz, Lawrence Marum, Brenda Picho, Anne Naggayi, Gertrude Musonda, Claudia Morrissey Conlon, Patrick Komakech, Vincent Kamara and Nancy A. Scott on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S68-S84; https://doi.org/10.9745/GHSP-D-18-00367
The Saving Mothers, Giving Life initiative employed 2 key strategies to improve the ability of pregnant women to reach maternal care: (1) increase the number of emergency obstetric and newborn care facilities, including upgrading existing health facilities, and (2) improve accessibility to such facilities by renovating and constructing maternity waiting homes, improving communication and transportation systems, and supporting community-based savings groups. These interventions can be adapted in low-resource settings to improve access to maternity care services.
Hobson, Reeti
- Open AccessSustainability and Scale of the Saving Mothers, Giving Life Approach in Uganda and ZambiaJessica Healey, Claudia Morrissey Conlon, Kennedy Malama, Reeti Hobson, Frank Kaharuza, Adeodata Kekitiinwa, Marta Levitt, Davy Wadula Zulu and Lawrence Marum on behalf of the Saving Mothers,Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S188-S206; https://doi.org/10.9745/GHSP-D-18-00265
The Saving Mothers, Giving Life district health systems strengthening approach provides a sustainable model for reducing maternal mortality at scale. Lessons from the learning districts demonstrated increased efficiency in allocation of resources for maternal and newborn health, better use of strategic information, improved management capacities, and increased community engagement.
- Open AccessSaving Mothers, Giving Life: It Takes a System to Save a MotherClaudia Morrissey Conlon, Florina Serbanescu, Lawrence Marum, Jessica Healey, Jonathan LaBrecque, Reeti Hobson, Marta Levitt, Adeodata Kekitiinwa, Brenda Picho, Fatma Soud, Lauren Spigel, Mona Steffen, Jorge Velasco, Robert Cohen and William Weiss on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S6-S26; https://doi.org/10.9745/GHSP-D-18-00427
A multi-partner effort in Uganda and Zambia employed a districtwide health systems strengthening approach, with supply- and demand-side interventions, to address timely use of appropriate, quality maternity care. Between 2012 and 2016, maternal mortality declined by approximately 40% in both partnership-supported facilities and districts in each country. This experience has useful lessons for other low-resource settings.
Hooks, Taylor
- Open AccessSaving Lives Together: A Qualitative Evaluation of the Saving Mothers, Giving Life Public-Private PartnershipAnne Palaia, Lauren Spigel, Marc Cunningham, Ann Yang, Taylor Hooks and Susan Ross on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S123-S138; https://doi.org/10.9745/GHSP-D-18-00264
Overall, the Saving Mothers, Giving Life partnership was praised as a successful model for interagency coordination. Key strengths included diversity in partner expertise, high-quality monitoring and evaluation, strong leadership, and country ownership. Uncertainty about partner roles and responsibilities, perceived power inequities between partners, bureaucratic processes, and limited Ministry of Health representation in the governance structure were some challenges that, if addressed by similar public-private partnerships under development, may improve long-term partnership success.
I
Isabirye, Paul
- Open AccessSaving Mothers, Giving Life Approach for Strengthening Health Systems to Reduce Maternal and Newborn Deaths in 7 Scale-up Districts in Northern UgandaSimon Sensalire, Paul Isabirye, Esther Karamagi, John Byabagambi, Mirwais Rahimzai and Jacqueline Calnan on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S168-S187; https://doi.org/10.9745/GHSP-D-18-00263
Saving Mothers, Giving Life (SMGL) strengthened the health system in 7 districts in Northern Uganda through a quality improvement approach. Quality improvement teams removed barriers to delivering maternal and newborn health services and improved emergency care, reducing preventable maternal and newborn deaths in a post-conflict, low-resource setting.
J
Johns, Benjamin
- Open AccessThe Costs and Cost-Effectiveness of a District-Strengthening Strategy to Mitigate the 3 Delays to Quality Maternal Health Care: Results From Uganda and ZambiaBenjamin Johns, Peter Hangoma, Lynn Atuyambe, Sophie Faye, Mark Tumwine, Collen Zulu, Marta Levitt, Tannia Tembo, Jessica Healey, Rui Li, Christine Mugasha, Florina Serbanescu and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S104-S122; https://doi.org/10.9745/GHSP-D-18-00429
A comprehensive district-strengthening approach to address maternal and newborn health was estimated to cost US$177 per life-year gained in Uganda and $206 per life-year gained in Zambia. The approach represents a very cost-effective health investment compared to GDP per capita.
K
Kaharuza, Frank
- Open AccessAddressing the First Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Approaches and Results for Increasing Demand for Facility Delivery ServicesFlorina Serbanescu, Mary M. Goodwin, Susanna Binzen, Diane Morof, Alice R. Asiimwe, Laura Kelly, Christina Wakefield, Brenda Picho, Jessica Healey, Agnes Nalutaaya, Leoda Hamomba, Vincent Kamara, Gregory Opio, Frank Kaharuza, Curtis Blanton, Fredrick Luwaga, Mona Steffen and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S48-S67; https://doi.org/10.9745/GHSP-D-18-00343
The Saving Mothers, Giving Life initiative used 3 coordinated approaches to reduce maternal deaths resulting from a delay in deciding to seek health care, known as the “first delay”: (1) promoting safe motherhood messages and facility delivery using radio, theater, and community engagement; (2) encouraging birth preparedness and increasing demand for facility delivery through community outreach worker visits; and (3) providing clean delivery kits and transportation vouchers to reduce financial barriers for facility delivery. These approaches can be adapted in other low-resource settings to reduce maternal and perinatal mortality.
- Open AccessSustainability and Scale of the Saving Mothers, Giving Life Approach in Uganda and ZambiaJessica Healey, Claudia Morrissey Conlon, Kennedy Malama, Reeti Hobson, Frank Kaharuza, Adeodata Kekitiinwa, Marta Levitt, Davy Wadula Zulu and Lawrence Marum on behalf of the Saving Mothers,Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S188-S206; https://doi.org/10.9745/GHSP-D-18-00265
The Saving Mothers, Giving Life district health systems strengthening approach provides a sustainable model for reducing maternal mortality at scale. Lessons from the learning districts demonstrated increased efficiency in allocation of resources for maternal and newborn health, better use of strategic information, improved management capacities, and increased community engagement.
- Open AccessAddressing the Third Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Ensuring Adequate and Appropriate Facility-Based Maternal and Perinatal Health CareDiane Morof, Florina Serbanescu, Mary M. Goodwin, Davidson H. Hamer, Alice R. Asiimwe, Leoda Hamomba, Masuka Musumali, Susanna Binzen, Adeodata Kekitiinwa, Brenda Picho, Frank Kaharuza, Phoebe Monalisa Namukanja, Dan Murokora, Vincent Kamara, Michelle Dynes, Curtis Blanton, Agnes Nalutaaya, Fredrick Luwaga, Michelle M. Schmitz, Jonathan LaBrecque, Claudia Morrissey Conlon, Brian McCarthy, Charlan Kroelinger and Thomas Clark on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S85-S103; https://doi.org/10.9745/GHSP-D-18-00272
Saving Mothers, Giving Life used 6 strategies to address the third delay—receiving adequate health care after reaching a facility—in maternal and newborn health care. The intervention approaches can be adapted in low-resource settings to improve facility-based care and reduce maternal and perinatal mortality.
- Open AccessImpact of the Saving Mothers, Giving Life Approach on Decreasing Maternal and Perinatal Deaths in Uganda and ZambiaFlorina Serbanescu, Thomas A. Clark, Mary M. Goodwin, Lisa J. Nelson, Mary Adetinuke Boyd, Adeodata R. Kekitiinwa, Frank Kaharuza, Brenda Picho, Diane Morof, Curtis Blanton, Maybin Mumba, Patrick Komakech, Fernando Carlosama, Michelle M. Schmitz and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S27-S47; https://doi.org/10.9745/GHSP-D-18-00428
Through district system strengthening, integrated services, and community engagement interventions, the Saving Mothers, Giving Life initiative increased emergency obstetric care coverage and access to, and demand for, improved quality of care that led to rapid declines in district maternal and perinatal mortality. Significant reductions in intrapartum stillbirth rate and maternal mortality ratios around the time of birth attest to the success of the initiative.
Kamara, Vincent
- Open AccessAddressing the Second Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Reaching Appropriate Maternal Care in a Timely MannerThandiwe Ngoma, Alice R. Asiimwe, Joseph Mukasa, Susanna Binzen, Florina Serbanescu, Elizabeth G. Henry, Davidson H. Hamer, Jody R. Lori, Michelle M. Schmitz, Lawrence Marum, Brenda Picho, Anne Naggayi, Gertrude Musonda, Claudia Morrissey Conlon, Patrick Komakech, Vincent Kamara and Nancy A. Scott on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S68-S84; https://doi.org/10.9745/GHSP-D-18-00367
The Saving Mothers, Giving Life initiative employed 2 key strategies to improve the ability of pregnant women to reach maternal care: (1) increase the number of emergency obstetric and newborn care facilities, including upgrading existing health facilities, and (2) improve accessibility to such facilities by renovating and constructing maternity waiting homes, improving communication and transportation systems, and supporting community-based savings groups. These interventions can be adapted in low-resource settings to improve access to maternity care services.
- Open AccessDid Saving Mothers, Giving Life Expand Timely Access to Lifesaving Care in Uganda? A Spatial District-Level Analysis of Travel Time to Emergency Obstetric and Newborn CareMichelle M. Schmitz, Florina Serbanescu, Vincent Kamara, Joan Marie Kraft, Marc Cunningham, Gregory Opio, Patrick Komakech, Claudia Morrissey Conlon and Mary M. Goodwin on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S151-S167; https://doi.org/10.9745/GHSP-D-18-00366
A spatial analysis of facility accessibility, taking into account road networks and environmental constraints on travel, suggests that the Saving Mothers, Giving Life (SMGL) initiative increased access to emergency obstetric and neonatal care in SMGL-supported districts in Uganda. Spatial travel-time analyses can inform policy and program efforts targeting underserved populations in conjunction with the geographic distribution of maternity services.
- Open AccessAddressing the First Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Approaches and Results for Increasing Demand for Facility Delivery ServicesFlorina Serbanescu, Mary M. Goodwin, Susanna Binzen, Diane Morof, Alice R. Asiimwe, Laura Kelly, Christina Wakefield, Brenda Picho, Jessica Healey, Agnes Nalutaaya, Leoda Hamomba, Vincent Kamara, Gregory Opio, Frank Kaharuza, Curtis Blanton, Fredrick Luwaga, Mona Steffen and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S48-S67; https://doi.org/10.9745/GHSP-D-18-00343
The Saving Mothers, Giving Life initiative used 3 coordinated approaches to reduce maternal deaths resulting from a delay in deciding to seek health care, known as the “first delay”: (1) promoting safe motherhood messages and facility delivery using radio, theater, and community engagement; (2) encouraging birth preparedness and increasing demand for facility delivery through community outreach worker visits; and (3) providing clean delivery kits and transportation vouchers to reduce financial barriers for facility delivery. These approaches can be adapted in other low-resource settings to reduce maternal and perinatal mortality.
- Open AccessAddressing the Third Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Ensuring Adequate and Appropriate Facility-Based Maternal and Perinatal Health CareDiane Morof, Florina Serbanescu, Mary M. Goodwin, Davidson H. Hamer, Alice R. Asiimwe, Leoda Hamomba, Masuka Musumali, Susanna Binzen, Adeodata Kekitiinwa, Brenda Picho, Frank Kaharuza, Phoebe Monalisa Namukanja, Dan Murokora, Vincent Kamara, Michelle Dynes, Curtis Blanton, Agnes Nalutaaya, Fredrick Luwaga, Michelle M. Schmitz, Jonathan LaBrecque, Claudia Morrissey Conlon, Brian McCarthy, Charlan Kroelinger and Thomas Clark on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S85-S103; https://doi.org/10.9745/GHSP-D-18-00272
Saving Mothers, Giving Life used 6 strategies to address the third delay—receiving adequate health care after reaching a facility—in maternal and newborn health care. The intervention approaches can be adapted in low-resource settings to improve facility-based care and reduce maternal and perinatal mortality.
Karamagi, Esther
- Open AccessSaving Mothers, Giving Life Approach for Strengthening Health Systems to Reduce Maternal and Newborn Deaths in 7 Scale-up Districts in Northern UgandaSimon Sensalire, Paul Isabirye, Esther Karamagi, John Byabagambi, Mirwais Rahimzai and Jacqueline Calnan on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S168-S187; https://doi.org/10.9745/GHSP-D-18-00263
Saving Mothers, Giving Life (SMGL) strengthened the health system in 7 districts in Northern Uganda through a quality improvement approach. Quality improvement teams removed barriers to delivering maternal and newborn health services and improved emergency care, reducing preventable maternal and newborn deaths in a post-conflict, low-resource setting.
Kekitiinwa, Adeodata
- Open AccessSustainability and Scale of the Saving Mothers, Giving Life Approach in Uganda and ZambiaJessica Healey, Claudia Morrissey Conlon, Kennedy Malama, Reeti Hobson, Frank Kaharuza, Adeodata Kekitiinwa, Marta Levitt, Davy Wadula Zulu and Lawrence Marum on behalf of the Saving Mothers,Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S188-S206; https://doi.org/10.9745/GHSP-D-18-00265
The Saving Mothers, Giving Life district health systems strengthening approach provides a sustainable model for reducing maternal mortality at scale. Lessons from the learning districts demonstrated increased efficiency in allocation of resources for maternal and newborn health, better use of strategic information, improved management capacities, and increased community engagement.
- Open AccessAddressing the Third Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Ensuring Adequate and Appropriate Facility-Based Maternal and Perinatal Health CareDiane Morof, Florina Serbanescu, Mary M. Goodwin, Davidson H. Hamer, Alice R. Asiimwe, Leoda Hamomba, Masuka Musumali, Susanna Binzen, Adeodata Kekitiinwa, Brenda Picho, Frank Kaharuza, Phoebe Monalisa Namukanja, Dan Murokora, Vincent Kamara, Michelle Dynes, Curtis Blanton, Agnes Nalutaaya, Fredrick Luwaga, Michelle M. Schmitz, Jonathan LaBrecque, Claudia Morrissey Conlon, Brian McCarthy, Charlan Kroelinger and Thomas Clark on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S85-S103; https://doi.org/10.9745/GHSP-D-18-00272
Saving Mothers, Giving Life used 6 strategies to address the third delay—receiving adequate health care after reaching a facility—in maternal and newborn health care. The intervention approaches can be adapted in low-resource settings to improve facility-based care and reduce maternal and perinatal mortality.
- Open AccessSaving Mothers, Giving Life: It Takes a System to Save a MotherClaudia Morrissey Conlon, Florina Serbanescu, Lawrence Marum, Jessica Healey, Jonathan LaBrecque, Reeti Hobson, Marta Levitt, Adeodata Kekitiinwa, Brenda Picho, Fatma Soud, Lauren Spigel, Mona Steffen, Jorge Velasco, Robert Cohen and William Weiss on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S6-S26; https://doi.org/10.9745/GHSP-D-18-00427
A multi-partner effort in Uganda and Zambia employed a districtwide health systems strengthening approach, with supply- and demand-side interventions, to address timely use of appropriate, quality maternity care. Between 2012 and 2016, maternal mortality declined by approximately 40% in both partnership-supported facilities and districts in each country. This experience has useful lessons for other low-resource settings.
Kekitiinwa, Adeodata R.
- Open AccessImpact of the Saving Mothers, Giving Life Approach on Decreasing Maternal and Perinatal Deaths in Uganda and ZambiaFlorina Serbanescu, Thomas A. Clark, Mary M. Goodwin, Lisa J. Nelson, Mary Adetinuke Boyd, Adeodata R. Kekitiinwa, Frank Kaharuza, Brenda Picho, Diane Morof, Curtis Blanton, Maybin Mumba, Patrick Komakech, Fernando Carlosama, Michelle M. Schmitz and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S27-S47; https://doi.org/10.9745/GHSP-D-18-00428
Through district system strengthening, integrated services, and community engagement interventions, the Saving Mothers, Giving Life initiative increased emergency obstetric care coverage and access to, and demand for, improved quality of care that led to rapid declines in district maternal and perinatal mortality. Significant reductions in intrapartum stillbirth rate and maternal mortality ratios around the time of birth attest to the success of the initiative.
Kelly, Laura
- Open AccessAddressing the First Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Approaches and Results for Increasing Demand for Facility Delivery ServicesFlorina Serbanescu, Mary M. Goodwin, Susanna Binzen, Diane Morof, Alice R. Asiimwe, Laura Kelly, Christina Wakefield, Brenda Picho, Jessica Healey, Agnes Nalutaaya, Leoda Hamomba, Vincent Kamara, Gregory Opio, Frank Kaharuza, Curtis Blanton, Fredrick Luwaga, Mona Steffen and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S48-S67; https://doi.org/10.9745/GHSP-D-18-00343
The Saving Mothers, Giving Life initiative used 3 coordinated approaches to reduce maternal deaths resulting from a delay in deciding to seek health care, known as the “first delay”: (1) promoting safe motherhood messages and facility delivery using radio, theater, and community engagement; (2) encouraging birth preparedness and increasing demand for facility delivery through community outreach worker visits; and (3) providing clean delivery kits and transportation vouchers to reduce financial barriers for facility delivery. These approaches can be adapted in other low-resource settings to reduce maternal and perinatal mortality.
Komakech, Patrick
- Open AccessAddressing the Second Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Reaching Appropriate Maternal Care in a Timely MannerThandiwe Ngoma, Alice R. Asiimwe, Joseph Mukasa, Susanna Binzen, Florina Serbanescu, Elizabeth G. Henry, Davidson H. Hamer, Jody R. Lori, Michelle M. Schmitz, Lawrence Marum, Brenda Picho, Anne Naggayi, Gertrude Musonda, Claudia Morrissey Conlon, Patrick Komakech, Vincent Kamara and Nancy A. Scott on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S68-S84; https://doi.org/10.9745/GHSP-D-18-00367
The Saving Mothers, Giving Life initiative employed 2 key strategies to improve the ability of pregnant women to reach maternal care: (1) increase the number of emergency obstetric and newborn care facilities, including upgrading existing health facilities, and (2) improve accessibility to such facilities by renovating and constructing maternity waiting homes, improving communication and transportation systems, and supporting community-based savings groups. These interventions can be adapted in low-resource settings to improve access to maternity care services.
- Open AccessDid Saving Mothers, Giving Life Expand Timely Access to Lifesaving Care in Uganda? A Spatial District-Level Analysis of Travel Time to Emergency Obstetric and Newborn CareMichelle M. Schmitz, Florina Serbanescu, Vincent Kamara, Joan Marie Kraft, Marc Cunningham, Gregory Opio, Patrick Komakech, Claudia Morrissey Conlon and Mary M. Goodwin on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S151-S167; https://doi.org/10.9745/GHSP-D-18-00366
A spatial analysis of facility accessibility, taking into account road networks and environmental constraints on travel, suggests that the Saving Mothers, Giving Life (SMGL) initiative increased access to emergency obstetric and neonatal care in SMGL-supported districts in Uganda. Spatial travel-time analyses can inform policy and program efforts targeting underserved populations in conjunction with the geographic distribution of maternity services.
- Open AccessImpact of the Saving Mothers, Giving Life Approach on Decreasing Maternal and Perinatal Deaths in Uganda and ZambiaFlorina Serbanescu, Thomas A. Clark, Mary M. Goodwin, Lisa J. Nelson, Mary Adetinuke Boyd, Adeodata R. Kekitiinwa, Frank Kaharuza, Brenda Picho, Diane Morof, Curtis Blanton, Maybin Mumba, Patrick Komakech, Fernando Carlosama, Michelle M. Schmitz and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S27-S47; https://doi.org/10.9745/GHSP-D-18-00428
Through district system strengthening, integrated services, and community engagement interventions, the Saving Mothers, Giving Life initiative increased emergency obstetric care coverage and access to, and demand for, improved quality of care that led to rapid declines in district maternal and perinatal mortality. Significant reductions in intrapartum stillbirth rate and maternal mortality ratios around the time of birth attest to the success of the initiative.
Kraft, Joan Marie
- Open AccessDid Saving Mothers, Giving Life Expand Timely Access to Lifesaving Care in Uganda? A Spatial District-Level Analysis of Travel Time to Emergency Obstetric and Newborn CareMichelle M. Schmitz, Florina Serbanescu, Vincent Kamara, Joan Marie Kraft, Marc Cunningham, Gregory Opio, Patrick Komakech, Claudia Morrissey Conlon and Mary M. Goodwin on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S151-S167; https://doi.org/10.9745/GHSP-D-18-00366
A spatial analysis of facility accessibility, taking into account road networks and environmental constraints on travel, suggests that the Saving Mothers, Giving Life (SMGL) initiative increased access to emergency obstetric and neonatal care in SMGL-supported districts in Uganda. Spatial travel-time analyses can inform policy and program efforts targeting underserved populations in conjunction with the geographic distribution of maternity services.
Kroelinger, Charlan
- Open AccessAddressing the Third Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Ensuring Adequate and Appropriate Facility-Based Maternal and Perinatal Health CareDiane Morof, Florina Serbanescu, Mary M. Goodwin, Davidson H. Hamer, Alice R. Asiimwe, Leoda Hamomba, Masuka Musumali, Susanna Binzen, Adeodata Kekitiinwa, Brenda Picho, Frank Kaharuza, Phoebe Monalisa Namukanja, Dan Murokora, Vincent Kamara, Michelle Dynes, Curtis Blanton, Agnes Nalutaaya, Fredrick Luwaga, Michelle M. Schmitz, Jonathan LaBrecque, Claudia Morrissey Conlon, Brian McCarthy, Charlan Kroelinger and Thomas Clark on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S85-S103; https://doi.org/10.9745/GHSP-D-18-00272
Saving Mothers, Giving Life used 6 strategies to address the third delay—receiving adequate health care after reaching a facility—in maternal and newborn health care. The intervention approaches can be adapted in low-resource settings to improve facility-based care and reduce maternal and perinatal mortality.
L
LaBrecque, Jonathan
- Open AccessAddressing the Third Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Ensuring Adequate and Appropriate Facility-Based Maternal and Perinatal Health CareDiane Morof, Florina Serbanescu, Mary M. Goodwin, Davidson H. Hamer, Alice R. Asiimwe, Leoda Hamomba, Masuka Musumali, Susanna Binzen, Adeodata Kekitiinwa, Brenda Picho, Frank Kaharuza, Phoebe Monalisa Namukanja, Dan Murokora, Vincent Kamara, Michelle Dynes, Curtis Blanton, Agnes Nalutaaya, Fredrick Luwaga, Michelle M. Schmitz, Jonathan LaBrecque, Claudia Morrissey Conlon, Brian McCarthy, Charlan Kroelinger and Thomas Clark on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S85-S103; https://doi.org/10.9745/GHSP-D-18-00272
Saving Mothers, Giving Life used 6 strategies to address the third delay—receiving adequate health care after reaching a facility—in maternal and newborn health care. The intervention approaches can be adapted in low-resource settings to improve facility-based care and reduce maternal and perinatal mortality.
- Open AccessSaving Mothers, Giving Life: It Takes a System to Save a MotherClaudia Morrissey Conlon, Florina Serbanescu, Lawrence Marum, Jessica Healey, Jonathan LaBrecque, Reeti Hobson, Marta Levitt, Adeodata Kekitiinwa, Brenda Picho, Fatma Soud, Lauren Spigel, Mona Steffen, Jorge Velasco, Robert Cohen and William Weiss on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S6-S26; https://doi.org/10.9745/GHSP-D-18-00427
A multi-partner effort in Uganda and Zambia employed a districtwide health systems strengthening approach, with supply- and demand-side interventions, to address timely use of appropriate, quality maternity care. Between 2012 and 2016, maternal mortality declined by approximately 40% in both partnership-supported facilities and districts in each country. This experience has useful lessons for other low-resource settings.
Levitt, Marta
- Open AccessThe Costs and Cost-Effectiveness of a District-Strengthening Strategy to Mitigate the 3 Delays to Quality Maternal Health Care: Results From Uganda and ZambiaBenjamin Johns, Peter Hangoma, Lynn Atuyambe, Sophie Faye, Mark Tumwine, Collen Zulu, Marta Levitt, Tannia Tembo, Jessica Healey, Rui Li, Christine Mugasha, Florina Serbanescu and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S104-S122; https://doi.org/10.9745/GHSP-D-18-00429
A comprehensive district-strengthening approach to address maternal and newborn health was estimated to cost US$177 per life-year gained in Uganda and $206 per life-year gained in Zambia. The approach represents a very cost-effective health investment compared to GDP per capita.
- Open AccessSustainability and Scale of the Saving Mothers, Giving Life Approach in Uganda and ZambiaJessica Healey, Claudia Morrissey Conlon, Kennedy Malama, Reeti Hobson, Frank Kaharuza, Adeodata Kekitiinwa, Marta Levitt, Davy Wadula Zulu and Lawrence Marum on behalf of the Saving Mothers,Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S188-S206; https://doi.org/10.9745/GHSP-D-18-00265
The Saving Mothers, Giving Life district health systems strengthening approach provides a sustainable model for reducing maternal mortality at scale. Lessons from the learning districts demonstrated increased efficiency in allocation of resources for maternal and newborn health, better use of strategic information, improved management capacities, and increased community engagement.
- Open AccessSaving Mothers, Giving Life: It Takes a System to Save a MotherClaudia Morrissey Conlon, Florina Serbanescu, Lawrence Marum, Jessica Healey, Jonathan LaBrecque, Reeti Hobson, Marta Levitt, Adeodata Kekitiinwa, Brenda Picho, Fatma Soud, Lauren Spigel, Mona Steffen, Jorge Velasco, Robert Cohen and William Weiss on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S6-S26; https://doi.org/10.9745/GHSP-D-18-00427
A multi-partner effort in Uganda and Zambia employed a districtwide health systems strengthening approach, with supply- and demand-side interventions, to address timely use of appropriate, quality maternity care. Between 2012 and 2016, maternal mortality declined by approximately 40% in both partnership-supported facilities and districts in each country. This experience has useful lessons for other low-resource settings.
Li, Rui
- Open AccessThe Costs and Cost-Effectiveness of a District-Strengthening Strategy to Mitigate the 3 Delays to Quality Maternal Health Care: Results From Uganda and ZambiaBenjamin Johns, Peter Hangoma, Lynn Atuyambe, Sophie Faye, Mark Tumwine, Collen Zulu, Marta Levitt, Tannia Tembo, Jessica Healey, Rui Li, Christine Mugasha, Florina Serbanescu and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S104-S122; https://doi.org/10.9745/GHSP-D-18-00429
A comprehensive district-strengthening approach to address maternal and newborn health was estimated to cost US$177 per life-year gained in Uganda and $206 per life-year gained in Zambia. The approach represents a very cost-effective health investment compared to GDP per capita.
Lori, Jody R.
- Open AccessAddressing the Second Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Reaching Appropriate Maternal Care in a Timely MannerThandiwe Ngoma, Alice R. Asiimwe, Joseph Mukasa, Susanna Binzen, Florina Serbanescu, Elizabeth G. Henry, Davidson H. Hamer, Jody R. Lori, Michelle M. Schmitz, Lawrence Marum, Brenda Picho, Anne Naggayi, Gertrude Musonda, Claudia Morrissey Conlon, Patrick Komakech, Vincent Kamara and Nancy A. Scott on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S68-S84; https://doi.org/10.9745/GHSP-D-18-00367
The Saving Mothers, Giving Life initiative employed 2 key strategies to improve the ability of pregnant women to reach maternal care: (1) increase the number of emergency obstetric and newborn care facilities, including upgrading existing health facilities, and (2) improve accessibility to such facilities by renovating and constructing maternity waiting homes, improving communication and transportation systems, and supporting community-based savings groups. These interventions can be adapted in low-resource settings to improve access to maternity care services.
Luwaga, Fredrick
- Open AccessAddressing the First Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Approaches and Results for Increasing Demand for Facility Delivery ServicesFlorina Serbanescu, Mary M. Goodwin, Susanna Binzen, Diane Morof, Alice R. Asiimwe, Laura Kelly, Christina Wakefield, Brenda Picho, Jessica Healey, Agnes Nalutaaya, Leoda Hamomba, Vincent Kamara, Gregory Opio, Frank Kaharuza, Curtis Blanton, Fredrick Luwaga, Mona Steffen and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S48-S67; https://doi.org/10.9745/GHSP-D-18-00343
The Saving Mothers, Giving Life initiative used 3 coordinated approaches to reduce maternal deaths resulting from a delay in deciding to seek health care, known as the “first delay”: (1) promoting safe motherhood messages and facility delivery using radio, theater, and community engagement; (2) encouraging birth preparedness and increasing demand for facility delivery through community outreach worker visits; and (3) providing clean delivery kits and transportation vouchers to reduce financial barriers for facility delivery. These approaches can be adapted in other low-resource settings to reduce maternal and perinatal mortality.
- Open AccessAddressing the Third Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Ensuring Adequate and Appropriate Facility-Based Maternal and Perinatal Health CareDiane Morof, Florina Serbanescu, Mary M. Goodwin, Davidson H. Hamer, Alice R. Asiimwe, Leoda Hamomba, Masuka Musumali, Susanna Binzen, Adeodata Kekitiinwa, Brenda Picho, Frank Kaharuza, Phoebe Monalisa Namukanja, Dan Murokora, Vincent Kamara, Michelle Dynes, Curtis Blanton, Agnes Nalutaaya, Fredrick Luwaga, Michelle M. Schmitz, Jonathan LaBrecque, Claudia Morrissey Conlon, Brian McCarthy, Charlan Kroelinger and Thomas Clark on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S85-S103; https://doi.org/10.9745/GHSP-D-18-00272
Saving Mothers, Giving Life used 6 strategies to address the third delay—receiving adequate health care after reaching a facility—in maternal and newborn health care. The intervention approaches can be adapted in low-resource settings to improve facility-based care and reduce maternal and perinatal mortality.
M
Malama, Kennedy
- Open AccessSustainability and Scale of the Saving Mothers, Giving Life Approach in Uganda and ZambiaJessica Healey, Claudia Morrissey Conlon, Kennedy Malama, Reeti Hobson, Frank Kaharuza, Adeodata Kekitiinwa, Marta Levitt, Davy Wadula Zulu and Lawrence Marum on behalf of the Saving Mothers,Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S188-S206; https://doi.org/10.9745/GHSP-D-18-00265
The Saving Mothers, Giving Life district health systems strengthening approach provides a sustainable model for reducing maternal mortality at scale. Lessons from the learning districts demonstrated increased efficiency in allocation of resources for maternal and newborn health, better use of strategic information, improved management capacities, and increased community engagement.
Marum, Lawrence
- Open AccessAddressing the Second Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Reaching Appropriate Maternal Care in a Timely MannerThandiwe Ngoma, Alice R. Asiimwe, Joseph Mukasa, Susanna Binzen, Florina Serbanescu, Elizabeth G. Henry, Davidson H. Hamer, Jody R. Lori, Michelle M. Schmitz, Lawrence Marum, Brenda Picho, Anne Naggayi, Gertrude Musonda, Claudia Morrissey Conlon, Patrick Komakech, Vincent Kamara and Nancy A. Scott on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S68-S84; https://doi.org/10.9745/GHSP-D-18-00367
The Saving Mothers, Giving Life initiative employed 2 key strategies to improve the ability of pregnant women to reach maternal care: (1) increase the number of emergency obstetric and newborn care facilities, including upgrading existing health facilities, and (2) improve accessibility to such facilities by renovating and constructing maternity waiting homes, improving communication and transportation systems, and supporting community-based savings groups. These interventions can be adapted in low-resource settings to improve access to maternity care services.
- Open AccessSustainability and Scale of the Saving Mothers, Giving Life Approach in Uganda and ZambiaJessica Healey, Claudia Morrissey Conlon, Kennedy Malama, Reeti Hobson, Frank Kaharuza, Adeodata Kekitiinwa, Marta Levitt, Davy Wadula Zulu and Lawrence Marum on behalf of the Saving Mothers,Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S188-S206; https://doi.org/10.9745/GHSP-D-18-00265
The Saving Mothers, Giving Life district health systems strengthening approach provides a sustainable model for reducing maternal mortality at scale. Lessons from the learning districts demonstrated increased efficiency in allocation of resources for maternal and newborn health, better use of strategic information, improved management capacities, and increased community engagement.
- Open AccessSaving Mothers, Giving Life: It Takes a System to Save a MotherClaudia Morrissey Conlon, Florina Serbanescu, Lawrence Marum, Jessica Healey, Jonathan LaBrecque, Reeti Hobson, Marta Levitt, Adeodata Kekitiinwa, Brenda Picho, Fatma Soud, Lauren Spigel, Mona Steffen, Jorge Velasco, Robert Cohen and William Weiss on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S6-S26; https://doi.org/10.9745/GHSP-D-18-00427
A multi-partner effort in Uganda and Zambia employed a districtwide health systems strengthening approach, with supply- and demand-side interventions, to address timely use of appropriate, quality maternity care. Between 2012 and 2016, maternal mortality declined by approximately 40% in both partnership-supported facilities and districts in each country. This experience has useful lessons for other low-resource settings.
McCarthy, Brian
- Open AccessAddressing the Third Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Ensuring Adequate and Appropriate Facility-Based Maternal and Perinatal Health CareDiane Morof, Florina Serbanescu, Mary M. Goodwin, Davidson H. Hamer, Alice R. Asiimwe, Leoda Hamomba, Masuka Musumali, Susanna Binzen, Adeodata Kekitiinwa, Brenda Picho, Frank Kaharuza, Phoebe Monalisa Namukanja, Dan Murokora, Vincent Kamara, Michelle Dynes, Curtis Blanton, Agnes Nalutaaya, Fredrick Luwaga, Michelle M. Schmitz, Jonathan LaBrecque, Claudia Morrissey Conlon, Brian McCarthy, Charlan Kroelinger and Thomas Clark on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S85-S103; https://doi.org/10.9745/GHSP-D-18-00272
Saving Mothers, Giving Life used 6 strategies to address the third delay—receiving adequate health care after reaching a facility—in maternal and newborn health care. The intervention approaches can be adapted in low-resource settings to improve facility-based care and reduce maternal and perinatal mortality.
Morof, Diane
- Open AccessAddressing the First Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Approaches and Results for Increasing Demand for Facility Delivery ServicesFlorina Serbanescu, Mary M. Goodwin, Susanna Binzen, Diane Morof, Alice R. Asiimwe, Laura Kelly, Christina Wakefield, Brenda Picho, Jessica Healey, Agnes Nalutaaya, Leoda Hamomba, Vincent Kamara, Gregory Opio, Frank Kaharuza, Curtis Blanton, Fredrick Luwaga, Mona Steffen and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S48-S67; https://doi.org/10.9745/GHSP-D-18-00343
The Saving Mothers, Giving Life initiative used 3 coordinated approaches to reduce maternal deaths resulting from a delay in deciding to seek health care, known as the “first delay”: (1) promoting safe motherhood messages and facility delivery using radio, theater, and community engagement; (2) encouraging birth preparedness and increasing demand for facility delivery through community outreach worker visits; and (3) providing clean delivery kits and transportation vouchers to reduce financial barriers for facility delivery. These approaches can be adapted in other low-resource settings to reduce maternal and perinatal mortality.
- Open AccessAddressing the Third Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Ensuring Adequate and Appropriate Facility-Based Maternal and Perinatal Health CareDiane Morof, Florina Serbanescu, Mary M. Goodwin, Davidson H. Hamer, Alice R. Asiimwe, Leoda Hamomba, Masuka Musumali, Susanna Binzen, Adeodata Kekitiinwa, Brenda Picho, Frank Kaharuza, Phoebe Monalisa Namukanja, Dan Murokora, Vincent Kamara, Michelle Dynes, Curtis Blanton, Agnes Nalutaaya, Fredrick Luwaga, Michelle M. Schmitz, Jonathan LaBrecque, Claudia Morrissey Conlon, Brian McCarthy, Charlan Kroelinger and Thomas Clark on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S85-S103; https://doi.org/10.9745/GHSP-D-18-00272
Saving Mothers, Giving Life used 6 strategies to address the third delay—receiving adequate health care after reaching a facility—in maternal and newborn health care. The intervention approaches can be adapted in low-resource settings to improve facility-based care and reduce maternal and perinatal mortality.
- Open AccessImpact of the Saving Mothers, Giving Life Approach on Decreasing Maternal and Perinatal Deaths in Uganda and ZambiaFlorina Serbanescu, Thomas A. Clark, Mary M. Goodwin, Lisa J. Nelson, Mary Adetinuke Boyd, Adeodata R. Kekitiinwa, Frank Kaharuza, Brenda Picho, Diane Morof, Curtis Blanton, Maybin Mumba, Patrick Komakech, Fernando Carlosama, Michelle M. Schmitz and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S27-S47; https://doi.org/10.9745/GHSP-D-18-00428
Through district system strengthening, integrated services, and community engagement interventions, the Saving Mothers, Giving Life initiative increased emergency obstetric care coverage and access to, and demand for, improved quality of care that led to rapid declines in district maternal and perinatal mortality. Significant reductions in intrapartum stillbirth rate and maternal mortality ratios around the time of birth attest to the success of the initiative.
Mugasha, Christine
- Open AccessThe Costs and Cost-Effectiveness of a District-Strengthening Strategy to Mitigate the 3 Delays to Quality Maternal Health Care: Results From Uganda and ZambiaBenjamin Johns, Peter Hangoma, Lynn Atuyambe, Sophie Faye, Mark Tumwine, Collen Zulu, Marta Levitt, Tannia Tembo, Jessica Healey, Rui Li, Christine Mugasha, Florina Serbanescu and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S104-S122; https://doi.org/10.9745/GHSP-D-18-00429
A comprehensive district-strengthening approach to address maternal and newborn health was estimated to cost US$177 per life-year gained in Uganda and $206 per life-year gained in Zambia. The approach represents a very cost-effective health investment compared to GDP per capita.
Mukasa, Joseph
- Open AccessAddressing the Second Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Reaching Appropriate Maternal Care in a Timely MannerThandiwe Ngoma, Alice R. Asiimwe, Joseph Mukasa, Susanna Binzen, Florina Serbanescu, Elizabeth G. Henry, Davidson H. Hamer, Jody R. Lori, Michelle M. Schmitz, Lawrence Marum, Brenda Picho, Anne Naggayi, Gertrude Musonda, Claudia Morrissey Conlon, Patrick Komakech, Vincent Kamara and Nancy A. Scott on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S68-S84; https://doi.org/10.9745/GHSP-D-18-00367
The Saving Mothers, Giving Life initiative employed 2 key strategies to improve the ability of pregnant women to reach maternal care: (1) increase the number of emergency obstetric and newborn care facilities, including upgrading existing health facilities, and (2) improve accessibility to such facilities by renovating and constructing maternity waiting homes, improving communication and transportation systems, and supporting community-based savings groups. These interventions can be adapted in low-resource settings to improve access to maternity care services.
Mumba, Maybin
- Open AccessImpact of the Saving Mothers, Giving Life Approach on Decreasing Maternal and Perinatal Deaths in Uganda and ZambiaFlorina Serbanescu, Thomas A. Clark, Mary M. Goodwin, Lisa J. Nelson, Mary Adetinuke Boyd, Adeodata R. Kekitiinwa, Frank Kaharuza, Brenda Picho, Diane Morof, Curtis Blanton, Maybin Mumba, Patrick Komakech, Fernando Carlosama, Michelle M. Schmitz and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S27-S47; https://doi.org/10.9745/GHSP-D-18-00428
Through district system strengthening, integrated services, and community engagement interventions, the Saving Mothers, Giving Life initiative increased emergency obstetric care coverage and access to, and demand for, improved quality of care that led to rapid declines in district maternal and perinatal mortality. Significant reductions in intrapartum stillbirth rate and maternal mortality ratios around the time of birth attest to the success of the initiative.
Munakampe, Margarate Nzala
- Open AccessCommunity Perspectives of a 3-Delays Model Intervention: A Qualitative Evaluation of Saving Mothers, Giving Life in ZambiaAlice Ngoma-Hazemba, Leoda Hamomba, Adam Silumbwe, Margarate Nzala Munakampe and Fatma Soud on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S139-S150; https://doi.org/10.9745/GHSP-D-18-00287
While the Saving Mothers, Giving Life's health systems strengthening approach reduced maternal mortality, respondents still reported significant barriers accessing maternal health services. More research is needed to understand the necessary intervention package to affect system-wide change.
Murokora, Dan
- Open AccessAddressing the Third Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Ensuring Adequate and Appropriate Facility-Based Maternal and Perinatal Health CareDiane Morof, Florina Serbanescu, Mary M. Goodwin, Davidson H. Hamer, Alice R. Asiimwe, Leoda Hamomba, Masuka Musumali, Susanna Binzen, Adeodata Kekitiinwa, Brenda Picho, Frank Kaharuza, Phoebe Monalisa Namukanja, Dan Murokora, Vincent Kamara, Michelle Dynes, Curtis Blanton, Agnes Nalutaaya, Fredrick Luwaga, Michelle M. Schmitz, Jonathan LaBrecque, Claudia Morrissey Conlon, Brian McCarthy, Charlan Kroelinger and Thomas Clark on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S85-S103; https://doi.org/10.9745/GHSP-D-18-00272
Saving Mothers, Giving Life used 6 strategies to address the third delay—receiving adequate health care after reaching a facility—in maternal and newborn health care. The intervention approaches can be adapted in low-resource settings to improve facility-based care and reduce maternal and perinatal mortality.
Musonda, Gertrude
- Open AccessAddressing the Second Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Reaching Appropriate Maternal Care in a Timely MannerThandiwe Ngoma, Alice R. Asiimwe, Joseph Mukasa, Susanna Binzen, Florina Serbanescu, Elizabeth G. Henry, Davidson H. Hamer, Jody R. Lori, Michelle M. Schmitz, Lawrence Marum, Brenda Picho, Anne Naggayi, Gertrude Musonda, Claudia Morrissey Conlon, Patrick Komakech, Vincent Kamara and Nancy A. Scott on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S68-S84; https://doi.org/10.9745/GHSP-D-18-00367
The Saving Mothers, Giving Life initiative employed 2 key strategies to improve the ability of pregnant women to reach maternal care: (1) increase the number of emergency obstetric and newborn care facilities, including upgrading existing health facilities, and (2) improve accessibility to such facilities by renovating and constructing maternity waiting homes, improving communication and transportation systems, and supporting community-based savings groups. These interventions can be adapted in low-resource settings to improve access to maternity care services.
Musumali, Masuka
- Open AccessAddressing the Third Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Ensuring Adequate and Appropriate Facility-Based Maternal and Perinatal Health CareDiane Morof, Florina Serbanescu, Mary M. Goodwin, Davidson H. Hamer, Alice R. Asiimwe, Leoda Hamomba, Masuka Musumali, Susanna Binzen, Adeodata Kekitiinwa, Brenda Picho, Frank Kaharuza, Phoebe Monalisa Namukanja, Dan Murokora, Vincent Kamara, Michelle Dynes, Curtis Blanton, Agnes Nalutaaya, Fredrick Luwaga, Michelle M. Schmitz, Jonathan LaBrecque, Claudia Morrissey Conlon, Brian McCarthy, Charlan Kroelinger and Thomas Clark on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S85-S103; https://doi.org/10.9745/GHSP-D-18-00272
Saving Mothers, Giving Life used 6 strategies to address the third delay—receiving adequate health care after reaching a facility—in maternal and newborn health care. The intervention approaches can be adapted in low-resource settings to improve facility-based care and reduce maternal and perinatal mortality.
N
Naggayi, Anne
- Open AccessAddressing the Second Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Reaching Appropriate Maternal Care in a Timely MannerThandiwe Ngoma, Alice R. Asiimwe, Joseph Mukasa, Susanna Binzen, Florina Serbanescu, Elizabeth G. Henry, Davidson H. Hamer, Jody R. Lori, Michelle M. Schmitz, Lawrence Marum, Brenda Picho, Anne Naggayi, Gertrude Musonda, Claudia Morrissey Conlon, Patrick Komakech, Vincent Kamara and Nancy A. Scott on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S68-S84; https://doi.org/10.9745/GHSP-D-18-00367
The Saving Mothers, Giving Life initiative employed 2 key strategies to improve the ability of pregnant women to reach maternal care: (1) increase the number of emergency obstetric and newborn care facilities, including upgrading existing health facilities, and (2) improve accessibility to such facilities by renovating and constructing maternity waiting homes, improving communication and transportation systems, and supporting community-based savings groups. These interventions can be adapted in low-resource settings to improve access to maternity care services.
Nalutaaya, Agnes
- Open AccessAddressing the First Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Approaches and Results for Increasing Demand for Facility Delivery ServicesFlorina Serbanescu, Mary M. Goodwin, Susanna Binzen, Diane Morof, Alice R. Asiimwe, Laura Kelly, Christina Wakefield, Brenda Picho, Jessica Healey, Agnes Nalutaaya, Leoda Hamomba, Vincent Kamara, Gregory Opio, Frank Kaharuza, Curtis Blanton, Fredrick Luwaga, Mona Steffen and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S48-S67; https://doi.org/10.9745/GHSP-D-18-00343
The Saving Mothers, Giving Life initiative used 3 coordinated approaches to reduce maternal deaths resulting from a delay in deciding to seek health care, known as the “first delay”: (1) promoting safe motherhood messages and facility delivery using radio, theater, and community engagement; (2) encouraging birth preparedness and increasing demand for facility delivery through community outreach worker visits; and (3) providing clean delivery kits and transportation vouchers to reduce financial barriers for facility delivery. These approaches can be adapted in other low-resource settings to reduce maternal and perinatal mortality.
- Open AccessAddressing the Third Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Ensuring Adequate and Appropriate Facility-Based Maternal and Perinatal Health CareDiane Morof, Florina Serbanescu, Mary M. Goodwin, Davidson H. Hamer, Alice R. Asiimwe, Leoda Hamomba, Masuka Musumali, Susanna Binzen, Adeodata Kekitiinwa, Brenda Picho, Frank Kaharuza, Phoebe Monalisa Namukanja, Dan Murokora, Vincent Kamara, Michelle Dynes, Curtis Blanton, Agnes Nalutaaya, Fredrick Luwaga, Michelle M. Schmitz, Jonathan LaBrecque, Claudia Morrissey Conlon, Brian McCarthy, Charlan Kroelinger and Thomas Clark on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S85-S103; https://doi.org/10.9745/GHSP-D-18-00272
Saving Mothers, Giving Life used 6 strategies to address the third delay—receiving adequate health care after reaching a facility—in maternal and newborn health care. The intervention approaches can be adapted in low-resource settings to improve facility-based care and reduce maternal and perinatal mortality.
Namukanja, Phoebe Monalisa
- Open AccessAddressing the Third Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Ensuring Adequate and Appropriate Facility-Based Maternal and Perinatal Health CareDiane Morof, Florina Serbanescu, Mary M. Goodwin, Davidson H. Hamer, Alice R. Asiimwe, Leoda Hamomba, Masuka Musumali, Susanna Binzen, Adeodata Kekitiinwa, Brenda Picho, Frank Kaharuza, Phoebe Monalisa Namukanja, Dan Murokora, Vincent Kamara, Michelle Dynes, Curtis Blanton, Agnes Nalutaaya, Fredrick Luwaga, Michelle M. Schmitz, Jonathan LaBrecque, Claudia Morrissey Conlon, Brian McCarthy, Charlan Kroelinger and Thomas Clark on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S85-S103; https://doi.org/10.9745/GHSP-D-18-00272
Saving Mothers, Giving Life used 6 strategies to address the third delay—receiving adequate health care after reaching a facility—in maternal and newborn health care. The intervention approaches can be adapted in low-resource settings to improve facility-based care and reduce maternal and perinatal mortality.
Nelson, Lisa J.
- Open AccessImpact of the Saving Mothers, Giving Life Approach on Decreasing Maternal and Perinatal Deaths in Uganda and ZambiaFlorina Serbanescu, Thomas A. Clark, Mary M. Goodwin, Lisa J. Nelson, Mary Adetinuke Boyd, Adeodata R. Kekitiinwa, Frank Kaharuza, Brenda Picho, Diane Morof, Curtis Blanton, Maybin Mumba, Patrick Komakech, Fernando Carlosama, Michelle M. Schmitz and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S27-S47; https://doi.org/10.9745/GHSP-D-18-00428
Through district system strengthening, integrated services, and community engagement interventions, the Saving Mothers, Giving Life initiative increased emergency obstetric care coverage and access to, and demand for, improved quality of care that led to rapid declines in district maternal and perinatal mortality. Significant reductions in intrapartum stillbirth rate and maternal mortality ratios around the time of birth attest to the success of the initiative.
Ngoma, Thandiwe
- Open AccessAddressing the Second Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Reaching Appropriate Maternal Care in a Timely MannerThandiwe Ngoma, Alice R. Asiimwe, Joseph Mukasa, Susanna Binzen, Florina Serbanescu, Elizabeth G. Henry, Davidson H. Hamer, Jody R. Lori, Michelle M. Schmitz, Lawrence Marum, Brenda Picho, Anne Naggayi, Gertrude Musonda, Claudia Morrissey Conlon, Patrick Komakech, Vincent Kamara and Nancy A. Scott on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S68-S84; https://doi.org/10.9745/GHSP-D-18-00367
The Saving Mothers, Giving Life initiative employed 2 key strategies to improve the ability of pregnant women to reach maternal care: (1) increase the number of emergency obstetric and newborn care facilities, including upgrading existing health facilities, and (2) improve accessibility to such facilities by renovating and constructing maternity waiting homes, improving communication and transportation systems, and supporting community-based savings groups. These interventions can be adapted in low-resource settings to improve access to maternity care services.
Ngoma-Hazemba, Alice
- Open AccessCommunity Perspectives of a 3-Delays Model Intervention: A Qualitative Evaluation of Saving Mothers, Giving Life in ZambiaAlice Ngoma-Hazemba, Leoda Hamomba, Adam Silumbwe, Margarate Nzala Munakampe and Fatma Soud on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S139-S150; https://doi.org/10.9745/GHSP-D-18-00287
While the Saving Mothers, Giving Life's health systems strengthening approach reduced maternal mortality, respondents still reported significant barriers accessing maternal health services. More research is needed to understand the necessary intervention package to affect system-wide change.
O
Opio, Gregory
- Open AccessDid Saving Mothers, Giving Life Expand Timely Access to Lifesaving Care in Uganda? A Spatial District-Level Analysis of Travel Time to Emergency Obstetric and Newborn CareMichelle M. Schmitz, Florina Serbanescu, Vincent Kamara, Joan Marie Kraft, Marc Cunningham, Gregory Opio, Patrick Komakech, Claudia Morrissey Conlon and Mary M. Goodwin on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S151-S167; https://doi.org/10.9745/GHSP-D-18-00366
A spatial analysis of facility accessibility, taking into account road networks and environmental constraints on travel, suggests that the Saving Mothers, Giving Life (SMGL) initiative increased access to emergency obstetric and neonatal care in SMGL-supported districts in Uganda. Spatial travel-time analyses can inform policy and program efforts targeting underserved populations in conjunction with the geographic distribution of maternity services.
- Open AccessAddressing the First Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Approaches and Results for Increasing Demand for Facility Delivery ServicesFlorina Serbanescu, Mary M. Goodwin, Susanna Binzen, Diane Morof, Alice R. Asiimwe, Laura Kelly, Christina Wakefield, Brenda Picho, Jessica Healey, Agnes Nalutaaya, Leoda Hamomba, Vincent Kamara, Gregory Opio, Frank Kaharuza, Curtis Blanton, Fredrick Luwaga, Mona Steffen and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S48-S67; https://doi.org/10.9745/GHSP-D-18-00343
The Saving Mothers, Giving Life initiative used 3 coordinated approaches to reduce maternal deaths resulting from a delay in deciding to seek health care, known as the “first delay”: (1) promoting safe motherhood messages and facility delivery using radio, theater, and community engagement; (2) encouraging birth preparedness and increasing demand for facility delivery through community outreach worker visits; and (3) providing clean delivery kits and transportation vouchers to reduce financial barriers for facility delivery. These approaches can be adapted in other low-resource settings to reduce maternal and perinatal mortality.
P
Palaia, Anne
- Open AccessSaving Lives Together: A Qualitative Evaluation of the Saving Mothers, Giving Life Public-Private PartnershipAnne Palaia, Lauren Spigel, Marc Cunningham, Ann Yang, Taylor Hooks and Susan Ross on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S123-S138; https://doi.org/10.9745/GHSP-D-18-00264
Overall, the Saving Mothers, Giving Life partnership was praised as a successful model for interagency coordination. Key strengths included diversity in partner expertise, high-quality monitoring and evaluation, strong leadership, and country ownership. Uncertainty about partner roles and responsibilities, perceived power inequities between partners, bureaucratic processes, and limited Ministry of Health representation in the governance structure were some challenges that, if addressed by similar public-private partnerships under development, may improve long-term partnership success.
Picho, Brenda
- Open AccessAddressing the Second Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Reaching Appropriate Maternal Care in a Timely MannerThandiwe Ngoma, Alice R. Asiimwe, Joseph Mukasa, Susanna Binzen, Florina Serbanescu, Elizabeth G. Henry, Davidson H. Hamer, Jody R. Lori, Michelle M. Schmitz, Lawrence Marum, Brenda Picho, Anne Naggayi, Gertrude Musonda, Claudia Morrissey Conlon, Patrick Komakech, Vincent Kamara and Nancy A. Scott on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S68-S84; https://doi.org/10.9745/GHSP-D-18-00367
The Saving Mothers, Giving Life initiative employed 2 key strategies to improve the ability of pregnant women to reach maternal care: (1) increase the number of emergency obstetric and newborn care facilities, including upgrading existing health facilities, and (2) improve accessibility to such facilities by renovating and constructing maternity waiting homes, improving communication and transportation systems, and supporting community-based savings groups. These interventions can be adapted in low-resource settings to improve access to maternity care services.
- Open AccessAddressing the First Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Approaches and Results for Increasing Demand for Facility Delivery ServicesFlorina Serbanescu, Mary M. Goodwin, Susanna Binzen, Diane Morof, Alice R. Asiimwe, Laura Kelly, Christina Wakefield, Brenda Picho, Jessica Healey, Agnes Nalutaaya, Leoda Hamomba, Vincent Kamara, Gregory Opio, Frank Kaharuza, Curtis Blanton, Fredrick Luwaga, Mona Steffen and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S48-S67; https://doi.org/10.9745/GHSP-D-18-00343
The Saving Mothers, Giving Life initiative used 3 coordinated approaches to reduce maternal deaths resulting from a delay in deciding to seek health care, known as the “first delay”: (1) promoting safe motherhood messages and facility delivery using radio, theater, and community engagement; (2) encouraging birth preparedness and increasing demand for facility delivery through community outreach worker visits; and (3) providing clean delivery kits and transportation vouchers to reduce financial barriers for facility delivery. These approaches can be adapted in other low-resource settings to reduce maternal and perinatal mortality.
- Open AccessAddressing the Third Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Ensuring Adequate and Appropriate Facility-Based Maternal and Perinatal Health CareDiane Morof, Florina Serbanescu, Mary M. Goodwin, Davidson H. Hamer, Alice R. Asiimwe, Leoda Hamomba, Masuka Musumali, Susanna Binzen, Adeodata Kekitiinwa, Brenda Picho, Frank Kaharuza, Phoebe Monalisa Namukanja, Dan Murokora, Vincent Kamara, Michelle Dynes, Curtis Blanton, Agnes Nalutaaya, Fredrick Luwaga, Michelle M. Schmitz, Jonathan LaBrecque, Claudia Morrissey Conlon, Brian McCarthy, Charlan Kroelinger and Thomas Clark on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S85-S103; https://doi.org/10.9745/GHSP-D-18-00272
Saving Mothers, Giving Life used 6 strategies to address the third delay—receiving adequate health care after reaching a facility—in maternal and newborn health care. The intervention approaches can be adapted in low-resource settings to improve facility-based care and reduce maternal and perinatal mortality.
- Open AccessImpact of the Saving Mothers, Giving Life Approach on Decreasing Maternal and Perinatal Deaths in Uganda and ZambiaFlorina Serbanescu, Thomas A. Clark, Mary M. Goodwin, Lisa J. Nelson, Mary Adetinuke Boyd, Adeodata R. Kekitiinwa, Frank Kaharuza, Brenda Picho, Diane Morof, Curtis Blanton, Maybin Mumba, Patrick Komakech, Fernando Carlosama, Michelle M. Schmitz and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S27-S47; https://doi.org/10.9745/GHSP-D-18-00428
Through district system strengthening, integrated services, and community engagement interventions, the Saving Mothers, Giving Life initiative increased emergency obstetric care coverage and access to, and demand for, improved quality of care that led to rapid declines in district maternal and perinatal mortality. Significant reductions in intrapartum stillbirth rate and maternal mortality ratios around the time of birth attest to the success of the initiative.
- Open AccessSaving Mothers, Giving Life: It Takes a System to Save a MotherClaudia Morrissey Conlon, Florina Serbanescu, Lawrence Marum, Jessica Healey, Jonathan LaBrecque, Reeti Hobson, Marta Levitt, Adeodata Kekitiinwa, Brenda Picho, Fatma Soud, Lauren Spigel, Mona Steffen, Jorge Velasco, Robert Cohen and William Weiss on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S6-S26; https://doi.org/10.9745/GHSP-D-18-00427
A multi-partner effort in Uganda and Zambia employed a districtwide health systems strengthening approach, with supply- and demand-side interventions, to address timely use of appropriate, quality maternity care. Between 2012 and 2016, maternal mortality declined by approximately 40% in both partnership-supported facilities and districts in each country. This experience has useful lessons for other low-resource settings.
Q
Quam, Lois
- Open AccessSaving Mothers, Giving Life: A Systems Approach to Reducing Maternal and Perinatal Deaths in Uganda and ZambiaLois Quam, Angeli Achrekar and Robert ClayGlobal Health: Science and Practice March 2019, 7(Supplement 1):S1-S5; https://doi.org/10.9745/GHSP-D-19-00037
The 5-year public-private partnership boldly addressed maternal mortality in Uganda and Zambia using a systems approach at the district level to avoid delays in women seeking, reaching, and receiving timely, quality services. This supplement provides details on the Saving Mothers, Giving Life partnership and approach, including the model, impact, costs, and sustainability.
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Rahimzai, Mirwais
- Open AccessSaving Mothers, Giving Life Approach for Strengthening Health Systems to Reduce Maternal and Newborn Deaths in 7 Scale-up Districts in Northern UgandaSimon Sensalire, Paul Isabirye, Esther Karamagi, John Byabagambi, Mirwais Rahimzai and Jacqueline Calnan on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S168-S187; https://doi.org/10.9745/GHSP-D-18-00263
Saving Mothers, Giving Life (SMGL) strengthened the health system in 7 districts in Northern Uganda through a quality improvement approach. Quality improvement teams removed barriers to delivering maternal and newborn health services and improved emergency care, reducing preventable maternal and newborn deaths in a post-conflict, low-resource setting.
Ross, Susan
- Open AccessSaving Lives Together: A Qualitative Evaluation of the Saving Mothers, Giving Life Public-Private PartnershipAnne Palaia, Lauren Spigel, Marc Cunningham, Ann Yang, Taylor Hooks and Susan Ross on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S123-S138; https://doi.org/10.9745/GHSP-D-18-00264
Overall, the Saving Mothers, Giving Life partnership was praised as a successful model for interagency coordination. Key strengths included diversity in partner expertise, high-quality monitoring and evaluation, strong leadership, and country ownership. Uncertainty about partner roles and responsibilities, perceived power inequities between partners, bureaucratic processes, and limited Ministry of Health representation in the governance structure were some challenges that, if addressed by similar public-private partnerships under development, may improve long-term partnership success.
S
Schmitz, Michelle M.
- Open AccessAddressing the Second Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Reaching Appropriate Maternal Care in a Timely MannerThandiwe Ngoma, Alice R. Asiimwe, Joseph Mukasa, Susanna Binzen, Florina Serbanescu, Elizabeth G. Henry, Davidson H. Hamer, Jody R. Lori, Michelle M. Schmitz, Lawrence Marum, Brenda Picho, Anne Naggayi, Gertrude Musonda, Claudia Morrissey Conlon, Patrick Komakech, Vincent Kamara and Nancy A. Scott on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S68-S84; https://doi.org/10.9745/GHSP-D-18-00367
The Saving Mothers, Giving Life initiative employed 2 key strategies to improve the ability of pregnant women to reach maternal care: (1) increase the number of emergency obstetric and newborn care facilities, including upgrading existing health facilities, and (2) improve accessibility to such facilities by renovating and constructing maternity waiting homes, improving communication and transportation systems, and supporting community-based savings groups. These interventions can be adapted in low-resource settings to improve access to maternity care services.
- Open AccessDid Saving Mothers, Giving Life Expand Timely Access to Lifesaving Care in Uganda? A Spatial District-Level Analysis of Travel Time to Emergency Obstetric and Newborn CareMichelle M. Schmitz, Florina Serbanescu, Vincent Kamara, Joan Marie Kraft, Marc Cunningham, Gregory Opio, Patrick Komakech, Claudia Morrissey Conlon and Mary M. Goodwin on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S151-S167; https://doi.org/10.9745/GHSP-D-18-00366
A spatial analysis of facility accessibility, taking into account road networks and environmental constraints on travel, suggests that the Saving Mothers, Giving Life (SMGL) initiative increased access to emergency obstetric and neonatal care in SMGL-supported districts in Uganda. Spatial travel-time analyses can inform policy and program efforts targeting underserved populations in conjunction with the geographic distribution of maternity services.
- Open AccessAddressing the Third Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Ensuring Adequate and Appropriate Facility-Based Maternal and Perinatal Health CareDiane Morof, Florina Serbanescu, Mary M. Goodwin, Davidson H. Hamer, Alice R. Asiimwe, Leoda Hamomba, Masuka Musumali, Susanna Binzen, Adeodata Kekitiinwa, Brenda Picho, Frank Kaharuza, Phoebe Monalisa Namukanja, Dan Murokora, Vincent Kamara, Michelle Dynes, Curtis Blanton, Agnes Nalutaaya, Fredrick Luwaga, Michelle M. Schmitz, Jonathan LaBrecque, Claudia Morrissey Conlon, Brian McCarthy, Charlan Kroelinger and Thomas Clark on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S85-S103; https://doi.org/10.9745/GHSP-D-18-00272
Saving Mothers, Giving Life used 6 strategies to address the third delay—receiving adequate health care after reaching a facility—in maternal and newborn health care. The intervention approaches can be adapted in low-resource settings to improve facility-based care and reduce maternal and perinatal mortality.
- Open AccessImpact of the Saving Mothers, Giving Life Approach on Decreasing Maternal and Perinatal Deaths in Uganda and ZambiaFlorina Serbanescu, Thomas A. Clark, Mary M. Goodwin, Lisa J. Nelson, Mary Adetinuke Boyd, Adeodata R. Kekitiinwa, Frank Kaharuza, Brenda Picho, Diane Morof, Curtis Blanton, Maybin Mumba, Patrick Komakech, Fernando Carlosama, Michelle M. Schmitz and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S27-S47; https://doi.org/10.9745/GHSP-D-18-00428
Through district system strengthening, integrated services, and community engagement interventions, the Saving Mothers, Giving Life initiative increased emergency obstetric care coverage and access to, and demand for, improved quality of care that led to rapid declines in district maternal and perinatal mortality. Significant reductions in intrapartum stillbirth rate and maternal mortality ratios around the time of birth attest to the success of the initiative.
Scott, Nancy A.
- Open AccessAddressing the Second Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Reaching Appropriate Maternal Care in a Timely MannerThandiwe Ngoma, Alice R. Asiimwe, Joseph Mukasa, Susanna Binzen, Florina Serbanescu, Elizabeth G. Henry, Davidson H. Hamer, Jody R. Lori, Michelle M. Schmitz, Lawrence Marum, Brenda Picho, Anne Naggayi, Gertrude Musonda, Claudia Morrissey Conlon, Patrick Komakech, Vincent Kamara and Nancy A. Scott on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S68-S84; https://doi.org/10.9745/GHSP-D-18-00367
The Saving Mothers, Giving Life initiative employed 2 key strategies to improve the ability of pregnant women to reach maternal care: (1) increase the number of emergency obstetric and newborn care facilities, including upgrading existing health facilities, and (2) improve accessibility to such facilities by renovating and constructing maternity waiting homes, improving communication and transportation systems, and supporting community-based savings groups. These interventions can be adapted in low-resource settings to improve access to maternity care services.
Sensalire, Simon
- Open AccessSaving Mothers, Giving Life Approach for Strengthening Health Systems to Reduce Maternal and Newborn Deaths in 7 Scale-up Districts in Northern UgandaSimon Sensalire, Paul Isabirye, Esther Karamagi, John Byabagambi, Mirwais Rahimzai and Jacqueline Calnan on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S168-S187; https://doi.org/10.9745/GHSP-D-18-00263
Saving Mothers, Giving Life (SMGL) strengthened the health system in 7 districts in Northern Uganda through a quality improvement approach. Quality improvement teams removed barriers to delivering maternal and newborn health services and improved emergency care, reducing preventable maternal and newborn deaths in a post-conflict, low-resource setting.
Serbanescu, Florina
- Open AccessAddressing the Second Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Reaching Appropriate Maternal Care in a Timely MannerThandiwe Ngoma, Alice R. Asiimwe, Joseph Mukasa, Susanna Binzen, Florina Serbanescu, Elizabeth G. Henry, Davidson H. Hamer, Jody R. Lori, Michelle M. Schmitz, Lawrence Marum, Brenda Picho, Anne Naggayi, Gertrude Musonda, Claudia Morrissey Conlon, Patrick Komakech, Vincent Kamara and Nancy A. Scott on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S68-S84; https://doi.org/10.9745/GHSP-D-18-00367
The Saving Mothers, Giving Life initiative employed 2 key strategies to improve the ability of pregnant women to reach maternal care: (1) increase the number of emergency obstetric and newborn care facilities, including upgrading existing health facilities, and (2) improve accessibility to such facilities by renovating and constructing maternity waiting homes, improving communication and transportation systems, and supporting community-based savings groups. These interventions can be adapted in low-resource settings to improve access to maternity care services.
- Open AccessThe Costs and Cost-Effectiveness of a District-Strengthening Strategy to Mitigate the 3 Delays to Quality Maternal Health Care: Results From Uganda and ZambiaBenjamin Johns, Peter Hangoma, Lynn Atuyambe, Sophie Faye, Mark Tumwine, Collen Zulu, Marta Levitt, Tannia Tembo, Jessica Healey, Rui Li, Christine Mugasha, Florina Serbanescu and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S104-S122; https://doi.org/10.9745/GHSP-D-18-00429
A comprehensive district-strengthening approach to address maternal and newborn health was estimated to cost US$177 per life-year gained in Uganda and $206 per life-year gained in Zambia. The approach represents a very cost-effective health investment compared to GDP per capita.
- Open AccessDid Saving Mothers, Giving Life Expand Timely Access to Lifesaving Care in Uganda? A Spatial District-Level Analysis of Travel Time to Emergency Obstetric and Newborn CareMichelle M. Schmitz, Florina Serbanescu, Vincent Kamara, Joan Marie Kraft, Marc Cunningham, Gregory Opio, Patrick Komakech, Claudia Morrissey Conlon and Mary M. Goodwin on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S151-S167; https://doi.org/10.9745/GHSP-D-18-00366
A spatial analysis of facility accessibility, taking into account road networks and environmental constraints on travel, suggests that the Saving Mothers, Giving Life (SMGL) initiative increased access to emergency obstetric and neonatal care in SMGL-supported districts in Uganda. Spatial travel-time analyses can inform policy and program efforts targeting underserved populations in conjunction with the geographic distribution of maternity services.
- Open AccessAddressing the First Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Approaches and Results for Increasing Demand for Facility Delivery ServicesFlorina Serbanescu, Mary M. Goodwin, Susanna Binzen, Diane Morof, Alice R. Asiimwe, Laura Kelly, Christina Wakefield, Brenda Picho, Jessica Healey, Agnes Nalutaaya, Leoda Hamomba, Vincent Kamara, Gregory Opio, Frank Kaharuza, Curtis Blanton, Fredrick Luwaga, Mona Steffen and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S48-S67; https://doi.org/10.9745/GHSP-D-18-00343
The Saving Mothers, Giving Life initiative used 3 coordinated approaches to reduce maternal deaths resulting from a delay in deciding to seek health care, known as the “first delay”: (1) promoting safe motherhood messages and facility delivery using radio, theater, and community engagement; (2) encouraging birth preparedness and increasing demand for facility delivery through community outreach worker visits; and (3) providing clean delivery kits and transportation vouchers to reduce financial barriers for facility delivery. These approaches can be adapted in other low-resource settings to reduce maternal and perinatal mortality.
- Open AccessAddressing the Third Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Ensuring Adequate and Appropriate Facility-Based Maternal and Perinatal Health CareDiane Morof, Florina Serbanescu, Mary M. Goodwin, Davidson H. Hamer, Alice R. Asiimwe, Leoda Hamomba, Masuka Musumali, Susanna Binzen, Adeodata Kekitiinwa, Brenda Picho, Frank Kaharuza, Phoebe Monalisa Namukanja, Dan Murokora, Vincent Kamara, Michelle Dynes, Curtis Blanton, Agnes Nalutaaya, Fredrick Luwaga, Michelle M. Schmitz, Jonathan LaBrecque, Claudia Morrissey Conlon, Brian McCarthy, Charlan Kroelinger and Thomas Clark on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S85-S103; https://doi.org/10.9745/GHSP-D-18-00272
Saving Mothers, Giving Life used 6 strategies to address the third delay—receiving adequate health care after reaching a facility—in maternal and newborn health care. The intervention approaches can be adapted in low-resource settings to improve facility-based care and reduce maternal and perinatal mortality.
- Open AccessImpact of the Saving Mothers, Giving Life Approach on Decreasing Maternal and Perinatal Deaths in Uganda and ZambiaFlorina Serbanescu, Thomas A. Clark, Mary M. Goodwin, Lisa J. Nelson, Mary Adetinuke Boyd, Adeodata R. Kekitiinwa, Frank Kaharuza, Brenda Picho, Diane Morof, Curtis Blanton, Maybin Mumba, Patrick Komakech, Fernando Carlosama, Michelle M. Schmitz and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S27-S47; https://doi.org/10.9745/GHSP-D-18-00428
Through district system strengthening, integrated services, and community engagement interventions, the Saving Mothers, Giving Life initiative increased emergency obstetric care coverage and access to, and demand for, improved quality of care that led to rapid declines in district maternal and perinatal mortality. Significant reductions in intrapartum stillbirth rate and maternal mortality ratios around the time of birth attest to the success of the initiative.
- Open AccessSaving Mothers, Giving Life: It Takes a System to Save a MotherClaudia Morrissey Conlon, Florina Serbanescu, Lawrence Marum, Jessica Healey, Jonathan LaBrecque, Reeti Hobson, Marta Levitt, Adeodata Kekitiinwa, Brenda Picho, Fatma Soud, Lauren Spigel, Mona Steffen, Jorge Velasco, Robert Cohen and William Weiss on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S6-S26; https://doi.org/10.9745/GHSP-D-18-00427
A multi-partner effort in Uganda and Zambia employed a districtwide health systems strengthening approach, with supply- and demand-side interventions, to address timely use of appropriate, quality maternity care. Between 2012 and 2016, maternal mortality declined by approximately 40% in both partnership-supported facilities and districts in each country. This experience has useful lessons for other low-resource settings.
Silumbwe, Adam
- Open AccessCommunity Perspectives of a 3-Delays Model Intervention: A Qualitative Evaluation of Saving Mothers, Giving Life in ZambiaAlice Ngoma-Hazemba, Leoda Hamomba, Adam Silumbwe, Margarate Nzala Munakampe and Fatma Soud on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S139-S150; https://doi.org/10.9745/GHSP-D-18-00287
While the Saving Mothers, Giving Life's health systems strengthening approach reduced maternal mortality, respondents still reported significant barriers accessing maternal health services. More research is needed to understand the necessary intervention package to affect system-wide change.
Soud, Fatma
- Open AccessCommunity Perspectives of a 3-Delays Model Intervention: A Qualitative Evaluation of Saving Mothers, Giving Life in ZambiaAlice Ngoma-Hazemba, Leoda Hamomba, Adam Silumbwe, Margarate Nzala Munakampe and Fatma Soud on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S139-S150; https://doi.org/10.9745/GHSP-D-18-00287
While the Saving Mothers, Giving Life's health systems strengthening approach reduced maternal mortality, respondents still reported significant barriers accessing maternal health services. More research is needed to understand the necessary intervention package to affect system-wide change.
- Open AccessSaving Mothers, Giving Life: It Takes a System to Save a MotherClaudia Morrissey Conlon, Florina Serbanescu, Lawrence Marum, Jessica Healey, Jonathan LaBrecque, Reeti Hobson, Marta Levitt, Adeodata Kekitiinwa, Brenda Picho, Fatma Soud, Lauren Spigel, Mona Steffen, Jorge Velasco, Robert Cohen and William Weiss on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S6-S26; https://doi.org/10.9745/GHSP-D-18-00427
A multi-partner effort in Uganda and Zambia employed a districtwide health systems strengthening approach, with supply- and demand-side interventions, to address timely use of appropriate, quality maternity care. Between 2012 and 2016, maternal mortality declined by approximately 40% in both partnership-supported facilities and districts in each country. This experience has useful lessons for other low-resource settings.
Spigel, Lauren
- Open AccessSaving Mothers, Giving Life: It Takes a System to Save a MotherClaudia Morrissey Conlon, Florina Serbanescu, Lawrence Marum, Jessica Healey, Jonathan LaBrecque, Reeti Hobson, Marta Levitt, Adeodata Kekitiinwa, Brenda Picho, Fatma Soud, Lauren Spigel, Mona Steffen, Jorge Velasco, Robert Cohen and William Weiss on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S6-S26; https://doi.org/10.9745/GHSP-D-18-00427
A multi-partner effort in Uganda and Zambia employed a districtwide health systems strengthening approach, with supply- and demand-side interventions, to address timely use of appropriate, quality maternity care. Between 2012 and 2016, maternal mortality declined by approximately 40% in both partnership-supported facilities and districts in each country. This experience has useful lessons for other low-resource settings.
- Open AccessSaving Lives Together: A Qualitative Evaluation of the Saving Mothers, Giving Life Public-Private PartnershipAnne Palaia, Lauren Spigel, Marc Cunningham, Ann Yang, Taylor Hooks and Susan Ross on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S123-S138; https://doi.org/10.9745/GHSP-D-18-00264
Overall, the Saving Mothers, Giving Life partnership was praised as a successful model for interagency coordination. Key strengths included diversity in partner expertise, high-quality monitoring and evaluation, strong leadership, and country ownership. Uncertainty about partner roles and responsibilities, perceived power inequities between partners, bureaucratic processes, and limited Ministry of Health representation in the governance structure were some challenges that, if addressed by similar public-private partnerships under development, may improve long-term partnership success.
Steffen, Mona
- Open AccessAddressing the First Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Approaches and Results for Increasing Demand for Facility Delivery ServicesFlorina Serbanescu, Mary M. Goodwin, Susanna Binzen, Diane Morof, Alice R. Asiimwe, Laura Kelly, Christina Wakefield, Brenda Picho, Jessica Healey, Agnes Nalutaaya, Leoda Hamomba, Vincent Kamara, Gregory Opio, Frank Kaharuza, Curtis Blanton, Fredrick Luwaga, Mona Steffen and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S48-S67; https://doi.org/10.9745/GHSP-D-18-00343
The Saving Mothers, Giving Life initiative used 3 coordinated approaches to reduce maternal deaths resulting from a delay in deciding to seek health care, known as the “first delay”: (1) promoting safe motherhood messages and facility delivery using radio, theater, and community engagement; (2) encouraging birth preparedness and increasing demand for facility delivery through community outreach worker visits; and (3) providing clean delivery kits and transportation vouchers to reduce financial barriers for facility delivery. These approaches can be adapted in other low-resource settings to reduce maternal and perinatal mortality.
- Open AccessSaving Mothers, Giving Life: It Takes a System to Save a MotherClaudia Morrissey Conlon, Florina Serbanescu, Lawrence Marum, Jessica Healey, Jonathan LaBrecque, Reeti Hobson, Marta Levitt, Adeodata Kekitiinwa, Brenda Picho, Fatma Soud, Lauren Spigel, Mona Steffen, Jorge Velasco, Robert Cohen and William Weiss on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S6-S26; https://doi.org/10.9745/GHSP-D-18-00427
A multi-partner effort in Uganda and Zambia employed a districtwide health systems strengthening approach, with supply- and demand-side interventions, to address timely use of appropriate, quality maternity care. Between 2012 and 2016, maternal mortality declined by approximately 40% in both partnership-supported facilities and districts in each country. This experience has useful lessons for other low-resource settings.
T
Tembo, Tannia
- Open AccessThe Costs and Cost-Effectiveness of a District-Strengthening Strategy to Mitigate the 3 Delays to Quality Maternal Health Care: Results From Uganda and ZambiaBenjamin Johns, Peter Hangoma, Lynn Atuyambe, Sophie Faye, Mark Tumwine, Collen Zulu, Marta Levitt, Tannia Tembo, Jessica Healey, Rui Li, Christine Mugasha, Florina Serbanescu and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S104-S122; https://doi.org/10.9745/GHSP-D-18-00429
A comprehensive district-strengthening approach to address maternal and newborn health was estimated to cost US$177 per life-year gained in Uganda and $206 per life-year gained in Zambia. The approach represents a very cost-effective health investment compared to GDP per capita.
Tumwine, Mark
- Open AccessThe Costs and Cost-Effectiveness of a District-Strengthening Strategy to Mitigate the 3 Delays to Quality Maternal Health Care: Results From Uganda and ZambiaBenjamin Johns, Peter Hangoma, Lynn Atuyambe, Sophie Faye, Mark Tumwine, Collen Zulu, Marta Levitt, Tannia Tembo, Jessica Healey, Rui Li, Christine Mugasha, Florina Serbanescu and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S104-S122; https://doi.org/10.9745/GHSP-D-18-00429
A comprehensive district-strengthening approach to address maternal and newborn health was estimated to cost US$177 per life-year gained in Uganda and $206 per life-year gained in Zambia. The approach represents a very cost-effective health investment compared to GDP per capita.
V
Velasco, Jorge
- Open AccessSaving Mothers, Giving Life: It Takes a System to Save a MotherClaudia Morrissey Conlon, Florina Serbanescu, Lawrence Marum, Jessica Healey, Jonathan LaBrecque, Reeti Hobson, Marta Levitt, Adeodata Kekitiinwa, Brenda Picho, Fatma Soud, Lauren Spigel, Mona Steffen, Jorge Velasco, Robert Cohen and William Weiss on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S6-S26; https://doi.org/10.9745/GHSP-D-18-00427
A multi-partner effort in Uganda and Zambia employed a districtwide health systems strengthening approach, with supply- and demand-side interventions, to address timely use of appropriate, quality maternity care. Between 2012 and 2016, maternal mortality declined by approximately 40% in both partnership-supported facilities and districts in each country. This experience has useful lessons for other low-resource settings.
W
Wakefield, Christina
- Open AccessAddressing the First Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Approaches and Results for Increasing Demand for Facility Delivery ServicesFlorina Serbanescu, Mary M. Goodwin, Susanna Binzen, Diane Morof, Alice R. Asiimwe, Laura Kelly, Christina Wakefield, Brenda Picho, Jessica Healey, Agnes Nalutaaya, Leoda Hamomba, Vincent Kamara, Gregory Opio, Frank Kaharuza, Curtis Blanton, Fredrick Luwaga, Mona Steffen and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S48-S67; https://doi.org/10.9745/GHSP-D-18-00343
The Saving Mothers, Giving Life initiative used 3 coordinated approaches to reduce maternal deaths resulting from a delay in deciding to seek health care, known as the “first delay”: (1) promoting safe motherhood messages and facility delivery using radio, theater, and community engagement; (2) encouraging birth preparedness and increasing demand for facility delivery through community outreach worker visits; and (3) providing clean delivery kits and transportation vouchers to reduce financial barriers for facility delivery. These approaches can be adapted in other low-resource settings to reduce maternal and perinatal mortality.
Weiss, William
- Open AccessSaving Mothers, Giving Life: It Takes a System to Save a MotherClaudia Morrissey Conlon, Florina Serbanescu, Lawrence Marum, Jessica Healey, Jonathan LaBrecque, Reeti Hobson, Marta Levitt, Adeodata Kekitiinwa, Brenda Picho, Fatma Soud, Lauren Spigel, Mona Steffen, Jorge Velasco, Robert Cohen and William Weiss on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S6-S26; https://doi.org/10.9745/GHSP-D-18-00427
A multi-partner effort in Uganda and Zambia employed a districtwide health systems strengthening approach, with supply- and demand-side interventions, to address timely use of appropriate, quality maternity care. Between 2012 and 2016, maternal mortality declined by approximately 40% in both partnership-supported facilities and districts in each country. This experience has useful lessons for other low-resource settings.
Y
Yang, Ann
- Open AccessSaving Lives Together: A Qualitative Evaluation of the Saving Mothers, Giving Life Public-Private PartnershipAnne Palaia, Lauren Spigel, Marc Cunningham, Ann Yang, Taylor Hooks and Susan Ross on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S123-S138; https://doi.org/10.9745/GHSP-D-18-00264
Overall, the Saving Mothers, Giving Life partnership was praised as a successful model for interagency coordination. Key strengths included diversity in partner expertise, high-quality monitoring and evaluation, strong leadership, and country ownership. Uncertainty about partner roles and responsibilities, perceived power inequities between partners, bureaucratic processes, and limited Ministry of Health representation in the governance structure were some challenges that, if addressed by similar public-private partnerships under development, may improve long-term partnership success.
Z
Zulu, Collen
- Open AccessThe Costs and Cost-Effectiveness of a District-Strengthening Strategy to Mitigate the 3 Delays to Quality Maternal Health Care: Results From Uganda and ZambiaBenjamin Johns, Peter Hangoma, Lynn Atuyambe, Sophie Faye, Mark Tumwine, Collen Zulu, Marta Levitt, Tannia Tembo, Jessica Healey, Rui Li, Christine Mugasha, Florina Serbanescu and Claudia Morrissey Conlon on behalf of the Saving Mothers, Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S104-S122; https://doi.org/10.9745/GHSP-D-18-00429
A comprehensive district-strengthening approach to address maternal and newborn health was estimated to cost US$177 per life-year gained in Uganda and $206 per life-year gained in Zambia. The approach represents a very cost-effective health investment compared to GDP per capita.
Zulu, Davy Wadula
- Open AccessSustainability and Scale of the Saving Mothers, Giving Life Approach in Uganda and ZambiaJessica Healey, Claudia Morrissey Conlon, Kennedy Malama, Reeti Hobson, Frank Kaharuza, Adeodata Kekitiinwa, Marta Levitt, Davy Wadula Zulu and Lawrence Marum on behalf of the Saving Mothers,Giving Life Working GroupGlobal Health: Science and Practice March 2019, 7(Supplement 1):S188-S206; https://doi.org/10.9745/GHSP-D-18-00265
The Saving Mothers, Giving Life district health systems strengthening approach provides a sustainable model for reducing maternal mortality at scale. Lessons from the learning districts demonstrated increased efficiency in allocation of resources for maternal and newborn health, better use of strategic information, improved management capacities, and increased community engagement.
In this issue
