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Global Health: Science and Practice

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More articles from ORIGINAL ARTICLE

  • Open Access
    Saving Lives Together: A Qualitative Evaluation of the Saving Mothers, Giving Life Public-Private Partnership
    Anne Palaia, Lauren Spigel, Marc Cunningham, Ann Yang, Taylor Hooks and Susan Ross on behalf of the Saving Mothers, Giving Life Working Group
    Global 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.

  • Open Access
    Saving Mothers, Giving Life Approach for Strengthening Health Systems to Reduce Maternal and Newborn Deaths in 7 Scale-up Districts in Northern Uganda
    Simon Sensalire, Paul Isabirye, Esther Karamagi, John Byabagambi, Mirwais Rahimzai and Jacqueline Calnan on behalf of the Saving Mothers, Giving Life Working Group
    Global 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.

  • Open Access
    Addressing the Second Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Reaching Appropriate Maternal Care in a Timely Manner
    Thandiwe 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 Group
    Global 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 Access
    The Costs and Cost-Effectiveness of a District-Strengthening Strategy to Mitigate the 3 Delays to Quality Maternal Health Care: Results From Uganda and Zambia
    Benjamin 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 Group
    Global 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 Access
    Community Perspectives of a 3-Delays Model Intervention: A Qualitative Evaluation of Saving Mothers, Giving Life in Zambia
    Alice Ngoma-Hazemba, Leoda Hamomba, Adam Silumbwe, Margarate Nzala Munakampe and Fatma Soud on behalf of the Saving Mothers, Giving Life Working Group
    Global 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 Access
    Did 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 Care
    Michelle 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 Group
    Global 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 Access
    Addressing the First Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Approaches and Results for Increasing Demand for Facility Delivery Services
    Florina 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 Group
    Global 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 Access
    Sustainability and Scale of the Saving Mothers, Giving Life Approach in Uganda and Zambia
    Jessica 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 Group
    Global 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 Access
    Addressing the Third Delay in Saving Mothers, Giving Life Districts in Uganda and Zambia: Ensuring Adequate and Appropriate Facility-Based Maternal and Perinatal Health Care
    Diane 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 Group
    Global 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 Access
    Impact of the Saving Mothers, Giving Life Approach on Decreasing Maternal and Perinatal Deaths in Uganda and Zambia
    Florina 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 Group
    Global 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.

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US AIDJohns Hopkins Center for Communication ProgramsUniversity of Alberta

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