Presentation by Dana Allison, Executive Directorto WWHI volunteer staff

December 8, 2010

1. WWHI History and Introduction

2. Organization3. Global Issue4. Why Women?5. Where we work6. On the ground7. Needs Assessment8. Where WWHI is today9. Program Possibilities10.Timeline11.Questions

•Work with UNHCR

•Dr. Youssoupha Ndiaye

•Studied other models extensively

•Millennium Development Goals not being met

So It Began…

Women’s World Health Initiative OrganizationIncorporated 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

Board ChairpersonCarri Hulet - The Langdon Group

Board Vice ChairpersonStephanie Mackay – Columbus Foundation

Executive TreasurerRichard Ence – Thatcher Company

Executive SecretaryChuck Larson – JUB Engineering

Keri Gibson, M.D. – University of Utah Community Clinics

Jacque M. Ramos Esq. - J Ramos Law FirmSeraphine Kapsandoy – R.N., BSN, Primary Children’s

HospitalZendina 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 1Reduce by three quarters the maternal mortality ratio

Target 2Achieve 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

“When women thrive, all of society benefits and succeeding generations are given a better start in life.”

-Kofi Annan

WHY WOMEN?

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.

Why Women? – Economic StrategiesWomen 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

Return on investment in maternal mortality

reductionIt 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

1. USAID Congressional Budget Justification FY 2002; Program, Performance, and Prospects – The Global Health Pillar.http://www.usaid.gov/pubs/cbj2002/prog_perf2002.html.

2. “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

Story of Awa

WHERE WE WHERE WE WORK:WORK:

SENEGAL, WEST SENEGAL, WEST AFRICAAFRICA

Where we work: SENEGAL

Population 11.7 million

CapitalDakar

LanguageFrench

Senegal Health System Statistics

Senegal

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. 

Where we work: SENEGAL

• 5 mothers and 41 newborns in Senegal die each day from complications related to giving birth1

1. USAID-funded Demographic and Health Survey (DHS),2005

• For every maternal death, at least 10 more suffer from serious obstetric complications

• only 12 percent of women used contraception

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 pregnancyEndemic 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

• 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

Where we work: Saraya District

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 villageRural Counsel = heads of 20 villagesSaraya is the center village and disperses mail and

medicine to the outer villages.

Demographics and Region

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.

Saraya, Senegal Statistics

“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

WWHI will act as a catalyst in the stabilization of communities and countries through educating, empowering, and saving countries’ best resource - women

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.

Mission Statement

Vision Statement

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

2) Integrate economically driven incentives with simple medical interventions to ensure sustainability.

Values

Saraya Health District

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

Needs Assessment

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 unmitigatedBirth control access and education is limited

but desired4 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

General Findings

Very little communication between healthpostsOnly women who access care are trackedLimited emergency services availableTravel at great cost and long distances for

emer. careMajority of women deliver at home, alone due

to cost and distanceAccess care often too lateComorbid malaria, malnutrition or anemia

cause many complicationsCost of care high

Findings cont.

Perceived needs: a) better communication methodsb) more constant source of suppliesc) better healthcare worker reimbursementd) more quality care in hospital through traininge) better education on birth control and family

planningf) better transportation in emergenciesg) water in the maternitiesh) decreased domestic labor and chores for

pregnant women

Findings cont.

Healthcare Delivery System

Tambacounda Regional Hospital

Fully Staffed – Surgical

Saraya District Hospital

Doctor/Midwife/Nurse/PHCC

7 Healthposts - Nurses

25 CaissesCHW/Matron

25 CaissesCHW/Matron

25 CaissesCHW/Matron

Birth without support

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?

Return to the Story of Awa…

Program Possibilities1.Technology – mobile2. Improve outcomes3.Training/Triage4.Medical reporting and

tracking

5.Healthcare Delivery System

6.Water

7.Birth Control and Family Planning

3.Village Health Payment System

Timeline and Implementation

1. Measureable Impact – Program Evaluation2. Demonstrate success and build trust with

local population3. Short term and long term

Proposed TimelineFebruary – present program to board March – present program to stakeholders in

SenegalApril – begin implementation measures

Where do you fit in?

1. Strong organization = Strong Programs

2.Garnering wide support 3.Capital Campaigns4.Program Development5.Communicating successes of

forgotten population6.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!!!

Questions?