December 05, 2018

Safer Births in Humanitarian Settings

Through strong partnerships and innovative approaches, Maternity Foundation is improving the health of mothers and babies in some of the world’s most fragile settings.

For women living in areas of conflict, pregnancy and childbirth are more dangerous than anywhere else. According to United Nation’s Population Fund, UNFPA, 60 percent of all maternal deaths take place in countries affected by humanitarian crisis or fragile conditions.

Maternity Foundation is working to improve maternal and newborn health in humanitarian and fragile settings in Ethiopia and Somalia through partnerships with PlanBørnefonden and Save the Children – and with more to come.

“Every mother and newborn deserve a safe childbirth – no matter where they live. In addition to the many other challenges women face in refugee and fragile settings, going through pregnancy and childbirth is extra vulnerable. By joining forces with strong players in the humanitarian field and using a combination of on-the-ground experience and new, innovative technologies, we can ensure a much stronger and effective response,” says Anna Frellsen, CEO of Maternity Foundation.

Safer Deliveries for South Sudanese Refugees
In Ethiopia, Maternity Foundation and PlanBørnefonden have joined forces to improve maternal and newborn health for South Sudanese refugees.

Ethiopia’s western region of Gambella is home to about 450,000 refugees from neighboring South Sudan. Since 2017, Maternity Foundation has worked with PlanBørnefonden to increase and improve access to maternal and newborn care for refugees in Gambella with support from the Danish Emergency Relief Fund, Novo Nordisk and other donors.

The key program activities include support to health workers at the clinics through capacity building in safer childbirth and newborn care.

Nicola Zewge is a midwife in Nguenyyiel Refugee Camp in Gambella, which is hosting around 75,000 refugees. Nicola and his colleagues have been trained by Maternity Foundation in basic emergency obstetrics and neo-natal care with Maternity Foundation’s digital tool, the Safe Delivery App, as a key component in the training.

“The Safe Delivery App is like a bible for midwives. We always have it right in our pockets” Nicola Zewga explains.

After Nicola Zewga was introduced to the Safe Delivery App, it has become his daily support system at the clinic where they manage up to 150 deliveries per month.

“Our work is risky – we have the lives of mothers and their babies in our hands every day. The Safe Delivery App makes it easier for us to manage. It’s very helpful. I think all midwives should use it”, Nicola says.

Since 2017, 57 midwives across six refugee camps in Gambella have been trained through the Safe Delivery App. Maternity Foundation and PlanBørnefonden are also providing hygiene items and dignity kits for new mothers with soap, sanitary pads and other essential items, as well as medical equipment for the health facilities.

Clinical Guidelines in Humanitarian Settings
In Ethiopia’s neighbouring country, Somalia, the Safe Delivery App was recently introduced as an on-the-job tool for healthcare workers in the Puntland region.

Somalia is one of the most dangerous places in the world to be pregnant and give birth. With a maternal mortality ratio at 732 deaths per 100,000 live births, women in Somalia face a big risk of dying of causes related to pregnancy and childbirth during their lifespan. In comparison, the United Nation’s goal is to reduce the global maternal mortality ratio to under 70 deaths per 100,000 births.

Through a collaboration between Maternity Foundation, Save the Children US, Save the Children Denmark, and University of Copenhagen, the Safe Delivery App is being implemented as a tool to strengthen the capacity of midwives in Puntland – in close collaboration with the regional Ministry of Health in Puntland.

”This partnership is not only about ‘an App’. It is about how to mutually benefit from our respective strengths. Bringing together the two organization’s specialized staff and expertise does not only add value to the actual work for children and professional health care givers in-country. It also brings value and learning back to the organizations”, says Jonas Keiding Lindholm, Secretary General of Save The Children Denmark (Red Barnet).

“In this case, Save the Children could facilitate and bring Maternity Foundation into a complex context of operating in a very fragile state, hence widening the potential for successful distribution and uptake of the App. Likewise, Save the Children and local government health facilities can apply new technology to reach midwifes and scale quality training and awareness – potentially saving the lives of more women and newborns by vitalizing guidelines and best practice, previously not digitalized in a fragile state contextualized format”, Jonas Keiding Lindholm from Save The Children Denmark (Red Barnet) says.

The collaboration with Save The Children in Somalia is part of a bigger project of integrating the Safe Delivery App into the global Newborn Field Guide in Humanitarian Settings, which is spear-headed by the inter-agency working group on reproductive health in crises (IAWG). A working group of global maternal health and humanitarian experts, which Maternity Foundation is proud to be part of.

Global Call to Action
The Safe Delivery App is currently being used in over 40 different countries worldwide, and Maternity Foundation’s extensive global experience is now serving as a foundation of best practices in our move into fragile and humanitarian settings. In addition, we are making efforts to learn from global experts and initiatives on maternal and newborn health within the field.

To accurately reflect the realities of pregnancy and childbirth in humanitarian settings, the Safe Delivery App has been updated with content on how to care for newborns with low birthweight – a risk which is especially high in humanitarian settings.

In addition, Maternity Foundation has joined UNFPA’s Safe Birth Even Here movement, a global pledge to ensure safer births for women and newborns affected by crisis, and we are partnering up with strong leaders in the humanitarian field to create synergies of expertise.

One of our strong partners on the ground, PlanBørnefonden, underlines the importance of partnerships to make a real impact:

“We really appreciated the opportunity to work together with Maternity Foundation in a humanitarian setting, knowing that their expertise and mobile health solutions for Maternal and Newborn health was needed where more than 80% of the refugee population are women and children. This is an example of an innovative partnership to respond to needs on the ground in a new way“, says Anne Smith Petersen, PlanBørnefonden’s Director of Programme, Influence and Grants.

Additionally, as part of our mission to improve care for more women and newborns living in areas affected by conflict and instability, Maternity Foundation have partnered up with Doctors Without Borders (MSF) to develop and implement an Arabic version of the Safe Delivery App, which we expect to launch in 2019.