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Presentation by Dana Allison, Executive Director to WWHI volunteer staff December 8, 2010. WWHI History and Introduction Organization Global Issue Why Women? Where we work On the ground Needs Assessment Where WWHI is today Program Possibilities Timeline Questions. So It Began….
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Presentation by Dana Allison, Executive Director to WWHI volunteer staff December 8, 2010
WWHI History and Introduction • Organization • Global Issue • Why Women? • Where we work • On the ground • Needs Assessment • Where WWHI is today • Program Possibilities • Timeline • Questions
So It Began… • Work with UNHCR • Dr. Youssoupha Ndiaye • Studied other models extensively • Millennium Development Goals not being met
Incorporated January 2009 – first staff meeting August 2009 • 3 founding members now 32 staff and board members • Increased our revenues by 900% • Trajectory of growth off the charts Women’s World Health Initiative Organization
Board Chairperson Carri Hulet - The Langdon Group Board Vice Chairperson Stephanie Mackay – Columbus Foundation Executive Treasurer Richard Ence – Thatcher Company Executive Secretary Chuck Larson – JUB Engineering Keri Gibson, M.D. – University of Utah Community Clinics Jacque M. Ramos Esq. - J Ramos Law Firm Seraphine Kapsandoy – R.N., BSN, Primary Children’s Hospital Zendina Mostert, MS, B.A. – Nonprofit Program Advisor
Millennium Development Goals • In 2000, international community pledged to, “spare no effort to free our fellow men, women and children from the abject and dehumanizing conditions of extreme poverty” • Goal #5 related to maternal health • Target 1 • Reduce by three quarters the maternal mortality ratio • Target 2 • Achieve universal access to reproductive health
Current Picture • From 1990 to 2005, the maternal mortality ratio declined only 2% in Sub-Saharan Africa • One woman still dies nearly every minute of every day from treatable or preventable complications related to pregnancy and childbirth • For every one woman who dies, 20 develop debilitating injuries, infections or disease related to or exacerbated by pregnancy and childbirth • Developing countries account for 99% of maternal deaths
WHY WOMEN? “When women thrive, all of society benefits and succeeding generations are given a better start in life.” -Kofi Annan
Woman’s income more likely than a man’s to go toward food, education, medicine, and other family needs1 • Women in many countries make important family decisions about nutrition, healthcare, and use of resources • One girl in seven in developing countries marries before the age of 15 • Children have a 14 times higher chance of dying in first year of life without a mother. Why Women? 1. Jowett M. “Safe Motherhood interventions in low income countries: an economic justification and evidence of cost-effectiveness.” Health Policy 53(3): 201-28. 2000.
Women contribute to economic growth; their UNPAID work at home and on the farm equals about 1/3 of global GDP • Women operate the majority of small businesses and farms in developing countries Why Women? – Economic Strategies
Return on investment in maternal mortality reduction • It is estimated that US$15 billion is lost every year due to maternal mortality1 • In countries where most maternal deaths occur, a package of essential services is estimated to cost less than US $1.50 per person2 • USAID Congressional Budget Justification FY 2002; Program, Performance, and Prospects – The Global Health Pillar.http://www.usaid.gov/pubs/cbj2002/prog_perf2002.html. • “World Health Report 2005: Make Every Mother and Child Count,” WHO (2005).
Disparities continue • 62% of midwives Africa-wide are not retained • Only 16% of women who want to prevent pregnancy, can • At current rate – goals won’t be met until 2045 Lacking Results
WHERE WE WORK: SENEGAL, WEST AFRICA
Where we work: SENEGAL Population11.7 million CapitalDakar Language French
Relative political stability • Partnerships with local healthcare workers in place • Average age of first birth is 12-14 years old in rural Senegal. • Senegal, West Africa 1/21 lifetime chance of dying from birthing a child. Canada, North America 1/11,000 lifetime risk of dying from birthing a child. Senegal
Where we work: SENEGAL • 5 mothers and 41 newborns in Senegal die each day from complications related to giving birth1 • For every maternal death, at least 10 more suffer from serious obstetric complications • only 12 percent of women used contraception 1. USAID-funded Demographic and Health Survey (DHS),2005
Causes of Maternal Mortality • Hemorrhage • Poor nutrition and related conditions such as hypertension and anemia. • Lack of access to obstetric care. • Low quality of care. • Lack of medication distribution and compliance. • Poor medical facilities and equipment. • Continued domestic labor throughout pregnancy • Endemic diseases such as malaria and parasitosis.
Only 58% births are attended by skilled birth attendant • * disproportionately unattended in rural areas • Only 2% births by Cesarean Section
Where we work: Saraya District • Difficult to access with only unfinished minor road access • No maintained roads to villages in Saraya District • High rates of poverty • Maternal Mortality Rate ~850/100,000
Demographics and Region • Saraya District is part of the Kedegou region. • The district is 6,835 square km • Official population - 36,000 • 50-60,000 people due to mining and border influx. • Village Leadership: • Chief = head of every village • Rural Counsel = heads of 20 villages • Saraya is the center village and disperses mail and medicine to the outer villages.
Saraya, Senegal Statistics • 64.5% births happen in their homes • Only 27.2% of births are assisted by a formally-trained birth attendant • 20.4% of the women in the region receive no prenatal care while most have 1 visit.
“On the Ground” • What has been done? • What are they doing already? • What can we build on? • Where should we focus?
WWHI Mission and Vision Mission Statement WWHI will invest in and educate women in vulnerable populations to change their own communities by building sustainable local health care systems focused on decreasing maternal and infant mortality and early detection of preventable disease. Vision Statement WWHI will act as a catalyst in the stabilization of communities and countries through educating, empowering, and saving countries’ best resource - women
Values • 4-pronged, and comprehensive– • Train local midwives and other healthcare workers • Increase capacity of local doctor • Integrate innovative technology modalities to increase access to quality health care and education • Integrate economically driven incentives with simple medical interventions to ensure sustainability.
Needs Assessment • Area of focus: • Saraya region of Senegal • Purpose: • Assess factors that may contribute to maternal mortality • Assess gaps in healthcare services as related to obstetric care • Assess the barriers to healthcare access • Get acquainted with the people, region, and culture
What was done: Visited Hospital Health posts Villages Conducted key informant interviews and focus group with Women and men in the community Midwives Healthcare providers Healthcare workers Community leaders
General Findings • Women have many children unmitigated • Birth control access and education is limited but desired • 4 Prenatal visits suggested. Given basic care and limited prenatal supplements (vit A, iron and tetanus shots) • Very low compliance due to a) cost b) distance c) lack of understanding d) low quality care
Findings cont. • Very little communication between healthposts • Only women who access care are tracked • Limited emergency services available • Travel at great cost and long distances for emer. care • Majority of women deliver at home, alone due to cost and distance • Access care often too late • Comorbid malaria, malnutrition or anemia cause many complications • Cost of care high
Findings cont. • Perceived needs: a) better communication methods b) more constant source of supplies c) better healthcare worker reimbursement d) more quality care in hospital through training e) better education on birth control and family planning f) better transportation in emergencies g) water in the maternities h) decreased domestic labor and chores for pregnant women
Healthcare Delivery System Tambacounda Regional Hospital Fully Staffed – Surgical Saraya District Hospital Doctor/Midwife/Nurse/PHCC 7 Healthposts - Nurses 25 Caisses CHW/Matron 25 Caisses CHW/Matron 25 Caisses CHW/Matron
Imagine if all mothers and their infants could expect a life of health and strength? Imagine if WWHI can facilitate security for families by assisting their efforts?
Program Possibilities • Technology – mobile • Improve outcomes • Training/Triage • Medical reporting and tracking • Healthcare Delivery System • Water • Birth Control and Family Planning • Village Health Payment System
Timeline and Implementation • Measureable Impact – Program Evaluation • Demonstrate success and build trust with local population • Short term and long term Proposed Timeline February – present program to board March – present program to stakeholders in Senegal April – begin implementation measures
Where do you fit in? • Strong organization = Strong Programs • Garnering wide support • Capital Campaigns • Program Development • Communicating successes of forgotten population • Ultimately – saving the lives of women and children
With limited resources we have accomplished much as an organization. You make all the difference for these children and mothers. Thank you for your past and continued support!!!
