mamaye! evidence, identity, design, engagement

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MAMAYE! MOTHERS BABIES ALIVE

E VIDENCE IDENTIT Y DESIGN ENGAGEMENT

MAMAYE! MOTHERS BABIES ALIVE

E VIDENCE IDENTIT Y DESIGN ENGAGEMENT

MAMAYE! – MOTHERS BABIES ALIVEEVIDENCE IDENTITY DESIGN ENGAGEMENT

The Evidence for Action consortium brings together experts from academic institutions, internationally recognised advocacy and accountability coalitions and civil society organisations. Our country teams work through local institutions and collaborate with a wide range of partners in each of our six focus countries.

The programme brings together world leaders in the generation and use of evidence on maternal mortality, and in advocacy efforts. Led by Options Consultancy Services, the consortium includes:

Options Consultancy Services; Advocacy International; Immpact, University of Aberdeen; The London School for Hygiene & Tropical Medicine; UCL Institute for Global Health, University College London; The Centre for Global Health, Population, Poverty, and Policy, University of Southampton; and Swiss Tropical and Public Health Institute.

SEPTEMBER 2015

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INTRODUCTION

Evidence for Action is a programme which works to transform health outcomes of mothers and babies, currently in Africa with a focus on 6 countries (Ethiopia, Ghana, Malawi, Nigeria, Sierra Leone and Tanzania). It was initially funded with UK aid from the UK government in 2010. We believe that evidence has the power to catalyse change. But too often data are not available to decision makers in formats that make sense to them and at times that they need them. This can make planning and prioritisation difficult and can result in resources invested which do not match need.

We also believe that even when decision makers have the data they need this does not automatically result in actions necessary to improve access to quality services for women and children. The political will must be right to influence decision makers to act. Where data are made available in accessible formats to the wider public, community support organisations and the media it can empower them to pressure decision makers to act and track the progress of their leaders against their responsibilities and commitments. From our experience over the last 4 years, evidence informed advocacy is a very powerful tool for change.

In this book we share examples of how we have packaged data to inform and influence from across the Evidence for Action programme. These evidence products range from factsheets and scorecards to infographics, posters and websites. We often call these creative assets as we take considerable time, once we have established the audience and the purpose, to select and package the right data, target the messaging and make it visually accessible and appealing. Their creative design captures the imagination and acts as a hook to engage our audience and facilitate evidence based decision-making and advocacy.

MamaYe is a core strategy of the programme. MamaYe is the campaign launched by Evidence for Action and it is the public face of the programme. The purpose of developing a campaign brand was to help provide an interface which was accessible to a broad audience, provide a common platform for advocates and increase the profile of maternal and newborn health issues to help ensure they received the necessary priority. We share some of the story of the MamaYe campaign which has provided a platform for many of our evidence products and associated creative assets.

Many of these examples are available via the MamaYe websites www.mamaye.org. We hope they inspire you to use evidence for action.

Louise Hulton, PhDProgramme Director Evidence for Action

INTRODUCTION

BUILDING A BRAND AND A PLATFORM

Visual identity

Websites

MATERNAL AND NEWBORN HEALTH ADVOCACY: REFRAMING THE ISSUE

Celebrating success

Raising awareness

Engaging the public in solutions

SHARING SOUND EVIDENCE

Evidence summaries and e-blasts

Infographics

Scorecards

Dashboards

Factsheets

Maternal Death Surveillance and Response (MDSR) Action Network

ENGAGING THE PUBLIC

Blood donation

Improving survival

Respectful care

Youth engagement

Political engagement

Media

STRENGTHENING ACCOUNTABILITY THROUGHOUT AFRICA

Health budgets

Monitoring commitments

Commission on Information and Accountability (CoIA)

Safe clinics

Campaign for the Accelerated Reduction of Maternal Mortality in Africa (CARMMA)

African Health Stats

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CONTENTS

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Our goal was to bring our packaged evidence products to a much wider audience than maternal and newborn health experts through an Africa-wide campaign, which we called MamaYe. Instead of making it proprietary, we wanted the campaign to be a platform which anyone could join, galvanising and adding value to our partners’ work.

In order for others to gather around MamaYe, we needed a recognisable and attractive visual identity, which spoke to the underlying message of the campaign: mothers and babies alive. We also needed a ‘shop window’ to showcase evidence, advocacy and other related communications from the campaign, facilitating access to our materials but also inspiring and drawing in further support.

After conducting research across Africa to design an overall brand, we created five websites – one for each MamaYe country - drawing on traditional textile designs in each country. An Africa-wide website pulls together evidence, advocacy and news from the five country sites. The MamaYe name and logo were originally designed with ARK Africa, a branding agency based in Kenya. Motherhood is central to the name and reflects the ways mothers are called ama, emaye, mama, mae in various African languages. The logo is simple and easy to adapt or replicate. The logo spiral resembles a mother holding her child and the surrounding half ring shows community support. MamaYe is a name which is universal, distinctly African, and able to communicate to a diverse and multi-cultural audience.

≥ Visual identity

≥ Websites


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VISUAL IDENTITY

10 11

The MamaYe name and logo was originally designed by ARK Africa, a branding agency based in Nairobi. They focused on motherhood as the central concept behind the name, and looked at the way mothers are called ama, emaye, mama, mae in various African languages. By combining these with the concept of motherhood and the positive attributions behind the campaign, they created a name which is universal, distinctly African, and able to communicate to a diverse and multi-cultural audience. MamaYe Is both uplifting and celebratory, and places the virtue of motherhood firmly at the centre of the campaign.

“The principal and journey of motherhood from conception, through pregnancy, and post-birth is relevant to all members of a community; the immediate and extended family, health practitioners & professionals and the community at large, touching every division of the target audience for the campaign. Everyone has a mother, or knows a woman that is mother. This is our common ground in all five countries.”– ARK Africa

Writing MamaYe in body textWhen writing MamaYe in body text, the letters M and Y should be capitalised. The exclamation mark can be dropped, so it would appear as MamaYe. If including the strapline, it should appear as MamaYe: Evidence for Action, where a colon separates the two elements.

The logomarkIt is important that the campaign has a logomark – a symbol that visually represents the campaign, aid familiarity and recognition amongst diverse audiences, and is easily replicable. The logomark is a symbolic mono line representation of the mother and baby and their place within the community.

The Strapline‘Evidence for Action’ is the strapline for MamaYe. Previously the strapline was ‘mothers, babies, alive!’ however over time this has been replaced. As of 2015 it is recommended that all instances of the logo

Mother and babyRepresented by a symbolic gesture of the mother holding her child in orange.

CommunityThe mother and child supported by the community, represented by a half-ring in teal.

The name and logo

Logomark

Logotype / Wordmark

Strapline

Stacked Logo

Landscape Logo

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The MamaYe name and logo was originally designed by ARK Africa, a branding agency based in Nairobi. They focused on motherhood as the central concept behind the name, and looked at the way mothers are called ama, emaye, mama, mae in various African languages. By combining these with the concept of motherhood and the positive attributions behind the campaign, they created a name which is universal, distinctly African, and able to communicate to a diverse and multi-cultural audience. MamaYe Is both uplifting and celebratory, and places the virtue of motherhood firmly at the centre of the campaign.

“The principal and journey of motherhood from conception, through pregnancy, and post-birth is relevant to all members of a community; the immediate and extended family, health practitioners & professionals and the community at large, touching every division of the target audience for the campaign. Everyone has a mother, or knows a woman that is mother. This is our common ground in all five countries.”– ARK Africa

Writing MamaYe in body textWhen writing MamaYe in body text, the letters M and Y should be capitalised. The exclamation mark can be dropped, so it would appear as MamaYe. If including the strapline, it should appear as MamaYe: Evidence for Action, where a colon separates the two elements.

The logomarkIt is important that the campaign has a logomark – a symbol that visually represents the campaign, aid familiarity and recognition amongst diverse audiences, and is easily replicable. The logomark is a symbolic mono line representation of the mother and baby and their place within the community.

The Strapline‘Evidence for Action’ is the strapline for MamaYe. Previously the strapline was ‘mothers, babies, alive!’ however over time this has been replaced. As of 2015 it is recommended that all instances of the logo


CommunityThe mother and child supported by the community, represented by a half-ring in teal.

The name and logo

Logomark

Logotype / Wordmark

Strapline

Stacked Logo

Landscape Logo


CommunityThe mother and child

supported by the community, represented by a half-ring in

teal.


The MamaYe HandbookGuidelines for advocacy, branding

and communications

The MamaYe HandbookGuidelines for advocacy, branding

and communications

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The MamaYe brand has a warm and engaging colour palette. There are two primary colours that should always be used in anything using colour.

The MamaYe orange is the main campaign colour, and should be used as the first choice of colour in any material – its warm hue is evocative of the warmth of maternal love and care. It can also carry an urgent and striking tone.

The cool MamaYe teal is the second choice of colour, used to complement the orange, it evokes concepts of cleanliness, hospitality, and safety. Together they make a colour combination which is unique to MamaYe, and evokes the principles behind the campaign.

There are also four secondary colours for advanced use - these should only be used as an accent or highlight to the primary colours (see example opposite).

Colour palette

The two dominant colours that form the basis of the MamaYe identity:

orange and teal.

MamaYe OrangeC - 7M - 77Y - 100K - 1

Burnt OrangeC - 29M - 80Y - 100K - 29

Dark BrownC - 52M - 52Y - 62K - 62

Dark TealC - 71M - 31Y - 52K - 15

Light TealC - 14M - 0Y - 9K - 0

MamaYe TealC - 53M - 2Y - 34K - 0

R - 2 2 1G - 8 4B - 1 8

R - 1 4 6G - 6 1B - 2 1

R - 7 5G - 6 5B - 5 2

R - 7 7G - 1 2 8B - 1 1 8

R - 2 7 7G - 2 4 1B - 2 3 8

R - 1 3 0G - 1 9 7B - 1 8 3

Seconday MamaYe Colours

Primary MamaYe Colours

Note: when a political party uses orange in their communication materials (such as Malawi in 2014), the MamaYe teal should become

the main colour, so as to avoid association with political parties.

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A MamaYe poster, which shows a well balanced use of both primary and secondary MamaYe colours.

AFRICANWOMENOF OUR SOCIETIESBACKBONEHAVE ALWAYS BEEN THE

EFFECT IN OUR COUNTRIES

IMAGINETHE CHANGE THEY COULD

REACH THEIR

FULL POTENTIALADDRESS BY H.E.

TO THE 68TH UNITED NATIONS GENERAL ASSEMBLYSEPT 2013

THE PRESIDENT OF THE REPUBLIC OF GHANAJOHN DRAMANI MAHAMA

IF ONLY WE’D HELP THEM

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Typography: usage examples

MEMBERS OF

THE FINANCE COMMITTEEYOU CAN;

GHANA REMAINS A DANGEROUS PLACE TO GIVE BIRTH COMPARED TO MANY COUNTRIES AROUND THE WORLD.

≥ Encourage government to increase health sector funding from today’s low 12.5% to 15% of the next budget.

≥ Encourage government to increase per capita spending to the WHO target of USD $54.

Did you know? Ghana’s government spending on health has fallen behind. In 2007 Ghana spent 15% of the government’s total budget on health, it is now just 12.5%. Government per capita spending on health is at only $27 per Ghanaian per year. The total of government and private spending on health per capita is only $48 per Ghanaian (with the government spending only $27 of this amount). $48 total still falls below the WHO recommended target of $54 per person.

≥ Encourage government to increase health sector funding from today’s low 12.5% to 15% of the next budget.

≥ Encourage government to increase per capita spending to the WHO target of USD $54.

Did you know? Ghana’s government spending on health has fallen behind. In 2007 Ghana spent 15% of the government’s total budget on health, it is now just 12.5%. Government per capita spending on health is at only $27 per Ghanaian per year. The total of government and private spending on health per capita is only $48 per Ghanaian (with the government spending only $27 of this amount). $48 total still falls below the WHO recommended target of $54 per person.

Members of the Finance CommitteeYou can;

Ghana remains a dangerous place to give birth compared to many countries around the world.

Example using both Knockout and PT Sans

Example using Knockout Full Featherweight and Knockout Full Heavyweight

Same example using only PT Sans

INCREASING MATERNALAND NEWBORN SURVIVALTOGETHER OUR VOICES ARE LOUDER

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Politcal poster in Malawi using Knockout Full Featherweight.This avoids using colour due to politcal association.

KEEP MOTHERS AND BABIES

AT THE HEART OF YOUR AGENDA

WHATEVER YOURPOLITICAL COLOURS

THEY ARE MALAWI’S FUTURE!

www.mamaye.org.mw

8 9The MamaYe Handbook – 2014

VISUAL IDENTITY BUILDING A BRAND AND A PLATFORM

MamaYe Brand Guidelines

MamaYe Brand Guidelines

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The MamaYe campaign has a suite of pictograms that can be used as visual aids to highlight key ideas and to help visualise abstract concepts. They add a friendly touch to communication materials and can be used instead of photography when there is little space or print restrictions.

They have been designed specifically within the look and feel of the MamaYe campaign. Using MamaYe orange as their primary colour, they also have curved and rounded features that derive from the bubbly MamaYe logo.

They also reflect the core principles behind the campaign - mothers are depicted as strong, positive, African women who are actively engaged with contemporary life. Note the posture of the woman holding her baby - her back is arched and she is standing tall, looking ahead and keeping a watchful eye on her baby.

Pictograms

Motherhood and family members (half body)

Pregnant woman

Woman with baby and her partner / husband

Woman with baby Woman with baby and phone

The pictograms depict strong, positive, African women, and express the core

principles behind MamaYe.

Woman with baby and activist placard

Woman with baby on her back

Pregnant woman and her partner / husband

Kangaroo Care

ManGirl Boy

001

005

002

006

003

007

004

008

009 010 011

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Baby

Many of the pictograms depicting people come in two different versions - half body and full body.

The half body pictograms are for primary use and should be the first choice when selecting a pictogram. This is because they are easier to see in small sizes and are more versatile due to their well rounded proportions.

The full body pictograms are taller and thinner, and should only be used when there is a shortage of horizontal space, or when the pictogram needs to fill a larger vertical area.

Note in the diagram on the right, how the two pictograms occupy the same amount of space, but the half body appears much larger.

All pictograms are available in vector (eps) and png formats.The numbers shown here correspond to those in the file names.

Motherhood and family members (full body)

Pregnant woman

Half body(for all kinds of use)

Full body(for tall or narrow spaces)

Woman with baby and her husband

Woman with baby Woman with baby and phone

Woman with baby and activist placard

Woman with baby on her back

Pregnant woman and her husband

Kangaroo Care

ManGirl Boy

012

016

013

017

014

018

015

019

020 021 022 023

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MapsMaps can be a useful visual tool, both in illustrating the respective country and also for use in infographics (such as choropleth maps). Each country map is available as solid shape (displayed below in orange) and also as a map separated by regions (displayed below in teal). Ghana

Tanzania

Nigeria Malawi

Sierra Leone

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The African continent, with the five focal countries highlighted that MamaYe operates in.

10 11MamaYe Brand Guidelines – 2014

VISUAL IDENTITY BUILDING A BRAND AND A PLATFORM

12 13MamaYe international website

WEBSITES

Ghana website


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WEBSITES

Malawi and Nigeria websites Sierra Leone and Tanzania websites


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WEBSITES

Home banners for the MamaYe international website


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Through MamaYe we work to actively reframe the debate and help transform attitudes to maternal and newborn health away from fatalism towards hope. We do this by communicating key evidence in a way that celebrates and showcases what works, raising aspirations and providing solutions.

≥ Celebrating success

≥ Raising aspirations

≥ Engaging the public in solutions

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MAMAYE HEROINE

CHARITY SALIMA

CHARITY SALIMA IS A NURSE MIDWIFE IN AREA 23 WHO

SHE REFERS THEM TO BWAILA HOSPITAL IN AN EMERGENCYSHE IS THERE FOR WOMEN

24 HOURS A DAY, 7 DAYS A WEEK CHARITY WILL LEAVE A LEGACY. SHE WILL BE REMEMBERED FOR SAVING LIVES

WHAT WILL YOUR LEGACY BE?

CHARITY OFFERS MOTHERS AFFORDABLE CARE BEFORE AND DURING CHILDBIRTHSAVES LIVES

WHAT CAN YOU DO?websitetwitterfacebook

mamaye.org.mwtwitter.com/MamaYeMWfacebook.com/MamaYeMalawi

CELEBRATING SUCCESS

Heroine posters – Malawi, 2013

PITALA

IN THE LAST 10 YEARS THERE HAVE BEEN

THIS IS BECAUSE SHE IS A LEADER THAT HAS HELPED HER COMMUNITYPLAN AND SPACE THEIR FAMILIES

WHAT CAN YOU DO?

PITALA HAS LED HER COMMUNITY INTO A NEW FUTUREWHERE MOTHERS AND BABIES SURVIVE CHILDBIRTH

MATERNAL DEATHS IN PITALA VILLAGEZ E R O

MAMAYE HEROINE

websitetwitterfacebook

mamaye.org.mwtwitter.com/MamaYeMWfacebook.com/MamaYeMalawi


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RICHARD SPENT HIS TIME AND MONEY ADORNING HIS LOCAL HEALTH FACILITY, OFTEN MISTAKEN FOR A MARKET BUILDING, WITH ARTWORK. THE MORE APPEALING ENVIRONMENT HAS ENCOURAGED PREGNANT

WOMEN TO ACCESS SKILLED CARE.

WHAT ACTION CAN YOU TAKE TO SAVE THE LIVES OF MOTHERS AND BABIES?

MAMAYE HERO AKINKUGBE RICHARDAKINKUGBE RICHARD

* RICHARD AKINKUGBE, CHAIRMAN, WARD DEVELOPMENT COMMITTEE, MOFERERE OJA PHC, ONDO, ONDO STATE

web:facebook:twitter:

www.mamaye.org.ngMamaYeNigeria@MamaYeNigeria

ABIYE CHAMPION

Hero / Heroine posters – Nigeria, 2014

CELEBRATING SUCCESS

THE EMERGENCY TRANSPORT SYSTEM USED BY THE GAR WARD DEVELOPMENT COMMITTEE HAS ENSURED 421 PREGNANT WOMEN AND 334 CHILDREN ACCESSED HEALTH FACILITIES.

IN GAR WARD MOTHERS & BABIES SURVIVE!

YOUR GROUP CAN TAKE ACTION, WHAT DO YOU DO TO SAVE LIVES?


www.mamaye.org.ngMamaYeNigeria@MamaYeNigeria

* MEMBERS OF GAR WARD DEVELOPMENT COMMITTEE, ALKALERI LOCAL GOVERNMENT, BAUCHI STATE

GAR WARD DEV. COMMITTEE

MAMAYE CHAMPIONSWHEN COMMUNITIES TAKE ACTION!


24 25Posters – Malawi, 2015

RAISING AWARENESS MATERNAL AND NEWBORN HEALTH ADVOCACY: REFRAMING THE ISSUE

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ENGAGING THE AFRICAN PUBLIC IN SOLUTIONS

‘Give Blood to save a Mama and a Baby’ Postcard – Sierra Leone, 2013 ‘Give birth in safe clinics’ Billboard – Sierra Leone, 2013 ‘Give birth in safe clinics’ Billboard – Sierra Leone, 2013


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At the start of the programme, we observed that decision-makers in this field did not have access to the right information at the right time. Evidence was often contained in lengthy, technical reports that were impenetrable to non-experts or lacked the analysis needed to make the information meaningful. In some cases it was not made available to all. It was also extremely dispersed and difficult to access – in scientific papers, numerous websites, reports, databases, guidelines - making it difficult for advocates or decision-makers to use.

MamaYe curates and brings this information together into a repository through its evidence web-pages, summarising the key messages for busy users while also making it simple to access the original source. Data is also translated into packaged evidence products with eye-catching and accessible designs, targeted to specific audiences. All our evidence products are peer-reviewed by experts in maternal and newborn health to ensure that the data and messaging are accurate.

≥ Evidence summaries and e-blasts

≥ Infographics

≥ Scorecards

≥ Dashboards

≥ Factsheets

≥ Maternal Death Surveillance and Response (MDSR) Action Network

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EVIDENCE SUMMARIES AND E-BLASTS

MamaYe evidence pages


MamaYe evidence blast

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For references and notes on calculations, visit: www.mamaye.org/references

PREMATURITY IN TANZANIAMost deaths due to preterm birth could be averted with the right care before, during and after delivery, largely using simple cost-effective interventions.

Prioritise these evidence-based, cost-effective, and feasible solutions across all health facilities in Tanzania that provide pregnancy and delivery services!

Newborn resuscitation Hygienic cord careAntibioticsMother to newborn skin-to-skin contactBreastfeedingSkilled healthcare providers Focus on the 48 hours surrounding birth.

EVERY YEAR IN TANZANIA

BABIES ARE BORN TOO SOON 213,500

THIS MEANS

1 IN EVERY 10DEATHS OF CHILDRENUNDER 5 YEARS OLD IS A BABY WITH PRETERM COMPLICATIONS.

TANZANIAN BABIES.

THAT IS

1 IN EVERY 9

OF THESE PRETERM BABIES DIE FROM PRETERM COMPLICATIONS.

9,400

TANZANIA HAS THE12TH LARGEST NUMBER OF PRETERM BIRTHS IN THE WORLD.

WATOTO NJITI NCHINI TANZANIAVifo vingi vinavyosababishwa na matatizo ya kuzaliwa njiti vingeweza kuzuilika kwa huduma sahihi kabla, wakati

na baada ya kuzaliwa kwa kutumia njia rahisi na zisizo na gharama kubwa.

Toa kipaumbele kwa hatua hizi muhimu na zenye gharama nafuu zinazopaswa kutolewa kwenye vituo vyote vya huduma za afya Tanzania ambapo huduma kwa wajawazito zinapatikana kabla, wakati na baada ya kujifungua!

Huduma za kuokoa maisha ya mtoto mchanga ikiwemo kumsaidia kupumuaUtunzaji wa kitovu AntibiotikiHuduma ya ngozi kwa ngozi kwa mama na mtoto mchanga Unyonyeshaji maziwa ya mamaWahudumu wa afya wenye ujuzi Msisitizo ukiwekwa katika saa 48 baada ya kujifungua.

1 HUZALIWA NJITI

TANZANIA: KILA MWAKA WATOTO WACHANGA

WANAZALIWA KABLA YA MUDA

213,500

KATI YA KILA WATOTO 9WANAOZALIWA HAI TANZANIA,

TANZANIA NI YA 12 ULIMWENGUNI KWA KUWA NA IDADI KUBWA YA WATOTO WANAOZALIWA KABLA YA MUDA.

KATI YA WATOTO HAO NJITI HUFARIKI KUTOKANA NA

MATATIZO YATOKANAYO NA KUZALIWA KABLA YA WAKATI.HII INAMAANISHA

9,4001 KATI YA KILA WATOTO 10WANAOFARIKI KABLA YA KUTIMIZA MIAKA 5 HUWA NI KWA SABABU YA

MATATIZO YANAYOHUSIANA NA KUZALIWA NJITI.

More than 80% of all newborn deaths result from preventable and treatable conditions. These lives could be saved with available medicines and simple interventions.


NEWBORN SURVIVAL IN TANZANIA

Newborn resuscitation Hygienic cord careAntibioticsMother to newborn skin-to-skin contactBreastfeedingSkilled healthcare providers Focus on the 48 hours surrounding birth.

Crucially, if these solutions are scaled up, as has been committed to in the Sharpened One Plan, we could save 9,400 newborn lives and avert 2,500 stillbirths by the end of 2015.

EVERY YEAR IN TANZANIA

BABIES DO NOT SURVIVE THE FIRST MONTH OF LIFE39,000

MOST NEWBORN DEATHS HAPPEN IN THE TIME AROUND DELIVERY – WHERE LIFESAVING ACTION IS MOST NEEDED.

THE 11TH HIGHEST NUMBER OF NEWBORN DEATHS IN THE WORLD.

BABIES ARE STILLBORN – ALMOST HALF OF THEM DYING DURING DELIVERY.

IN ADDITION

47,000

OF ALL DEATHS TO CHILDREN UNDER 5 YEARS OLD.

OVERALL CHILD DEATHS HAVE REDUCED DRAMATICALLY, YET PROGRESS FOR NEWBORN SURVIVAL HAS BEEN MUCH SLOWER.

NEWBORN DEATHS NOW ACCOUNT FOR

40%

For references and notes on calculations, visit: www.mamaye.org/references

VIFO VINGI VYA WATOTO WACHANGA HUTOKEA KATIKA KIPINDI

CHA KUZALIWA – KIPINDI AMBACHO HATUA MADHUBUTI ZA KUOKOA MAISHA ZINAHITAJIKA.

TANZANIA: KILA MWAKA WATOTO WACHANGA

HAWAISHI ZAIDI YA MWEZI MMOJA WA MAISHA

39,000

HIVI SASA VIFO VYA WATOTO WACHANGA VINACHANGIA ASILIMIA

YA VIFO VYOTE VYA WATOTO WALIO NA UMRI WA CHINI YA MIAKA 5.

KWA UJUMLA, VIFO VYA WATOTO VIMEPUNGUA KWA KIWANGO

KIKUBWA, LAKINI MAENDELEO YAMEKUWA YA KASI NDOGO KWENYE UHAI WA WATOTO WACHANGA

40%

HUZALIWA WAFU – KARIBU NUSU YAO WAKIFA WAKIWA WANAZALIWA.

NA ZAIDI YA HAPO, WATOTO WACHANGA 47,000

Zaidi ya asilimia 80% ya vifo vyote vya watoto wachanga hutokana na sababu zinazozuilika au kutibika. Maisha ya watoto hawa yangeweza kuokolewa kwa kuwepo dawa na huduma nyingine rahisi.

Toa kipaumbele kwa hatua hizi muhimu na zenye gharama nafuu zinazopaswa kutolewa kwenye vituo vyote vya huduma za afya Tanzania ambapo huduma kwa wajawazito zinapatikana kabla, wakati

na baada ya kujifungua!

UHAI WA WATOTO WACHANGA TANZANIA

Huduma za kuokoa maisha ya mtoto mchanga ikiwemo kumsaidia kupumuaUtunzaji wa kitovu AntibiotikiHuduma ya ngozi kwa ngozi kwa mama na mtoto mchanga Unyonyeshaji maziwa ya mamaWahudumu wa afya wenye ujuzi Msisitizo ukiwekwa katika saa 48 baada ya kujifungua.Muhimu zaidi ni kwamba, iwapo hatua hizi zitasimamiwa

utekelezaji wake katika maeneo mengi zaidi, kama ambavyo imeahidiwa katika Mkakati Ulioboreshwa wa Kupunguza

Vifo vya Mama na Watoto wachanga, basi ifikapo mwaka 2015 tunaweza kuokoa maisha ya watoto wachanga 9,400 pamoja na kuepusha watoto wengine

2,500 kuzaliwa wafu.

TUNASHIKA NAFASI YA 11 MIONGONI MWA NCHI ZENYE IDADI KUBWA YA VIFO VYA WATOTO WACHANGA ULIMWENGUNI.

INFOGRAPHICS

World Prematurity Day – Tanzania, 2014

0

50

100

150

200

MCHINJI MOTHERS & BABIES CAN SURVIVE & THRIVE IF WE ALL TAKE THE FOLLOWING THREE STEPS:

CALLING ON MCHINJI’S HEALTHCARE WORKERS!

HEADACHES

SEVERE ABDOMINAL PAIN

BLURRED VISION

BLEEDING DURING PREGNANCY OR AFTER YOUR BABY IS BORN

SWELLING OF HANDS, FEET AND FACE

FEVER OR FEELING SHIVERY, COLD AND SWEATY

200

150

100

50

0JAN 2012

NU

MB

ER

OF

UN

ITS BLOOD DEMAND

BLOOD SUPPLY

SEPT 2013

WHAT ARE THE DANGER SIGNS?WHY?

WHY?

Because 77 women died from pregnancy and childbirth related causes in Mchinji between 2010 and 2013.

Because between 2010 and 2013 nearly half of women in Mchinji who died during pregnancy or childbirth died because of blood loss.

WHAT CAN YOU DO?

WHAT CAN YOU DO?

1.

1.

1.2.

3.

2.

2.

40 WOMEN

19 WOMEN

9 WOMEN3.

3.

KNOW THE DANGER SIGNS

INCREASE BLOOD SUPPLIES

COUNT NEWBORN DEATHS

Help mamas have an ACTION PLAN: WHERE to go WHEN to go HOW to get there

SPEAK OUT! If your health facility does not have the supplies and equipment needed to care for mothers and babies - it’s not safe!

If supplies, like blood or equipment, are running low in your health facility INFORM the district health officer or safe motherhood coordinator.

Make sure you have:

YOU need these to make a difference to your community.

Keep counting newborn deaths

Record EVERY newborn death and EVERY stillbirth in your clinic

Share these records with your safe motherhood coordinator

Failed to recognise danger signs

From July to September 2013 there was almost no blood available in Mchinji. There is still not enough blood to meet demand

BLOOD AVAILABILITY & DEMAND

!

!

www.mamaye.org.mwMamaYeMalawi@MamaYeMW


All data obtained from Mchinji HMIS on maternal and newborn health (January 2011-March 2014).

Because there were 502 newborn deaths in Mchinji in 2013.

THAT’S NEARLY 10 NEWBORNS EVERY WEEK

BECAUSE THEIR DEATHS WERE NOT COUNTED LESSONS WERE NOT LEARNT.

When many babies die, their deaths are often ignored. As a result we overlook the causes of death and cannot learn from the experience and many more newborn babies die from preventable causes. That is why it is important to COUNT all the babies born – including those that die – in Mchinji.

WHAT CAN YOU DO?WHY?

Went through an unsafe traditional practice

Refused treatment

9 with missing data

!

!

!

!

!

!

!

THERE WAS NO BLOOD AVAILABLE DURING THESE EMERGENCIES.

SUPPLIES

EQUIPMENT

BLOOD

! IF BLOOD SHORTAGES CONTINUE, WOMEN WILL CONTINUE TO DIE.


Mchinji’s healthcare workers poster – Malawi, 2014

34 35

INFOGRAPHICS

‘World Blood Donor’ infographics – 2013 / 14


World Prematurity Day – Global, 2013

36 37

SCORECARDS

mamaye.org.ngMamaYeNigeria@MamaYeNigeria

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Jigawa State ISS Scorecard

Data for 12 CEmONC hospitals, and BEmONC

health facilities in 9 Gunduma Districts

Health facilities scorecard – Nigeria, 2014


6

Patients Care Performance Management

Criteria assessed: The availability of doctors 24 hours a day, seven days a week; protocols are available and in use; clinical and management meetings are regularly held; information is available and in use; education and communication (IEC) materials are available and in use; and effective sharps and material disposal methods are in place.

Babura General Hospital:

Birnin kudu

General Hospital:

Birniwa General Hospital:

Balangu General Hospital:

Dutse General

Hospital:

Gumel General Hospital:

Gwaram General

Hospital:

Hadeja General Hospital:

Jahun General

Hospital:

Kafin Hausa General Hospital:

Kazaure General

Hospital:

Ringim General Hospital:

State Average:

1st quarter 2013 2nd quarter 2013 1st quarter 2014

80%

73%

87%

80%

93%

0%

67%

80%

100%

53%

93%

73%

73%

93%

87%

80%

80%

73%

80%

73%

93%

87%

87%

73%

93%

83%

80%

93%

80%

87%

80%

100%

93%

87%

87%

87%

93%

100%

89%

18

Patients Care Performance Management

Criteria assessed: Revised standing orders are available and in use; education and communication (IEC) materials are available and in use; each facility has basic laboratory equipment where services are provided and available.

Birnin Kudu Gunduma:

Birniwa Gunduma:

Dutse Gunduma:

Gumel Gunduma:

Hadejia Gunduma:

Jahun Gunduma:

Kafin Hausa Gunduma:

Kazaure Gunduma:

Ringim Gunduma:

State Average:

1st quarter 2013 2nd quarter 2013 1st quarter 2014

89%

80%

91%

95%

88%

86%

91%

90%

84%

88%

77%

86%

90%

92%

84%

87%

79%

82%

84%

85%

90%

83%

93%

95%

90%

83%

85%

83%

87%

89%

38 39

mamaye.org.ngMamaYeNigeria@MamaYeNigeria

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MAMAYE ASKS YOU TO ENSURE:

1. Better and complete data for tracking MNCH progress

2. Functional blood banks in every secondary health facility

3. Every woman in your district delivers in a facility with a skilled birth attendant

4. The commitment to allocate 15% of government spending to the health sector is metKANO STATE

MATERNAL, NEWBORN AND

CHILD HEALTH SCORECARD

SCORECARDS

Kano State MNCH Scorecard – Nigeria, 2014

KANO STATE MNH SCORECARDINDICATOR 2011 2012 INDICATOR 2011

43% 32%

67% 67%

% of pregnant women making at least 4 antenatal care visits according to standards 48% 40%

49% 50%

% of secondary health care facilities providing comprehensive emergency obstetric care services 30% 32%

8% 9%

Evidence of civil society organisations’ involvement in the development, monitoring and review of mid-term sector strategy

HIGH HIGH

Availability of standards and mechanisms for graded accreditation of private facilities offering MNCH services

NO YES

At least 12 multi-sectoral and development partner meetings held according to the extant coordination mechanism in a year

5

% of health budget spent on health research and evaluation by the State (Target is 2%)

99% 98%

2% 2%

% of health facilities with protocols (job aids) for MCH

Monthly payment of midwifery service scheme (MSS) midwives by the Federal Government

50%

% of health facilities with midwives and community health extension workers, providing care 24 hours a day, 7 days a week

50%

80%

% of facilities with at least 3 modern family planning commodities in stock

% of fully immunised children aged 12-23 months

% of births attended by a skilled health personnel

State budget allocated to the health sector (Target is 15%)

% of public health facilities having active facility health committees

% of neonates who did not present with sepsis

% of 15-49 year-old females using modern contraception

% of health facilities with magnesium

% of health facilities with oxytocin or ergometrine

% of health facilities with antibiotics

Availability of misoprostol

Availability of antihypertensive drugs

% of health facilities with fluids and giving sets

% of health facilities with haematinics

% of health facilities with disinfection materials

% of health facilities with mosquito nets

% of health facilities with safety boxes in all service points

% of health facilities with waste bins

% of health facilities with a good water source

% of health facilities with an electricity source

% of health facilities with delivery kits

% of health facilities with free MCH packs

Monthly payment of MSS midwives by the State

Monthly payment of MSS midwives by the LGA

% of health facilities with medical doctors

% of health facilities with lab technicians

% of health facilities with anti-malarial drugs

NO DATA AVAILABLE INDICATOR ACHIEVED: RELATIVELY GOOD PROGRESS: POOR PERFORMANCE:

COLOUR KEY:

75–100%50–74% BELOW 5O%

2012

80%

50%

80%

60%

80%

80%

50%

80%

50%

80%

50%

50%

80%


40 41

We call on the government to increase the budget for health and make sure that funds are disbursed on time

PROMISED 15%

COMMITED TO SPEND 10.5% IN 2013

AS OF JULY 2013 LESS THAN 2% HAD BEEN DISBURSED

KEEP THE PROMISE, MEET THE ABUJA TARGET TRANSFER FUNDS ON TIME!

INVEST MORE IN EACH SIERRA LEONEAN MAKE HEALTH A PRIORITY IN SALONE

FEWER MOTHERS AND BABIES WILL SURVIVE IF OUR GOVERNMENT DOES NOT INVEST MORE IN THE NATIONS HEALTH

In 2001 Sierra Leone promised to spend 15% of its total annual budget on health by 2015 under the Abuja Declaration.

Despite the increase of health budget from 7.4% in 2012 to 10.5% in 2013, Sierra Leone is still below the promised 15% target. Yet the gap can be closed. Neighbouring countries like Liberia achieved 15% Abuja target before 2015.1

Allocated funds are not getting to where they are most needed on time. Six months into 2013, less than 2% of the 10.5% that had been promised for health had actually been disbursed.4

This means that many health providers, working tirelessly in remote communities have gone for at least 6 months without the funds.

The World Health Organisation (WHO) advises governments to spend at least US$54 per person in order to provide basic health services.5 Sierra Leone only spends $7.6 per person, far below the recommendation. In comparison, Ghana spends 4 times more.6

Our health is worth more than LE 43,000 per person! We estimate that increasing Government health expenditure per capita by $1 a year could save 1000 more children under-5 and 100 more mothers in Sierra Leone.7

In 2012 Sierra Leone had the fastest growing economy insub-Saharan Africa.

However the proposed expenditure on health as a proportion of GDP remains unacceptably low at 1.2% in 2013.

$6.4

1.2%

$6.6 $7.6

2011 2012 2013

MOREPER$1

Government’s Health Budget as a share of GDP

1000 MORECHILDRENUNDER 5

100 MORE MOTHERS IN SALONE

Progress Against Abuja Target

Proportion Of Health Budget Disbursed

GoSL Health Expenditure Per Capita

WHO RECOMMENDATIONPER CAPITA GOSL EXPENDITURE ON HEALTH

$54 $54 $54

11%7.4%

10.5%

2011 2012 2013

ABUJA TARGETGOVERNMENT HEALTH BUDGET

15% 15% 15%

IF OUR ECONOMIC GROWTHIS TO BE SUSTAINABLE THEN WE MUST INVEST IN THE HEALTH OF OUR PEOPLE.

Sources

All except ‘Proportion of Health Budget Disbursed’ cited from: Budget Tracking Report 20131. UNAIDS 20132. WHO 20123. UNICEF 20124. MoFED: Release of FY 2013 first half ( Jan- Jun) allocations5. Morena-Serra 20116. Africa public health 20127. Estimates; Source: Bokhari et al. 2007, WHO 2012, UNICEF 2013

SIERRA LEONE HEALTH BUDGET TRACKING SCORECARD 2013

5 MOTHERS2

AND 30 BABIES3

DIE EVERY DAY IN SIERRA LEONE. WE MUST INVEST IN HEALTH.

SCORECARDS

Health budget scorecard – Sierra Leone, 2013

Although 46% of the money transferred to each council had been sent by the middle of the year, no council had received funding during the first quarter.

FUNDS FOR HEALTH NEED TO BE DISBURSED TIMELY.Freetown receives the highest amount for health, far before the other districts. Although Bonthe receives the most per person, due to the small population of the district, the council still receives the smallest amount for health compared to the other districts. Kono receives few money per person and overall.

7000

BONTHE WESTERN KOINADUGU KAILAHUN KENEMA PUJEHUN MOYAMBA KAMBIA BOMBALI TONKOLILI PORT LOKO KONO BO

1 2 3 4 5 6 7 8 9 10 11 12 13

6100 4700 4300 3500 2400 2200 1800 1600 1400 1300 1200 1000 700

6000

5000

4000

3000

2000

1000

RANK2013 PER CAPITA

EXPENDITURE

DISTRICT COUNCILS NEED TO SPEND MORE ON HEALTH

IN LEONES, ROUNDED TO THE NEAREST HUNDRED LEONES

IN MILLION LEONES, ROUNDED TO THE NEAREST HUNDRED OF MILLION

Health Expenditure Per Person, January - June 2013

Disbursement from Ministry of Finance to Local councils, by end of June 2013

FREETOWN BO BOMBALI KENEMA PORT LOKO WESTERNRURAL TONKOLILI KAILAHUN KOINADUGU KONO KAMBIA PUJEHUN MOYAMBA BONTHE

111000 3400 3300 3100 2200 1800 1500 1500 1400 1300 1200 1100 1000 700

5100 1600 1500 1400 1000 800 700 700 600 600 500 500 500 300

12000

10000

8000

6000

4000

2000

ALLOCATED

DISBURSED

0

Sources: • Africa Public Health Alliance and Public Health Network (2012) 2012 Public health financing scorecard

- Second quarter 2012: AU July 2012 summit , & joint conference of ministers of finance and health• Bokhari, F.,Y.Gai, and P. Gottret (2007) Government health expenditures and health outcomes. Health

economics 16 • Budget tracking Consortium (2013) Sierra Leone Budget tracking Report 2013• MoFED: Release of FY 2013 first half ( January- June) allocations• UNAIDS and AU (2013) Abuja+12: shaping the future of health in Africa• UNICEF (2012) Child mortality report 2012.• WHO, UNFPA, UNICEF and the World Bank (2012) Trends in maternal mortality: 1990 to 2010• R. Moreno-Serra et al. (2011) The effects of health coverage on population outcomes

www.mamaye.org.sl

SIERRA LEONE HEALTH BUDGET TRACKING SCORECARD 2013

We call on the government to increase the budget for health and make sure that funds are disbursed on time

FEWER MOTHERS AND BABIES WILL SURVIVE IF OUR GOVERNMENT DOES NOT INVEST MORE IN THE NATIONS HEALTH


42 43

DASHBOARDS

Mchinji district dashboard – Malawi, 2014



web:facebook:

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SPEAK UP FOR YOUR DISTRICT. THE MOTHERS, BABIES AND PUBLIC OF MCHINJI ARE RELYING ON YOU!

Calling on Mchinji’s district leaders Help save the mothersand babies in your district!

YOU CAN HELP SAVE THE LIVES OF MCHINJI’S MOTHERS AND BABIES.HOW?

Excessive bleeding is the leading cause of maternal deaths in Mchinji. Blood loss is responsible for half of maternal deaths in Mchinji.

A lack of blood was a contributing factor in 1 in 5 maternal deaths.

You must encourage community members to give blood regularly because the amount of blood available in Mchinji district is low.

Make sure district planners manage the collection and storage of blood. This will improve the availability of blood in Mchinji

Help facilitate and support blood donation campaigns in mchinji’s communities.

Voluntary blood donation can save the lives of our mothers and babies.

(cumulative since 2010)

Total deaths = 68 between 2010 - 2013.

2. Address blood shortages in Mchinji

Mchinji: Immediate cause of Maternal deaths

Blood availability and demand

LESS BLOOD WAS DONATED IN 2013 THAN 2012. WITHOUT BLOOD, WOMEN WILL CONTINUE TO DIE.

Hemorrhage

Eclampsia

Sepsis

Anaemia

Pulmonary Embolism

Others

47%

9%

12%

10%

3%

19%

0

50

100

150

200200

150

100

50

0

JAN 2

012

MAR 2

012

MAY 2

012

JUL 2

012

SEP 2012

NOV

2012

JAN 2

013

MAR 2

013

MAY 2

013

JUL 2

013

SEP 2013

NOV

2013

JAN 2

014

MAR 2

014

NU

MB

ER

OF

UN

ITS

BLOOD DEMAND

BLOOD SUPPLY

FROM JULY TO SEPTEMBER 2013 THERE WAS ALMOST NO BLOOD AVAILABLE IN MCHINJI. THERE IS STILL NOT ENOUGH BLOOD TO MEET DEMAND

Mchinji policy maker leaflet – Malawi, 2014

44 45

SIERRA LEONEDEcEmbER 2013

EvERy wOmAN cAN SuRvIvE

chILDbIRth wIth SAfE cLINIcS

Maternal and newborn health factsheet

we CoUld SaVe UP tofroM PregnanCy related CaUSeS and Childbirth

2000Maternal Mortality

faCility iMProVeMent teaM (fit)

aSSeSSMentS

neonatal Mortality

Mdgs

This is the death of a woman while pregnant or within 42

days of termination of pregnancy, from any cause related to

or aggravated by the pregnancy or its management, but not

from accidental or incidental causes. It can be measured

in terms of maternal mortality ratio, which is the number

of maternal deaths during a given time period per 100,000

live births (WHO 2012).

The FIT assess emergency obstetric and newborn services

in light of the availability of key enablers which are: water

and sanitation; electricity; referrals; equipment; laboratory

and blood services; staffing; drugs and supplies.

(MoHS, 2013)

This is the death of a newborn baby within the first 28 days

of life. It can be measured in terms of neonatal mortality

rate, which is the number of deaths per 1,000 live births

(WHO 2006).

The United Nations Millennium Development Goals

(MDGs) are eight goals that 191 UN states have agreed

to try to achieve by the year 2015. The United Nations

Millennium Declaration, signed in September 2000

commits world leaders to combat poverty, hunger,

disease, illiteracy, environmental degradation and

discrimination against women (WHO 2013).

MamaYe sierra Leone

12A King StreetOff the MazeDALAN Consultants

Freetown, Sierra Leonemamaye.org.slMamayeSierraLeone@MamaYeSL


1 NEWBORN COULD BE SAVED EVERY HOUR

A WOmAN iN SiERRA LEONE HAS ALifEtimE RiSk Of DYiNgfROm A mAtERNAL CAUSEIN SIERRA LEONE

1 in 23

one thirdOf mAtERNAL DEAtHSin sierra leone are caused by

haeMorrhage or heaVy bleeding

Source: WHO, UNICEF, UNFPA & The World Bank 2012

Source: UNICEF, 2012

Source: MoHS-RHFP Programme, 2013


woMen who die annUally

mORE tHAN ONE NEWBORN BABY DiES EVERY HOURUP tO

TERMS EXPLAINED

?

To download sources please visit:

www.mamaye.org/references

January 2014

WitH ACCESS tO SAfE CLiNiCS AND SkiLLED CARE

SIERRA LEONE

DEcEmbER 2013

EvERy wOmAN cAN SuRvIvE chILDbIRth wIth SAfE cLINIcS

Maternal and newborn health

factsheetwe CoUld SaVe UP to

froM PregnanCy related CaUSeS and Childbirth

2000 Maternal Mortality

faCility iMProVeMent teaM (fit) aSSeSSMentS

neonatal Mortality

Mdgs

This is the death of a woman while pregnant or within 42 days of termination of pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes. It can be measured in terms of maternal mortality ratio, which is the number of maternal deaths during a given time period per 100,000 live births (WHO 2012).

The FIT assess emergency obstetric and newborn services in light of the availability of key enablers which are: water and sanitation; electricity; referrals; equipment; laboratory and blood services; staffing; drugs and supplies.(MoHS, 2013)

This is the death of a newborn baby within the first 28 days of life. It can be measured in terms of neonatal mortality rate, which is the number of deaths per 1,000 live births (WHO 2006).

The United Nations Millennium Development Goals (MDGs) are eight goals that 191 UN states have agreed to try to achieve by the year 2015. The United Nations Millennium Declaration, signed in September 2000 commits world leaders to combat poverty, hunger, disease, illiteracy, environmental degradation and discrimination against women (WHO 2013).

MamaYe sierra Leone12A King StreetOff the MazeDALAN ConsultantsFreetown, Sierra Leone

mamaye.org.slMamayeSierraLeone@MamaYeSL

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1 NEWBORN COULD BE SAVED EVERY HOUR

A WOmAN iN SiERRA LEONE HAS A

LifEtimE RiSk Of DYiNgfROm A mAtERNAL CAUSE

IN SIERRA LEONE

1 in 23

one thirdOf mAtERNAL DEAtHSin sierra leone are caused byhaeMorrhage or heaVy bleeding


Source: UNICEF, 2012

Source: MoHS-RHFP Programme, 2013


woMen who die annUally

mORE tHAN ONE NEWBORN BABY DiES EVERY HOUR

UP tO

TERMS EXPLAINED

?

To download sources please visit:www.mamaye.org/references

January 2014

WitH ACCESS tO SAfE CLiNiCS AND SkiLLED CARE

TERMS EXPLAINED

Maternal Mortality

neonatal Mortality

MDGs

is the death of a woman while pregnant or within 42 days of termination of pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes. It can be measured in terms of maternal mortality ratio, which is the number of maternal deaths during a given time period per 100,000 live births (WHO 2012).

It is the death of a child who is born alive, but dies within the first 28 days of life. It can be measured in terms of neonatal mortality rate, which is the number of deaths per 1,000 live births (WHO 2006).

The United Nations Millennium Development Goals (MDGs) are eight goals that 191 UN states have agreed to try to achieve by the year 2015. The United Nations Millennium Declaration, signed in September 2000 commits world leaders to combat poverty, hunger, disease, illiteracy, environmental degradation and discrimination against women. (WHO 2013c)

Mama Ye TanzaniaPlot 164C, Msasani BeachKinondoni, P.O. Box 13731Dar es Salaam


mamaye.or.tzMamaYeTZ@MamaYeTZ

January 2014

web:facebook:

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?

JUST HALF OF WOMEN attending antenatal care

for preGnancy coMplications

are Given inforMation about warn!ng signs

Source: NBS and ICF Macro 2011

17,000 first-day deaths every year

there is the possibility of saving the lives of up to

When a baby is born alive and does not surviveit indicates poor quality delivery care

WE COULD SAVE UP TO

MotHers WHo cUrrently DieEACH YEAR

8500

130 neWBorns every day

eacH Day 47 neWborns

of all Tanzanian newborn deaThsHappen on tHe Day tHey are born

tanzania is one of them

do not survive their first day

Source: Save the Children 2013

Source: Save the Children 2013

Source: WHO, UNICEF, UNFPA and The World Bank 2012

10 countriesof all neWborn DeatHs Globally occUr intwo thirds

one third

THERE ARE

TANZANIA

Maternal and neWborn health

factsheetWE COULD SAVEAN ESTIMATED

MOTHERS EVERY YEAR2700 Maternal MOrtalItY

neOnatal MOrtalItY

MDGs

is the death of a woman while pregnant or within 42 days of termination of pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes. It can be measured in terms of maternal mortality ratio, which is the number of maternal deaths during a given time period per 100,000 live births (WHO, UNICEF, UNFPA & The World Bank 2012).


The United Nations Millennium Development Goals (MDGs) are eight goals that 191 UN states have agreed to try to achieve by the year 2015. The United Nations Millennium Declaration, signed in September 2000 commits world leaders to combat poverty, hunger, disease, illiteracy, environmental degradation and discrimination against women (WHO 2013).

MamaYe Ghana Alliance for Reproductive Health Rights (ARHR)The Alliance SecretariatP. O. Box CT6103Cantonments, Accra,Greater Accra Region Ghana

mamaye.org.ghmamayeGH@MamaYeGH

web:facebook:

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63NEWBORNS COULD BE SAVED DAILY

A WOMAN IN GHANA HAS A

LIfETIME RISk Of DYINGfROM A MATERNAL CAUSE

63 NEWBORNS DIE EVERY DAY DURING CHILDBIRTH

WITH ACCESS TO SAfE CLINICS AND SkILLED CARE

IN GhANA

1 in 68

39 m dw vesfOR EVERY 200,000 pOpULATION THERE ARE

53 pER 200,000 WOULD BE REqUIREDto meet the national target

NATIoNAlly


Source: Derived from UNICEF 2012

Source: Ministry of Health & Ghana Health Service 2011


TERMS EXPLAINED

?


January 2014

GhANA

Maternal anD newbOrn health

factsheetWE COULD SAVEAN ESTIMATED

MOTHERS EVERY YEAR3000 MATERNAL MORTALITY

NEONATAL MORTALITY

MDGs

is the death of a woman while pregnant or within 42 days of termination of pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes. It can be measured in terms of maternal mortality ratio, which is the number of maternal deaths during a given time period per 100,000 live births (WHO, UNICEF, UNFPA & The World Bank 2012).


The United Nations Millennium Development Goals (MDGs) are eight goals that 191 UN states have agreed to try to achieve by the year 2015. The United Nations Millennium Declaration, signed in September 2000 commits world leaders to combat poverty, hunger, disease, illiteracy, environmental degradation and discrimination against women (WHO 2013c).

MamaYe Malawi Parent and Child Health InitiativeE4A KCN Offices,P.O. Box 31686LilongweMalawi

mamaye.org.mwMamaye-Malawi@MamaYeMW

web:facebook:

twitter:

2NEWBORNS COULD BE SAVED EVERY HOUR

A WOMAN iN MALAWi HAS A

LifETiME RiSk Of DYiNgfROM A MATERNAL CAUSE

2 NEWBORNS DiE EVERY HOUR DURiNg CHiLDBiRTHIN MALAWI

1 in 36

80 000UNiTS Of BLOOD EACH YEAR66% of blood needed in Malawi goes to mothers and children

MALAWI NEEDS


Source: Derived from UNICEF 2012

Source: M’baya 2009


TERMS EXPLAINED

?


January 2014

MALAWI

MATERNAL AND NEWbORN hEALTh

factsheet

FACTSHEETS

Maternal and newborn health factsheet – 2013/14/15


46 47

FACTSHEETS

Sepsis factsheet – 2014


Water, sanitation and hygiene facts and figures – 2015

48 49

MATERNAL DEATH SURVEILLANCE AND RESPONSE ACTION NETWORK

MDSR Action Network – website


Maternal Death Reviews: Call to Action – Sierra Leone, 2013

Sierra Leone Maternal Death Reviews :A National Call to Action

Sierra Leone Maternal Death Reviews:A National Call to Action

Sierra Leone has demonstrated progress in reducing maternal mortality; however, the lifetime risk of a woman dying in childbirth is 1 in 21. With a maternal mortality ratio of 857 maternal deaths among every 100,000 live births, it is still far off achieving the Millennium development target of 320 per 100,000 live births by 2015.

Maternal Death Reviews are a way of identifying causes contributing to maternal deaths where the findings can be used to improve quality of health care services and improve maternal survival.

1 in 21Lifetime risk ofdying in childbirth

Maternal Health in Sierra Leone

Health facilities or communities examining each maternal death through a systematic approach can lead to the following benefits that can inform appropriate non-punitive actions:· Establish the number and causes of deaths for action· Identify gaps in service delivery and improve professional practice and training· Better understanding of community barriers and challenges· Gain insight into the health system failures and weaknesses for action· More efficient management of resources.

In total, only around 10% of all maternal deaths across the country (224 among an estimated 2,050) were reported in 2011 through the facility-based MDR system from 13 district hospitals.

1. Haemorrhage (34%) accounted for over a third of all maternal deaths.2. Eclampsia (23%) accounted for over a fifth of all deaths.3. Puerperal sepsis (19%) accounted for nearly a fifth of maternal deaths.

Benefits of MDRs

Findings from a nation-wide MDR

The three main causes of reported maternal death were:

Key characteristics of the maternal deaths· The deaths occurred among women between 13 years and 48 years; more than a fifth of them (21%) were under 19 years of age. · A third of women were pregnant for the first time.· Most women (71%) were in their third trimester of pregnancy at the time of death.· Only a third (34%) of women were known to have a history of antenatal care attendance.· Most of the women (60%) died during the postnatal period, and almost half of those died within the first 10 days, particularly within the first 48 hours.

Other direct causes

Indirectcauses

Haemorrhage

Sepsis

Unsafe abortions

Eclampsia

Since the start of the Free Health Care Initiative in April 2010, more pregnant women, lactating mothers and children under 5 years old are accessing health care. For example, the number of deliveries recorded in facilities has increased four-fold since 2009 to 11,800 in 2011.

Although the proportion of maternal deaths in facilities has decreased since 2009, a key challenge that still remains is to improve the quality of care. One way to do this is through maternal death reviews (MDRs).

“This information can help to identify the root causes to prevent further deaths from the same causes on an action that can be followed up”

Most maternal deaths are avoidable. Maternal Death Review involves an in-depth investigation of the causes and circumstances surrounding a maternal death. It captures information about the number of maternal deaths and circumstances surrounding each death. This information can to help identify the root causes to prevent further deaths from the same causes based on actions that can be followed up.

“Without information, there can be no action”

What is a maternal death review ?

2009 2010 2011

Total deliveries recorded in facilities4.2 % 12,534

11,762

Maternal deaths (% of total deliveries in facilities)

Still births (% of total deliveries in facilities)

16.3 %

4,542

9.2 %

2.4 %

8.1 % 1.9 %

· Supportive legislation on MDR should be passed to ensure the process is seen as non-punitive action. · Strengthening of blood services, especially increasing availability of blood. · Strengthening referrals at all levels of care. · Establish database that can contribute towards more complete and comprehensive analysis. · Ensure actions are taken based on findings of MDRs by government and partners.· Strengthening adolescent friendly health service delivery with emphasis on programme targeting teenage pregnancies.· Strengthening advocacy at all levels with emphasis on increasing budget allocation to undertake MDR process and act on findings. · Strengthening community advocacy and sensitisation activities with emphasis on danger signs, service delivery and prompt referral to a facility.· Community MDRs should be incorporate into the national MDR process as a means of capturing more information about maternal deaths.

Avoidable factors

Strategic recommendations & next steps

Significantfactors

MOHS REPRODUCTIVE HEALTH AND FAMILY PLANNING PROGRAMME

Minimal Factors· Long distance to facility· TBAs not referring patient· Lack of medication

Moderate Factors· Lack of doctors and midwives· Lack of onward referral· Delay to initiate treatment· Poor staff management· Management at inappropriate level· Infrequent / prolong observations without any action

Significant Factors· Delay in seeking care · Non attendance of ANC · Non recognition of danger signs· Lack of blood · Lack of protocols · Delay in referral· Problems with initiate diagnosis / incorrect management

PCM Hospital, Fourah Bay Road FreetownMobile: Program manager 078564251E-mail: [email protected] Photos ©

Fatou Wurie Photography

51

ENGAGING THE PUBLIC

MamaYe works to develop materials which will appeal to the public in a visual language familiar to people from different parts of the continent.

Our ‘heroes and heroines’ posters seek to showcase real people who are playing their part in addressing maternal and newborn survival. To attract the attention of the public and media we draw on colours, patterns and designs used by musicians and other artists from our focus countries. We work with partners to make data available to the public through community events such as blood donation or MamaYe! Clubs. Our engagement in national election campaigns seeks to place maternal and newborn survival at the heart of all political party agendas. We support the capacity development of journalists and equip them with the skills and tools needed to investigate, understand, and share maternal and newborn evidence in accurate and innovative ways.

≥ Blood donation

≥ Improving survival

≥ Respectful care

≥ Youth engagement

≥ Political engagement

≥ Media

52 53

BLOOD DONATION

Blood donation banner – Tanzania, 2014

DAMU SALAMAUHAI WA MAMADAMU SALAMAUHAI WA MAMADAMU SALAMAUHAI WA MAMA

facebook: MamaYeTZ twitter: @MamaYeTZJiunge na majadiliano www.mamaye.or.tz/sw

ENGAGING THE PUBLIC

Blood donation poster – Tanzania, 2014

54 55

BLOOD DONATION

T-Shirt ‘I gave blood to save a mama’ – Tanzania, 2012

www.mamaye.org.tz

‘I gave blood to save a mama’ – Tanzania, 2012

ENGAGING THE PUBLIC

56 57

BLOOD DONATION

Blood donation posters – Nigeria, 2013

ENGAGING THE PUBLIC

58 59

INCREASING MATERNALAND NEWBORN SURVIVALTOGETHER OUR VOICES ARE LOUDER

mamayeGH@MamaYeGH

facebook:twitter:www.mamaye.org.gh

EVERY GHANAIAN MOTHER DESERVES A SAFE BIRTH

AND A HEALTHY B BYmamaye.org.ghmamayeGH@MamaYeGH

website:facebook:twitter:

IMPROVING SURVIVAL

Maternal and newborn survival web banner – Ghana, 2014

web:twiter:

facebook:

mamaye.org.gh@MamaYeGHMamaYeGH

Ghana’s RMNCH Commitments and Policies

Ghana’s RMNCH leaflet – Ghana, 2014

ENGAGING THE PUBLIC

60 61


References

All data obtained from Mchinji HMIS on maternal and newborn health (January 2011-September 2013).

1: World Health Organization, UNICEF, UNFPA, The World Bank & the United Nations Population Division. (2014). Maternal mortality in 1990-2013: Malawi. Geneva: WHO

web:facebook:

twitter:

LANKHULANI M’MALO MWA ANTU ANU! AMAI, ANA NDI ENA ONSE AKUDALIRA INU KUTI MUCHITEPO KANTHU!

KUPULUMUTSA NDI KUPITITSA PATSOGOLO MIYOYO YA AMAYI NDI ANA

MAFUMUAKUMCHINJI

CHITANIPO KANTHU!

Traditional leaders and community leaflet – Malawi, 2014

IMPROVING SURVIVAL

Onetsetsani kuti amayi oyembekezera akalandire chithandizo ku chipatala pamene nthawi yochira yafika

Perekani magazi. Limbikitsani ena kuti apereke magazi

Thetsani kachetechete wa imfa za makanda m’boma la Mchinji. Onetsetsani kuti imfazi zikufufuzidwa.

Yamikilani ntchito za bwino za anamwino m’boma la Mchinji

Zipatala zizikhala zodalililika ndi amai ndi ana ndiudindo wanu. Zipatala zodalilika zizikhala ndi:Madzi aukhondo Anamwino ovomerezeka ndi boma MagetsiMankhwala ndi zipangizo zoyenera Makina abwino akulabotale Galimoto zonyamula odwala

NGATI CHIPATALA CHA M’DERA LANU CHILIBE IZI, KALANKHULENI NDI WOYANG’ANIRA ZA UMOYO M’DERA LANU

KODI MUNGATANI? N’CHIFUKWA CHIYANI MUTENGEPO MBALI?

1.

4.

5.

6.

2.

!

Amayi ayenera kudziwa zazindikiro zoopsya pa nthawi yomwe ali oyembekezera ndi pobereka. Zina mwa zizindikiro ndi izi: Kupweteka kwambiri kwa m’mimba Kutaya magazi ambiri pamene ali oyembekezera kapena pamene mwana wabadwa Kupweteka kwa mutu Kutupa kwa manja, mapazi ndi nkhope Kuona zizumbazumba Kutentha thupi kapena kunjenjemera, kuzizidwa kapenanso kutuluka thukuta lambiri.

3.PAKATI PA CHAKA CHA 2010 NDI 2013 AMAI 77 A M’BOMA LA MCHINJI ADAMWALIRA CHIFUKWA CHA UCHEMBERE

KULANDIRA CHITHANDIZO NTHAWI YOYENERA

KUNGATHANDIZE KUPULUMUTSA MIYOYO 3400 YA AMAI PA CHAKA

M’MALAWI 1

Magazi ochuluka akufunika kuti miyoyo ya amai ndi ana ipulumutsidwe.

Makanda ambiri akumwalira mboma la Mchinji.

Amai oyembekezera ambili samadziwa nthawi yoti apemphe thandizo pa nkhani za ubereki/uchembereAmai atatu mwa asanu omwe adamwalira chifukwa cha uchembere samadziwa zizindikiro zoopsya zomwe zimaoneka panthwawi yobereka

THANDIZANI AMAYI OYEMBEKEZERA KUTI A

KONZEKERE PAMENE AONA ZIZINDIKIRO ZOOPSYA.

Mu chaka cha 2013, makanda okwanira 502 adamwalira mu zipatala za m’boma la mchinji. Makanda 502 pa chaka = Makanda 9 pasabata.

Anthu ambiri salabadira za imfa za makanda. Izi zikutathauza kuti sitingatengepo phunziro pa imfazi. Choncho makanda ambiri adzapitirira kumwalira. Kotero ndi kofunika kuti ana onse obadwa ngakhalenso omwalira aziwelengedwa.

Boma la Mchinji liri ndi vuto la kusowa kwa magazi othandizira amai oyembekezera ndi ana. Mwa imfa zisanu imodzi imadza Kamba kosowa magazi.

Pafupifupi theka la amai omwe amamwalira ali oyembekezera kapena nthawi yobereka m’boma la Mchinji ndi chifukwa chotaya magazi ambiri

PEREKANI MAGAZI. LIMBIKITSANI ANTHU A M’MUDZI MWANU KUTI ADZIPEREKA MAGAZI.

ONETSETSANI KUTI MAFUMU NDI ANTHU

AM’MUDZI AKUFUFUZA IMFA ZAMAKANDA. IZI

ZIDZATHANDIZA KUPEWA IMFA ZAM’TSOGOLO.

1.

2.

3.!

!

ENGAGING THE PUBLIC

62 63

UNAWEZA KUWAKINARA WAKUWAOKOAAKINAMAMA NA WATOTO WACHANGA

WEWE

JIUNGE NA KAMPENI MUOKOE MAMAMUOKOE MTOTO MCHANGA

MAMA YE! KUWA SEHEMU

LA HASHA!

MAMA YE! TANZANIA INATOA WITO KWA WATANZANIA WOTE

NA KUTOKUBALI DHANA POTOFU KUWAKIFO WAKATI WA KUJIFUNGUA NI JAMBO LA KAWAIDA

KUCHUKUA HATUA KWA AJILI YA AKINA MAMA NA WATOTO WACHANGA

YA MABADILIKO!www.mamaye.or.tz/swfacebook: MamaYeTZtwitter: @MamaYeTZ

Rukwa mothers leaflet – Tanzania, 2015

IMPROVING SURVIVAL

MP leaflet/poster – Ghana, 2013

AFRICANWOMENOF OUR SOCIETIESBACKBONEHAVE ALWAYS BEEN THE

EFFECT IN OUR COUNTRIES

IMAGINETHE CHANGE THEY COULD

REACH THEIR

FULL POTENTIALADDRESS BY H.E.

TO THE 68TH UNITED NATIONS GENERAL ASSEMBLYSEPT 2013

THE PRESIDENT OF THE REPUBLIC OF GHANAJOHN DRAMANI MAHAMA

IF ONLY WE’D HELP THEM

ENGAGING THE PUBLIC

64 65

YOU CAN BE A CHAMPION FOR THESURVIVAL OF OURBABIES

Rukwa mothers poster – Tanzania, 2015

IMPROVING SURVIVAL

INASIKITISHA SANA KWAMBA KILA MWAKA WATOTO WACHANGA WA TANZANIA 50,000 HUFARIKI NDANI YA MWEZI WA KWANZA BAADA YA KUZALIWA

Cha

nzo:

UN

FPA

, /W

HO

WATOTO WOTE WACHANGA WA TANZANIA WANASTAHILI KUISHI!

Maelfu ya watoto hawa wachanga wangeweza kuokolewa kama wanawake wote wajawazito:

Wangejifungulia kwenye vituo vya huduma za afya

Wangepata huduma ya kitaalamu mara tu baada ya kujifungua

Wangekuwa na taarifa kuhusu dalili za hatari za ujauzito

KITUO CHA HUDUMA ZA AFYA KILICHO KARIBU NAWE KINATAKIWA KUTOA HUDUMA ZIFUATAZO KWA AKINAMAMA NA WATOTO WACHANGA:

UNAWEZA KUFANYA NINI KUSAIDIA?

Huduma ya kitaalamu

Huduma bure ikiwemo dawa*

Huduma sahihi na kwa wakati hasa kwenye dharura

* Dawa muhimu na vifaa tiba ni pamoja na dawa za kutibu maambukizi pamoja na sindano maalum kwa ajili ya wajawazito wenye dalili za kujifungua kabla ya muda (antibiotics and steroid injections); vifaa kuwasaidia watoto wachanga kupumua (neonatal bags and masks), dawa ya kusafisha kitovu cha mtoto (chlorohexidine) na dawa za kutibu maambukizi kwa watoto (antibiotics).

≥ Jenga ufahamu miongoni mwa viongozi na jamii kuhusu hatua hizi zinazoweza kuwaokoa watoto wachanga

≥ Wahimize wanawake kujifungulia kwenye vituo vya huduma za afya na si majumbani

≥ Hamasisha maandalizi ya kumwezesha mama mjamzito kujifungulia katika kituo cha huduma za afya kama vile usafiri, msindikizaji, chakula n.k.

≥ Kuwa mwanaharakati kuhamasisha uwepo wa Mfuko wa Afya wa Jamii kwenye kituo chenu ambao utahakikisha dawa na vifaa vingine muhimu vinapatikana bure kwa wajawazito kabla na baada ya kujifungua*

AKINAMAMA NA FAMILIA:

Mnyonyeshe mtoto wako ziwa la mama mara tu

baada ya kuzaliwa

Mpe mtoto joto kwa kumbeba karibu kabisa na mwili

Jifunze jinsi ya kutunza usafi

wa kitovu.

HALI HII HAIKUBALIKI!

Rukwa babies leaflet in Swahili – Tanzania, 2014

ENGAGING THE PUBLIC

66 67

HOW TO SAVE BABIES BORN TOO SOONHOW TO SAVE BABIES BORN TOO SOON

MOTHERS:

IF YOUR BABYIS BORN TOO SOON

IF YOU THINk YOU ARE ABOUT TO gIvE BIRTH EARlY - gO TO A clINIc wHERE YOU cAN gET HElp

Breastfeed your baby within one hour of birth

Feed often with only breast milk

If your baby can’t suck properly ask your health worker for help

Drink plenty of water and eat healthy food

Keep newborn babies warm, and next to your skin

Learn how to keep your baby’s cord clean – ask your health worker

Think about family planning and longer spaces between babies – ask your health worker for advice

www. mamaye.org.ghfacebook: mamayeGHtwitter: @MamaYeGH

Prematurity poster – Ghana, 2013

IMPROVING SURVIVAL

EVERY YEAR

THAT’S

5,400 OF THESE

1 OUT OF EVERY 3 DEATHS

BABIES ARE BORN TOO SOON

AMONG NEWBORN BABIES

DIE FROM PRETERM BIRTH COMPLICATIONS

PREMATURITY IN MALAWI

1 & 2

3

3 & 4

111,700

Prematurity Day leaflet – Malawi, 2013

ENGAGING THE PUBLIC

68 69

RESPECTFUL CARE

Respectful care: ‘Inzi and Lazizi’ comics – Tanzania, 2013

ENGAGING THE PUBLIC

70 71

YOUTH ENGAGEMENT

Play your part in safe clincs – Sierra Leone, 2014

youth! act for salone’s futureYOU can help build a strong future for Sierra Leone

You must be a student or a young person aged 16-26. To apply answer this question in 250 words:

“What can I do to buILd a proSperouS future for SIerra Leone?”

Send your answer in 250 words with your full name, email address, phone number to: [email protected]

Or send us your contact details and 250 word answer as a message on Facebook:www.facebook.com/MamaYeSL

Got questions? Get in touch via Facebook or Twitter @MamaYeSLor text only on +23278974218.

Deadline for submissions is Monday 17th February at 5pm.

To do so, apply to be one of the 50 young people who will take action using mobile phones to save the lives of mothers and babies. Step up, learn more and have the chance to use technology for change.

Mobile project poster – Sierra Leone, 2013/14

ENGAGING THE PUBLIC

72 73

KEEP MOTHERS AND BABIES

AT THE HEART OF YOUR AGENDA

WHATEVER YOURPOLITICAL COLOURS

THEY ARE MALAWI’S FUTURE!

WWW.MAMAYE.ORG.MW

POLITICAL ENGAGEMENT

Election posters – Malawi, 2014

TSOGOLO LA MALAWI NDI

AMAYI NDI ANA

MOYO WA AMAYI NDI ANA NDI UDINDO WA

ZIPANI ZONSE!

CHONDE ATETEZENI!

WWW.MAMAYE.ORG.MW

ENGAGING THE PUBLIC

74 75

POLITICAL ENGAGEMENT

Budget advocacy leaflet – Sierra Leone, 2012

Earlier this year, Save the Children, Oxfam, World Vision and the

Budget Advocacy Network came to Bo to assess spending on health.

We wanted to know how much of the Bo Council budget was being promised for

health, and how this money was being spent. Why? Because we think your health

and especially ‘mami en pikin welbodi’ should be a priority

How Much Moneyis Going to Your Health Services in Moyamba?

Earlier this year, Save the Children, Oxfam, World Vision and the Budget

Advocacy Network came to Moyamba to assess spending on health. We wanted to know how much of the Moyamba Council budget was being promised for health, and how this money was being spent.

Why? Because we think your health and especially ‘mami en pikin welbodi’ should be a priority.

What did we find?

The money promised to the the health clinics has increased by 20% and to the DHMT by 133% DHMT: District health management team

The money promised for health has increased by 82% But, actual spending has not kept up. The money spent has only increased by 72%. 76 million were promised but not given.

We are alarmed at the difference between what the Council says it is transferring to the DHMT and the health clinics, and what the DHMT and health clinics are actually receiving. In 2011, the Council said it transferred 1 143 million Leone and the DHMT received 882 million Leone – leaving 261 million Leone unaccounted for (approximately). Similarly, the Council said is transferred 92 million Leone and the health clinics recorded receiving 21 million Leone – leaving 71 million Leone unaccounted for.

261 million Leone unaccounted for

The information was provided by Moyamba Council and the Ministry of Finance for 2009 to 2011.

we are concerned becausefinancial record keeping is poor

ENGAGING THE PUBLIC

Make Yourself Hea

rd.

Compared to other districts, Moyamba is ranked 5th in terms of money disbursed per person for you health. It needs to receive more money for health and increase the amount of spending.

All of the budget for health is used – no more underspending

The DHMT and health clinics get all the money promised to them

Improve financial record keeping

Petition the Central Government to increase the money given to health at District level. Put your mark on the petition today

Election Time is HereTo improve health in Moyamba,

tell your candidates to promise that :

VOTEWELBODI 2012

1234

Budget Advocacy Network

5th

76 77

MamaYe is about making life-saving changes for Africa’s mothers and babies. We support existing change-makers, governments, healthcare professionals and individuals to ensure that mothers and babies survive and thrive. We do this through a strategic combination of evidence, advocacy and accountability.

We believe in re-framing the debate and transforming African attitudes to maternal and newborn health ( MNH ) away from fatalism towards hope by using clearly articulated and accurate evidence and stories of success. We can encourage changes in behaviour and influence those who have the resources and power to change policy.

MamaYe empowers you with evidence to act for change. Our highly resourced website gives information on health budgets, research, clinical guidelines, government investment in MNH and more. We produce an array of creative assets from scorecards to banners and we encourage you to use them.

MamaYe is a campaign initiated by Evidence for Action funded by UKAID.

E4A works in Ethiopia, Ghana, Malawi, Nigeria, Sierra Leone and Tanzania.

UKaidfrom the British peoplemamaye.org

MamaYeAfrica@MamaYeAfrica

web:facebook:

twitter:

MAMAYE DICTIONARYDefinition of maternal and newborn health terms

MEDIA

MamaYe dictionary for journalists – 2014/15

The termination of a pregnancy before the foetus has attained viability. An abortion can occur spontaneously, in which case it is often called a miscarriage. An abortion can also be purposely induced, which is called an induced abortion. See also Unsafe Abortion

Aspects of the structure of health services or health facilities that enhance the ability of people to reach a health care practitioner, in terms of location, time, and ease of approach.

Shah, I. H., Ahman, E., & Ortayli, N. (2014). Safe Abortion Annex. In ICPD Beyond 2014 Expert Meeting on Women’s Health - rights, empowerment and social determinants, 30 September - 2nd October. Mexico City, Mexico.

World Health Organization. (2015). Health Systems Strengthening Glossary. Retrieved from http://www.who.int/healthsystems/hss_glossary/en

Source / Further information:


Abortion

Accessibility (of Health Services)

A

The expected number of girls aged 15-19 that will become pregnant each year out of 1 000 girls in that same age group, in a given population.

World Health Organization. (2015). Adolescent fertility. Retrieved from http://www.who.int/gho/maternal_health/reproductive_health/adolescent_fertility_text/en/


Adolescent Fertility Rate (AFR)

TERMS

The number of neonatal deaths in a particular population in a given time (usually a year) expressed as the number of deaths for each 1000 births in the same population and time period.

An intervention after a baby is born to help him/her breathe and to help his/her heart beat. Bag-and-mask resuscitation with room air is sufficient for nearly all babies not breathing at birth.

The death of a child who is born alive but dies within the first 28 days of life.

UNICEF, The World Health Organization, The World Bank, & United Nations Population Division. (2014). Levels and Trends in Child Mortality Report 2014: Estimates Developed by the UN Inter-agency Group for Child Mortality Estimation. New York: UNICEF. Retrieved from http://www.who.int/maternal_child_adolescent/documents/levels_trends_child_mortality_2014/en/

World Health Organization & UNICEF. (2014). Every Newborn: an action plan to end preventable deaths. Geneva: WHO. Retrieved from http://www.everynewborn.org/every-newborn-action-plan/

UNICEF, The World Health Organization, The World Bank, & United Nations Population Division. (2014). Levels and Trends in Child Mortality Report 2014: Estimates Developed by the UN Inter-agency Group for Child Mortality Estimation. New York: UNICEF. Retrieved from http://www.who.int/maternal_child_adolescent/documents/levels_trends_child_mortality_2014/en/




Neonatal Mortality Rate (NMR)

Newborn Resuscitation

Neonatal Death

MNSource / Further information:

International household survey carried out by countries assisted by UNICEF for monitoring the situation of children and women.

UNICEF. (2014). Multiple Indicator Cluster Survey (MICS). Retrieved from http://www.unicef.org/statistics/index_24302.html

Multiple Indicator Cluster Survey (MICS)

The medical field dealing with the care of women throughout pregnancy, including before birth, during birth, and in the period following birth.

World Health Organization, UNFPA, UNICEF, & AMDD. (2009). Monitoring Emergency Obstetric Care: A handbook. Geneva: WHO, UNFPA, UNICEF, & AMDD. Retrieved from http://www.who.int/reproductivehealth/publications/monitoring/9789241547734/en/


Obstetrics

Life-threatening medical conditions that occur in pregnancy or during or after labour and delivery.

World Health Organization, UNFPA, UNICEF, & AMDD. (2009). Monitoring Emergency Obstetric Care: A handbook. Geneva: WHO, UNFPA, UNICEF, & AMDD. Retrieved from http://www.who.int/reproductivehealth/publications/monitoring/9789241547734/en/


Obstetric Emergencies

0

Is the failure of the fetus to descend through the birth canal. This may be for several reasons including the head being too large to fit through the pelvis or that the fetus is in a difficult position. Obstructed or prolonged labour can be identified using a partograph. An assisted delivery or an emergency delivery by caesarean section may be necessary.

World Health Organization. (2008). Managing prolonged and obstructed labour: Midwifery education module 3. Retrieved from http://www.who.int/maternal_child_adolescent/documents/3_9241546662/en/


Obstructed Labour

ENGAGING THE PUBLIC

78 79

MEDIA

Mama Ye pull-out in the Union of Tanzania Press Club newsletter 2014 / 15

Mama ye! 2014

uhai wa akina mama na watoto wachanga

OKOA MAISHA YA MAMA NA VICHANGA WA TANZANIA

iv

Udumavu wa watoto wapungua Shinyanga

Siku ya Wakunga Duniani 2015

Inatoka Uk. 3

Salaam, Lindi na Katavi ili kujifuza, kubadilishana maarifa na uzoefu na kujadiliana kuhusu changamoto zinazowakabili katika utaaji wa huduma na namna ya kuzishughulikia changamoto husika.

Shirikisho la Vyama Vya Wakunga Duniani au International Confederation of Midwives (ICM) linasena ya kwamba katika nchi ambako wakunga wanafunzwa kwa mujibu wa mtaala unaojitegemea, kumekuwepo na matokeo mazuri sana katika kupunguza vifo vya kina mama na watoto wachanga.

Naye Waziri Mkuu Pinda,

katika hotuba yake, alitia msisitizo juu ya umuhimu wa Wakunga katika kupunguza vifo vya kina mama na watoto wachanga, kwa msingi wa Ripoti ya Hali ya Wakunga Duniani ya mwaka 2014, iliyozinduliwa rasmi jijini Dar es Salaam na Waziri wa Afya na Ustawi wa Jamii, Dk Seif Rashid, ambamo suala hilo limeelezwa kwa kina.

Ndani ya machapisho yaitwayo The Lancet Series on Midwifery, 2014 na Essential Interventions for MNCH, umuhimu wa wakunga wa uwepo wa wakunga wenye ujuzi, wanao simamiwa na kuongozwa kupitia muungano wao wa ki - taaluma, limetiliwa msisitizo, kadhalika.

Na Kareny Masasy, Shinyanga

Kasi ya kudumaa miongoni mwa watoto wa mkoa

wa Shinyanga imeshuka kutoka asilimia 43 mwaka 2010 hadi kufikia asilimia 30 kufikia Aprili, 2014.

Kaimu Katibu wa Hospitali ya Rufaa ya mkoa, Dk Fabian Kalabwe alithibitisha, ya kwamba wilaya ya Kishap, hata hivyo, bado inaongoza kwa kukabiliwa na tatizo hilo la kudumaa kwa watoto.

Kutokana na hali hiyo alitoa mwito kwa viongozi – watendaji na wanasiasa wa ngazi zote - kuhakikisha ya kwamba suala la wajawazito na watoto wachanga kupatiwa lishe bora linapewa kipaumbele unaostahili.

“Tatizo la lishe duni, inayosababisha kudumaa kwa watoto wachanga, litapatiwa ufumbuzi endapo elimu kwa umma juu ya umuhimu wa matumizi ya madini joto itatolewa, kwa kuwatumia waratibu wenye sifa”, alisisitiza Dk Kalabwe.

Naye Mkurugenzi Mtendaji huyo wa wa Kitengo cha Chakula na Lishe, katika Wizara ya Afya na Ustawi wa Jamii, Dk Joyceline Kaganda aalionyesha kushangazwa kwake na hali hiyo ya kudumaa kwa watoto, alisisitiza ya kwamba mtoto anatakiwa apatiwe maziwa ya mama.

“Hivi sasa ni asilimia 28.9 ya watoto ndiyo wanaonyonyeshwa na mama zao nchini”, alifafanua Dk Joyceline na kuongeza:

“Mjamzito akikosa

virutubisho, hususani madini joto, hata ubongo wa mtoto mchanga aliyeko tumboni mwake utadumaa na na hatimaye kuwa taahira pindi anapozaliwa, hali ambayo ni ngumu kuirkebisha”, alifafanua.

Kitakwimu, alisema, bado kiwango cha udumavu miongoni mwa watoto wa mkoa wa Dodoma bado kipo juu kitaifa, kama ilivyo mikoa ya Kagera, Iringa na Njombe kutokana na ukosefu wa elimu ya lishe.

Naye Bw Waibe Mwita,

mwezeshaji wa masuala ya lishe kitaifa, alisema ya kwamba, kwa asilimia 50, viifo vya watoto wa umri wa chini ya miaka mitano nchini vinasababishwa na ukosefu wa lishe.

Akinukuu takwimu za Shirika la Afya Duniani (WHO), Mkurugenzi Mtendaji wa Kitengo cha Chakula na Lishe alisema ya kwamba pia vifo hivyo husababishwa na malaria (asilimia 7) na kuhara (asilimia 1).

Na Mercy Sekabogo, Njombe

Vifo vingi vya watoto wachanga nchini vinatokana na

uzembe wa wauguzi na wakunga wasio na ujuzi wala stadi zozote za kutambua matatizo ya dharura yanayowasibu wajawazito.

Muuguzi Msaidizi wa Hospitali Teule ya Ilembula, inayomilikiwa na Kanisa la Kikristo la Kilutheri Tanzania (KKKT, Bibi Hanna Nyamdadi alieleza ya kwamba tatizo hilo hukuzwa na ukosefu wa utaalam na elimu kuhusu dalili za hatari kwa wajawazito.

“Hii imewasababishia watoto wachanga wane na kina mama wanne wafariki mwaka 2014, baada ya wajawazito husika kucheleweshwa kufikishwa Hospitalini hapo”, alisema Bibi Hanna.

Watoto wengine, alisema, huzaliwa wakiwa

wamechoka sana na hivyo kuwachukua muda mrefu kurejea katika hali ya kawaida.

Hospitali hiyo inayomilikiwa na Kanisa la Kikristo la Kilutheri Tanzania (KKKT), Ilembula, wilayani Wanging’ombe, huwahudumia kina mama kutoka Zahanati na Vituo vya Afya vya mkoa huo mpya wa Njombe na vijiji vya mikoa ya Mbeya na Iringa.

Tatizo jingine linachangia vifo vya kina mama na watoto, kwa mujibu wa watu waliohojiwa Hospitalini hapo, ni uhaba wa damu salama,ambapo kiasi kinachopatikana ni asilimia 20 tu ya mahitaji.

Takwimu zinaonyesha ya kwamba, jumla ya kina mama 2,256 walijifungulia Hospitalini hapo ambapo 1,477 kati yao kwa njia ya kawaida na 784 kwa njia ya upasuaji.

Wakunga wasio na ujuzi lawamani

ENGAGING THE PUBLIC

Mama ye! 2014

uhai wa akina mama na watoto wachanga

OKOA MAISHA YA MAMA NA VICHANGA WA TANZANIA

iv

Sekta ya Afya itengewe fedha zaidi

Na Daniel Limbe, Chato

Mtoto mchanga, anayekadiriwa kuwa na umri wa siku

tatu, amekutwa akiwa ametelekezwa nje ya uzio wa Hospitali ya wilaya ya Chato, mkoani Geita saa chache tu baada ya kuzaliwa kwake.

Akithibitisha kutokea kwa mkasa huo, Mganga Mkuu wa Hospitali hiyo, Dk Pius Buchukundi, alisema ya kwamba walinzi wa hospitali

Na Chiku Lweno, Dar es Salaam

Ujumbe wetu mkuu ni kwamba endapo kutakuwa na ongezeko la bajeti hadi kufikia asilimia 15% kwa ajili ya sekta

ya afya Hapa Tanzania: Watoto wachanga 21 kati ya kila vizazi

hai 1,000 hufariki nchini na akinamama 410 kwa kila vizazi hai 100,000 (takwimu za 2013).

Uwiano wa watoto wanaozalikwa kukiwa na uangalizi wa mhudumu wa afya mwenye ujuzi ni 49% (takwimu za 2010)

Idadi ya wahudumu wenye ujuzi kwa kila watu 10,000 - Daktari 0.1 na Muuguzi Mkunga 2 (takwimu za 2006)

Matumizi ya huduma za kisasa za uzazi wa mpango 34%, Mahitaji ya njia hizo za uzazi wa mpango ambayo hayajakidhiwa 25%

Mahudhurio ya wajawazito japo mara moja 96% na mahudhurio ya kliniki japo mara nne 43% (takwimu za 2010)

Kiwango cha Matumizi ya Bajeti ya Serikali kilichotengwa mahususi kwa ajili ya Matumizi kwenye sekta ya afya ni asilimia 10% (takwimu za 2012)

Maelezo zaidi kuhusu CARMMA fungua tovuti yao kwa anuani hii: http://www.carmma.org/

Kwa taarifa nyingi zenye ushahidi wa kitaalamu tembelea tovuti ya Mama Ye! kwenye ukurasa wa Ushahidi kwa anuani hii: http://www.mamaye.or.tz.

Na Kenneth Simbaya, Dar es Salaam

Ushiriki wa wananchi katika kuandaa bajeti, usimamizi na

ufuatiliaji wa matumizi ya bajeti vitasaidia sana katika kuhakikisha vipaumbele vya wananchi vinazingatiwa wakati wa kupanga bajeti, hivyo kuwa na bajeti inayojibu changamoto za wananchi.

Wananchi wanaweza kushiriki katika mchakato wa upangaji wa bajeti, kwenye hatua za awali, wakati wa uandaaji katika ngazi ya Kata,

kwa kushiriki katika mikutano au vikao vya kuainisha vipaumbele na kupanga bajeti, Halmashauri kwa kushiriki vikao vya baraza la madiwani na kwa kupitia madiwani wao, katika ngazi ya bunge kwa kupitia wabunge wao.

Wakati wa matumizi, wananchi wanapaswa kushiriki katika kufuatilia matumizi, husik, kwa kupitia mikutano mbalimbali na kuhoji taarifa ya mapato na matumizi, na kwa kupitia asasi za kiraia, ili kuhakikisha ya kwamba bajeti inatumika katika malengo yaliyo kusudiwa.

Ushiriki wa wananchi utasadia kuongezeka kwa bajeti pale inapohitajika, hivyo kuwapunguzia gharama za matibabu kwa kina wajawazito na watoto wa chini ya miaka mitano.

Pia hii itamaanisha kwamba dawa, vifaa tiba na wahudumu wenye ujuzi watakuwepo na kuleta maendeleo kwenye maeneo yetu.

Hivyo, chukua hatua ili kuhakikisha ya kwamba unashiriki katika upangaji na kusimamia matumizi ya bajeti katika eneo lako.

Wananchi washirikishwe upangaji bajeti, usimamizi

Mtoto atelekezwa Hospitali Chatondiyo waliomgundua mtoto huyo baada ya kilio chacke.

“Mtoto alilia sans, kuanzia saa nane kasi cha walinzi kutishika wakidhani labda inahusiana na wachawi.. lakini ilipofika saa 12 asubuhi, waliamua kwenda ili kujiridhisha”,alisema Dk Buchukundi na kuongeza:

“Walivyobaini kuwa ni mtoto mchanga, walimwamsha Dk Alexander Mpondaguzi ambaye alimpatia matibabu, baada ya kuidhinishiwa na Polisi”.

Kwa mujibu wa Dk

Buchukundi, mtoto hajambo, huku Polisi jalada la kipolisi Na. CHT/RB/1906/2014 likiwa limefunguliwa tayari.

Naye, Afisa Ustawi wa Jamii, katika Hospitali hiyo ya wilaya ya Chato, Bibi Leonia Mkingule alisema ya kwamba michango inaendele ili kupata fedha za nauli za kumsafirisha mtoto huyo kwenda Kituo cha kulelea watoto wadogo cha Kanisa la Kiinjili la Kilutheli Tanzania (KKKT, Dayosisi ya Kaskazini Magharibi, Bukoba.

80 81


Central to Evidence for Action’s Africa-wide work is providing consolidated and packaged evidence to strengthen accountability. Our aim is to ensure that data are used for tracking of commitments and comparison of maternal and newborn health and its enablers within and across countries.

Transparency is core to accountability. MamaYe helps create and support web accountability platforms and scorecards, thus ensuring that reliable data are accessible and understandable. Our comparative scorecards are a key tool to engage the public and decision-makers, and translate often technical information into a format that a range of audiences can understand and use.

Through the Africa Health Budget Network, we engage civil society organisations across the continent to campaign for more money for health and better accountability and transparency of health financing.

We support the African Union in a number of ways, including re-designing the website for their flagship Campaign for the Accelerated Reduction of Maternal Mortality in Africa, and collaborating on the production of the African Health Stats website. African Health Stats is an innovative data site that allows you to chart, map and compare key health indicators across all 54 African Union member states, using data from officially-recognised international sources.

These evidence-based products and web accountability platforms support dialogue with policy makers and enable advocates to more easily track the progress of their leaders against commitments.

≥ Health budgets

≥ Monitoring commitments

≥ Commission on Information and Accountability (CoIA)

≥ Safe clinics

≥ Campaign for the Accelerated Reduction of Maternal Mortality in Africa (CARMMA)

≥ African Health Stats

82 83

WE, THE AFRICA HEALTH BUDGET NETWORK, CALL ON OUR HONOURABLE MINISTERS OF HEALTH TO TAKE ACTION! Make health budgets more transparent.

Without budget transparency, there can be no accountability for health commitments!

For more information on data sources and scoring method, go to www.mamaye.org/references

www.mamaye.org/en/budget-network [email protected]

THE AFRICA HEALTH BUDGET NETWORK CALLS ON ALL AFRICAN GOVERNMENTS TO COUNT AND SHARE TO SHOW YOU CARECount how much you spend on health as a government

Share health budget information with the public

Show you care about women and children’s health

BEST PRACTICE KEY

PROGRESS REQUIRED INADEQUATE

TRANSPARENT ALLOCATION TO HEALTH1. Does the Executive’s Budget Proposal or any supporting budget documentation present expenditures for the budget year by functional classification and for individual programmes?COIA recommendation 8: TransparencySource: Open Budget Index 2012, Questions 2 and 4 http://survey.internationalbudget.org/#download

TRANSPARENT SPENDING ON HEALTH2.What level of detail is the focus of the explanation of the differences between the enacted levels and the actual outcome for expenditures presented in the Year-End Report?

Source: Open Budget Index 2012, Question 80 http://survey.internationalbudget.org/#download

COIA recommendation 8: Transparency

SPENDING IS LINKED TO HEALTH OUTCOMES3. Are the nonfinancial data presented useful for assessing how an expenditure program is performing? Are the performance indicators sufficiently well designed, such that one can assess whether there has been progress toward meeting policy goals? Are performance indicators used in conjunction with performance targets?

Source: Open Budget Index 2012, Questions 51, 53 and 54 http://survey.internationalbudget.org/#download

COIA recommendation 6: Reaching women and children

4. BUDGET INFORMATION CLEARLY COMMUNICATED TO THE PUBLICIs there a Citizens Budget and if so how is it disseminated to the public?COIA recommendation 7: National oversightSource: Open Budget Index 2012, Question 110http://survey.internationalbudget.org/#download

TRANSPARENT BUDGET TIMETABLE5. Does the executive adhere to its timetable for the preparation and release of the budget?

Source: Open Budget Index 2012, Question 58http://survey.internationalbudget.org/#download

COIA recommendation 7: National oversight

WE, THE AFRICA HEALTH BUDGET NETWORK, CALL ON OUR HONOURABLE MINISTERS OF HEALTH TO TAKE ACTION! Make health budgets

more transparent. Without budget transparency, there can

be no accountability for

health commitments!

For more information on data sources and scoring

method, go to www.mamaye.org/references

www.mamaye.org/en/budget-network

[email protected]

THE AFRICA HEALTH BUDGET NETWORK CALLS ON ALL AFRICAN GOVERNMENTS TO COUNT AND SHARE TO SHOW YOU CARECount how much you

spend on health as a

government Share health budget

information with the public

Show you care about

women and children’s

health

BEST PRACTICE

KEY

PROGRESS REQUIRED INADEQUATE

TRANSPARENT ALLOCATION TO HEALTH

1. Does the Executive’s Budget Proposal or any supporting budget

documentation present expenditures for the budget year by

functional classification and for individual programmes?


Source: Open Budget Index 2012, Questions 2 and 4

http://survey.internationalbudget.org/#download

TRANSPARENT SPENDING ON HEALTH

2.What level of detail is the focus of the explanation of the

differences between the enacted levels and the actual

outcome for expenditures presented in the Year-End Report?

Source: Open Budget Index 2012, Question 80



SPENDING IS LINKED TO HEALTH OUTCOMES

3. Are the nonfinancial data presented useful for assessing

how an expenditure program is performing?

Are the performance indicators sufficiently well

designed, such that one can assess whether there has

been progress toward meeting policy goals?

Are performance indicators used in conjunction with

performance targets?Source: Open Budget Index 2012, Questions 51, 53 and 54


COIA recommendation 6: Reaching women and children4. BUDGET INFORMATION CLEARLY

COMMUNICATED TO THE PUBLIC

Is there a Citizens Budget and if so how is it

disseminated to the public?




TRANSPARENT BUDGET TIMETABLE

5. Does the executive adhere to its timetable for the

preparation and release of the budget?




NOUS APPELONS NOS GOUVERNEMENTS À:

Légende *

Objectif atteint Proche de l’objectif, progrès réalisésProche de l’objectif, pas de progrès Loin de l‘objectif, progrès réalisés Loin de l‘objectif, pas de progrès

NOUS APPELONS LA COMMUNAUTÉ INTERNATIONALE À:

Contribuer aux budgets de la santé dans les pays à faible revenu

Rendre la coopération fiscale internationale plus équitable

Investir dans le renforcement des systèmes fiscaux des pays africains

Priorité de la santé dans le budget national

Dépenses publiques de santé prévues en 2014, en pourcentage du budget total. Objectif atteint : >15% ; Proche de l’objectif : >10% ; Progrès réalisés : 2014>2013.

2.

Le gouvernement dépense-t-il assez pour la santé de chacun?

Dépenses publiques de santé prévues en 2014, par personne. Objectif atteint : >$86; Proche de l’objectif : >$40; Progrès réalisés : 2014>2013.

3.

1. Les dépenses pour la santé sont-elles à la hauteur de la richesse du pays?

Dépenses publiques de santé prévues en 2014, en pourcentage du PIB. Objectif atteint : >5%; Proche de l’objectif : >3%; Progrès réalisés : 2014>2013.

4. Le budget national est-il transparent?

Type de classification budgétaire, 2013. Etoile = classification par programme et bénéficiaire; Vert = classification par programme; Jaune = classification par secteur détaillée; Orange = classification par sous-ministère ou par secteur; Rouge = classification par ministère.

Faire des dépenses pour la santé une priorité dans le prochain budget

Dépenser plus pour la santé de chacun

Augmenter le financement public en fonction de la richesse du pays

Renforcer la transparence des budgets

* Sauf pour la transparence du budget de la santé – voir explications ci-dessous

NOUS APPELONS LES DIRIGEANTS AFRICAINS À METTRE EN OEUVRE LA COUVERTURE SANITAIRE UNIVERSELLE.

mamaye.org/[email protected]

web:email:

Données: Government Spending Watch 2015 Pour plus d’informations sur les données et les méthodologies, visitez www.mamaye.org/references

governmentspendingwatch.org [email protected]

web:email:

NOUS APPELONS NOS

GOUVERNEMENTS À:

Légende *

Objectif atteint

Proche de l’objectif, progrès réalisés

Proche de l’objectif, pas de progrès

Loin de l‘objectif, progrès réalisés

Loin de l‘objectif, pas de progrès

NOUS APPELONS

LA COMMUNAUTÉ

INTERNATIONALE À:

Contribuer aux budgets

de la santé dans les pays

à faible revenu

Rendre la coopération fiscale

internationale plus équitable

Investir dans le renforcement

des systèmes fiscaux des

pays africains

Priorité de la santé dans

le budget national

Dépenses publiques de santé prévues en 2014,

en pourcentage du budget total. Objectif atteint :

>15% ; Proche de l’objectif : >10% ; Progrès réalisés :

2014>2013.

2.

Le gouvernement dépense-t-il assez pour

la santé de chacun?

Dépenses publiques de santé prévues en 2014,

par personne. Objectif atteint : >$86; Proche de

l’objectif : >$40; Progrès réalisés : 2014>2013.3.

1. Les dépenses pour la santé sont-elles à la

hauteur de la richesse du pays?

Dépenses publiques de santé prévues en 2014, en

pourcentage du PIB. Objectif atteint : >5%; Proche

de l’objectif : >3%; Progrès réalisés : 2014>2013.

4. Le budget national est-il transparent?

Type de classification budgétaire, 2013.

Etoile = classification par programme et bénéficiaire;

Vert = classification par programme;

Jaune = classification par secteur détaillée;

Orange = classification par sous-ministère

ou par secteur;

Rouge = classification par ministère.

Faire des dépenses pour

la santé une priorité dans

le prochain budget

Dépenser plus pour la santé

de chacun

Augmenter le financement public

en fonction de la richesse du pays

Renforcer la transparence

des budgets* Sauf pour la transparence du budget de la santé – voir explications ci-dessous

NOUS APPELONS LES

DIRIGEANTS AFRICAINS

À METTRE EN OEUVRE LA

COUVERTURE SANITAIRE

UNIVERSELLE.

mamaye.org/budget-network

[email protected]

web:

email:

Données: Government Spending Watch 2015

Pour plus d’informations sur les données et les méthodologies,

visitez www.mamaye.org/references

governmentspendingwatch.org

[email protected]

web:

email:

Africa Health Budget Network transparency and spending scorecards – 2014 / 15

HEALTH BUDGETS

Angola

Benin

Botswana

Burkina Faso

Cameroon

Chad

DRC*

Equatorial Guinea

Ghana

Kenya

Liberia

Malawi

Mali

Mozambique

Namibia

Niger

Nigeria

Rwanda

Senegal

Sierra Leone

South Africa

Sao Tome & Principe

Tanzania

Uganda

Zambia

Zimbabwe

1. TRANSPARENT ALLOCATION TO HEALTH

Democratic Republic of Congo*

2. TRANSPARENT SPENDING ON HEALTH

3. SPENDING LINKED TO HEALTH OUTCOMES

4. BUDGET INFORMATION CLEARLY COMMUNICATED TO THE PUBLIC

5. TRANSPARENT BUDGET TIMETABLE

PRIORITÉ DE LA SANTÉ DANS LE BUDGET

NATIONAL

LE GOUVERNEMENT DÉPENSE-T-IL ASSEZ POUR LA SANTÉ DE

CHACUN?

LES DÉPENSES POUR LA SANTÉ SONT-ELLES

À LA HAUTEUR DE LA RICHESSE DU PAYS?

LE BUDGET NATIONAL EST-IL TRANSPARENT?

ANGOLABÉNIN

BURKINA FASOBURUNDI

CAMEROUNCAP-VERT

CONGOCÔTE D’IVOIRE

ÉTHIOPIEGHANA

GUINÉE-BISSAUKENYA

LESOTHO LIBÉRIA

MADAGASCARMALAWI

MALIMOZAMBIQUE

NIGEROUGANDA

RDCRÉPUBLIQUE CENTRAFRICAINE

RWANDASÉNÉGAL

SIERRA LEONESWAZILAND

TANZANIETOGO

ZAMBIEZIMBABWE

Toutes les données proviennent de la base de données 2015 de Government Spending Watch. Vous pouvez télécharger toutes les données sur le site suivant: www.governmentspendingwatch.org/spending-data

GSW surveille les dépenses publiques vers les secteurs OMD afin que les gouvernements rendent compte de leurs priorités politiques. GSW repose sur deux grands principes: la nécessité d’une plus grande transparence des dépenses publiques et d’un libre accès à des données complètes et récentes pour les citoyens, leurs représentants parlementaires, et la société civile.


84 85

HEALTH BUDGETS

‘Is that all I’m worth?’ – Sierra Leone, 2014


Tracking health spending – Nigeria, 2013 / 15

86 87

DECISION MAKERS ACT NOW

FOR MALAWI’S NEWBORNS!

In 2014, Malawi committed to the

Every Newborn Action Plan to take

action and reduce preventable newborn

deaths from rates of 31 per 1,000 live

births in 2010 to 25 per 1,000 live

births by 2020 through:

> Strengthening and investing in

care during labour, birth and the

first day and week of life.

> Improving the quality of maternal

and newborn care.

> Reduce inequalities.

> Harnessing the power of parents,

families, and communities.

> Counting every newborn through

better measurement and

accountability.

Malawi also pledged to increase funds

for maternal and child health:

> Decision makers need to take action

and invest more money in health,

and in the health of Malawi’s

mothers and children.

> Update and implement policies

including the Essential Medicines

List and Malawi Standard Treatment

Guidelines, Roadmap for Accelerating

the Reduction of Maternal and Neonatal

Morbidity and Mortality in Malawi and

the Sexual Reproductive and Health

Rights Policy (SRHR) to include simple

lifesaving interventions that can save

the lives of many newborns.

Prioritise simple and effective lifesaving

solutions to save newborn lives:

> Masks and bags to help babies

born too soon breathe

> Antibiotics

> Skin-to-skin contact

(kangaroo mother care)

> Breastfeeding

> Trained health workers

> Chlorhexidine for cord care

web:twitter:

facebook:

mamaye.org.mw

@MamaYeMW

MamaYeMalawi

For references and notes

on calculations, visit:

www.mamaye.org/references

1 OUT OF 3 NEWBORN DEATHS IN MALAWI IS DUE TO PRETERM

BIRTH COMPLICATIONS

ACT NOW FOR MALAWI’S NEWBORNS!

Act Now for newborns leaflet – Malawi, 2014

MONITORING COMMITMENTS

Countdown to 2015 launch – Malawi, 2015’


88 89

web:twitter:

facebook:

mamaye.org.tz@MamaYeTZMamaYeTZ

ACT NOW TO SAVE NEWBORNS! CHUKUA HATUA KUOKOA WATOTO WACHANGA!

MONITORING COMMITMENTS

Act Now leaflet – Tanzania, 2014

4 5

We have made commitments!

In 2014 Tanzania committed to the Every Newborn Action Plan 3 and the Sharpened One Plan.4 These strategies set out the priority solutions, and call for a united effort to dramatically reduce preventable stillbirths and newborn deaths, by:

• Strengthening family planning for safer planned pregnancies, especially for adolescents;

• Investing in the quality of care around delivery and postnatal care and special care for small and sick babies;

• Reducing inequities in those accessing quality care; • Harnessing the power of communities to ensure

all deliveries and newborns receive essential care; • Counting every newborn for better measurement

and accountability.3,4

Crucially, if these solutions are scaled up we could save 9,400 newborn lives and avert 2,500 stillbirths by the end of 2015.4

Tumeahidi!

Mwaka 2014 Tanzania imeahidi na kuweka dhamira ya kutekeleza Mpango Kazi wa Kila Mtoto Mchanga 3 na Mpango Mkakati Ulioboreshwa wa Kupunguza Vifo vya Mama na Watoto.4 Mikakati hii inaonyesha vipaumbele, na kutoa rai ya kuunganisha nguvu ili kuweza kupunguza kwa kiasi kikubwa vifo vinavyozuilika vya watoto wachanga wanaozaliwa wafu na wale wanaokufa baada ya kuzaliwa, kwa:

• Kuboresha uzazi wa mpango, hususani kwa vijana;• Kuwekeza katika kutoa huduma bora wakati na

baada ya kujifungua, na huduma maalum kwa watoto njiti na wagonjwa;

• Kupunguza pengo la usawa katika upatikanaji wa huduma bora;

• Unganisha nguvu ya jamii ili kuhakikisha kila uzazi na watoto wachanga wanapata huduma muhimu;

• Kuhakikisha kila mtoto anayezaliwa anasajiliwa ili kuboresha tathmini na uwajibikaji. 3,4

Muhimu zaidi ni kwamba mambo haya yakitiliwa mkazo tunaweza kuokoa maisha ya watoto wachanga 9,400 pamoja na kuepusha watoto wengine 2,500 kuzaliwa wafu ifikapo mwishoni mwa mwaka 2015.4

6 7


• Newborn resuscitation; • Hygienic cord care;• Antibiotics;• Mother to newborn skin-to-skin contact;• Breastfeeding;• Trained health workers; • With a focus on the 48 hours surrounding birth.3,5

For references, visit : Marejeo: yanapatikana mtandaoni, tembelea: www.mamaye.org/references

Toa kipaumbele kwa hatua hizi muhimu na zenye gharama nafuu zinazopaswa kutolewa kwenye vituo vyote vya huduma za afya Tanzania ambapo huduma kwa wajawazito zinapatikana kabla, wakati na baada ya kujifungua!

• Huduma za kuokoa maisha ya mtoto mchanga ikiwemo kumsaidia kupumua

• Utunzaji wa kitovu • Vijiuasumu (antibiotiki)• Mbinu ya ngozi kwa ngozi kwa mama na mtoto mchanga • Unyonyeshaji maziwa ya mama• Wahudumu wa afya waliosomea fani hiyo • Msisitizo ukiwekwa katika masaa 48 baada ya kujifungua. 3,5

Decision Makers Act Now! Watoa Maamuzi – Chukueni Hatua!

1 UNICEF. Committing to Child Survival: A Promise Renewed Progress Report 2014. UNICEF New York 2 Lawn JE, Blencowe H, Pattinson R et al. Stillbirths: Where? When? Why? How to make the data count? Lancet 2011; 377: 1448-63 3 WHO, UNICEF. 2014. Every Newborn: an action plan to end preventable deaths. Geneva: World Health Organization. Available from www.everynewborn.org 4 United Republic of Tanzania, The National Road Map Strategic Plan to Accelerate Reduction of Maternal, Newborn and Child Deaths in Tanzania 2008-2015 The Sharpened One Plan. April 2014 5 March of Dimes, The Partnership for Maternal Newborn & Child Health, Save the Children, World Health Organization. (2012). Born Too Soon: The Global Action Report on Preterm Birth. (Eds) Howson, C.P., Kinney, M.V., & Lawn, J.L. WHO: Geneva.


90 91

AMHiN acknowledges and appreciates the generous technical and financial support of the following organisations towards the development of this scorecard.

Progress on Country Accountability

Framework for Women’s and Children’s

Health in Nigeria

2014

COMMISSION ON INFORMATION AND ACCOUNTABILITY (CoIA)

Country Accountability Framework – Nigeria, 2014

ADVOCACY AND OUTREACH

2013 OVERALL SCORE:

2014 OVERALL SCORE:

44%

40%SCORE KEY: Not present, needs to be developed

Needs a lot of strengthening

Needs some strengthening

Already present, no action needed

11

13

SCORE SCORE

SCORE SCORE

2013 SITUATIONAL ANALYSIS

2013 SITUATIONAL ANALYSIS

2014 STATUS

2014 STATUS

RECOMMENDATIONS

RECOMMENDATIONS

Parliament organises public forums for information sharing and discussions on RMNCH issues.

Parliament has not established a specific committee on transparent accountability for RMNCH, however there exists a Standing Committee on Health and Standing Committee on MDGs that meet regularly to discuss health issues including RMNCH . There is multistakeholder commission and committee that reports to the parliament on RMNCH issues. Parliament does not organize public fora. These are usually initiated by ministries, agencies, NGOs and CSOs working directly with parliamentarians.

Parliament has not established a specific committee on transparent accountability for RMNCH, however there exists a Standing Committee on Health and Standing Committee on MDGs that meet regularly to discuss health issues including RMNCH . There is multistakeholder commission and committee that reports to the parliament on RMNCH issues. Parliament does not organize public fora. These are usually initiated by ministries, agencies, NGOs and CSOs working directly with parliamentarians.

Parliament has established transparent accountability mechanism for RMNCH, such as a multi-stakeholder commission or committee that reports to parliament.

1. PARLIAMENT ACTIVE ON RMNCH ISSUES

1. PARLIAMENT ACTIVE ON RMNCH ISSUES

Parliament has not established a transparent and multi-stakeholder accountability mechanism for RMNCH. Most interaction with Parliament has been driven by MNCH advocates on an “as needed” basis. However there is a committee on health and another on MDGs. MNCH issues are discussed here and at the Inter-Parliamentary Union.

Support the legislature to establish accountability mechanism on RMNCH especially on financing and availability of quality data.

CSOs to work with the NASS to facilitate the organization of public hearings/forums for sharing of information on RMNCH periodically.

Proceedings are captured by the committee clerks, but whether these minutes are shared with the wider House is unclear.There have been stand alone engagements such as public hearings on the National Health Bill, parliamentarian advocates for vaccine financing and respectful maternity care.

ADVOCACY AND OUTREACH


92 93

COMMISSION ON INFORMATION AND ACCOUNTABILITY (CoIA)

CoIA indicator infographics – Tanzania and Nigeria, 2013/14


94 95

mamaye.org.slMamaYeSL@MamaYeSL

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twitter:

References

1. Ministry of Health & Sanitation, Reproductive and Family Planning Programme. (2012). Sierra Leone Maternal Death Reviews: A National Call to Action. Freetown: MoHS

2. Government of Sierra Leone, Ministry of Health & Sanitation, Reproductive and Child Health Directorate. (2013), Summary Report of July 2013: Facility Improvement Team (FIT) Assessment Exercise. Freetown: GoSR, MoHS, RCHD

3. Blencowe, H., Cousens, S., Mullany, L.C., Lee, A.C.C., Kerber, K., Wall, S., Darmstadt, G.L., & Lawn, J.E. (2011). Clean birth and postnatal care practices to reduce neonatal deaths from sepsis and tetanus: a systematic review and Delphi estimation of mortality effect. BMC Public Health, 11(Suppl 3): S11

4. Ministry of Health & Sanitation, Reproductive and Family Planning Programme. (2012). Sierra Leone Maternal Death Reviews: A National Call to Action. Freetown: MoHS

5. The Partnership for Maternal, Newborn and Child Health. (Undated). Opportunities for Africa’s Newborns Practical data, policy and programmatic support for newborn care in Africa. Chapter 3. Geneva: PMNCH

6. Cheng, J.J., Schuster-Wallace, C.J., Watt, S., Newbold, B.K., & Mente, A. (2012). An ecological quantification of the relationships between water, sanitation and infant, child, and maternal mortality. Environmental Health, 11(4)

7. Blencowe, H., et al. (2011). Op cit.

8. Campbell, A. (2014, January 21). Sierra Leone News: Half of Salone to access clean water by 2016. Awoko. Retrieved from http://awoko.org/2014/01/28/sierra-leone-news-half-of-salone-to-access-clean-water-by-2016/

Water and Safe ClinicsPolicy BriefMay 2014

SAFE CLINICS

Water and safe clinics – Sierra Leone, 2014

The Youth of Salone call on the Ministry of Water Resources & the Ministry of Health and Sanitation to act on water in clinics

Community Voices:

Commendable effort has taken place in Sierra Leone to improve access to water. Government deems water as a priority in Sierra Leone. This is demonstrated through the creation of a new water resources ministry and a commitment to ensure that piped water is available to at least half of Sierra Leoneans by 2016 8. Through a 500-strong youth group, with support from MamaYe, the citizens of Sierra Leone are calling on local councils, MPs and government ministers responsible for water resources, health and sanitation to act on their commitment. Young people want to ensure that safe water is made accessible to all Sierra Leoneans and that many more mothers and babies survive during childbirth.

It is imperative that there is more collaboration between government ministries to make Sierra Leone’s clinics safe for all mothers and newborns. We know that more must be done; we know that more CAN be done to SAVE the lives of our SIERRA LEONE mothers and babies when swift collaborative action is taken at a policy level between government ministries.

“We have seen a growing investment in WASH by donor partners and NGOs, but this fails to translate into the improvement of safe water and good sanitation at health facility level. If we really take a step back, how effective is it to save a child from dying of diseases like cholera, but loose the same child or mother to an infection contracted at a health facility due to lack of safe piped water and poor sanitation practices.

There is a need to redirect some WATSAN investment towards improving safe water and sanitation across health facilities. We look up to government to lead on this partnership with donor partners and ministries to achieve this.”

Community Leader

Community Health Chairman

“Everyone knows that we don’t have water, but the newly built school has water because they have the resources, like their pipes are not broken. Guma valley doesn’t respond to us, our community leaders don’t always respond to us, we don’t even respond to our selves. The outcome of that, our women don’t want to come deliver in this hospital. We have very little to offer them, and that is not what we want to see. We want to make this health facility good, but someone has to listen”

Every day 5 women and 27 babies die in Sierra Leone. Our mothers and babies are dying unnecessarily.

This must stop!

These deaths are traumatic for families and communities, and have long-term economic consequences. It is these poor but changeable survival rates that rank Sierra Leone as one of the worst places in the world to give birth.

The introduction of the Free Health Care Initiative (FHCI) has brought about an unprecedented increase in access and utilization of health services for mothers and their newborns. Yet, there remains a serious need to improve quality of care provided by health services in order to ensure that clinics are safe. Despite four years of FHCI, mortality rates for our mothers and babies remain high.

SAFE CLINICS WILL IMPROVE THE SURVIVAL OF MOTHERS AND BABIES.

SAFE CLINICS SAVE LIVES.

AVAILABILITY OF CLEAN WATER AND GOOD SANITATION ARE CENTRAL TO MAKING A SAFE CLINIC.


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SAFE CLINICS STRENGTHENING ACCOUNTABILITY THROUGHOUT AFRICA

FACILITY PERFORMANCE AGAINST ENABLERS

Ranking Water & Sanitation

Electricity Referrals Equipment Blood & Laboratory

Staffing Drugs

Pujehun Govt. Hospital 1st

Kabala Govt. Hospital 2nd

Kenema Govt. Hospital 2nd

Koidu Govt. Hospital 2nd

Magburaka Govt. Hospital 5th

Makeni Govt. Hospital 5th

PCMH Govt. Hospital 5th

Moyamba Govt. Hospital 8th

Kailahun Govt. Hospital 9th

Kambia Govt. Hospital 9th

Bo Govt. Hospital 11th

Bonthe Govt. Hospital 12th

Progress of selected Government Hospitals in achieving Comprehensive Emergency Obstetric & Neonatal Care (CEmONC) status, December 2014

Performance rating Score Facility has:

Green 4 Met all criteria

Yellow 3 Mostly met criteria

Orange 2 Partially met criteria

Red 1 Not met criteria

The Facility Improvement Team (FIT) assessments score selected health facilities, including Government Hospitals , on their readiness to provide quality EmONC based on whether they meet certain criteria for each of seven enablers ranging from water and sanitation to essential drugs. See over page for the details of these criteria. The criteria for a hospital is different to a CHC. This is because of variations in their capacity to perform certain procedures. Each facility is scored using the same traffic light colour system for each enabler as described on the score card for CEmONCs.

63% 67% 61%

68% 74%

80% 87%

92% 92% 89% 81% 80%

0%

20%

40%

60%

80%

100%

Nov Mar June Sept Dec Mar June Sept Jan Jul Jul Dec

2010 2011 2012 2013 2014

Each facility is given an overall score. The image to the left shows the progress s for all hospitals since the FIT assessments started. The rating is based on the total scores of all enablers of the hospitals and expressed as a percentage.

See below for more details of how each hospital performed for each enabler using the traffic light rating and how each hospital ranked among all the hospitals assessed under the FIT. For more details, contact Dr. Santigie Sesay, Director, Reproductive & Child Health, MoHS Sierra Leone; [email protected]

Safer Clinic (QuIC FIT) Scorecard: WESTERN AREA District Enablers

Enabler

PCMH Government Hospital

Lumley Gov’t

Hospital

George Brook CHC

Goderich CHC

Murray Town CHC

Regent CHC

Songo CHC

Tombo CHC

WaterlooCHC York CHC

Ross Road CHC

Water and Sanitation

Electricity

Referrals

Equipment

Laboratory

Staffing

Drugs

Comments/Actions

Nil Blood not in the bank

No power supply from NPA Elbow gloves are improvised Drug supplies not yet replenished

Late Ambulance response No equipment for Hb test No Gentamycin

Late Ambulance response No power supply MVExtractor & MVA not in supply IV/IM Ampicillin and Gentamycin not in supply

Nil No equipment for Hb test

Elbow gloves are improvised No Calcium Gluconate No oxytocin

Nil No staff for Assisted Vaginal Delivery & Manual Vacuum Aspiration No staff & equipment for Hb test No electricity no generator

No equipment for Hb test No power supply from the national grid.

Facility Improvement Team (FIT) assessment scorecards – Sierra Leone, 2014 Quality of Institutional Care (QuIC FIT) scorecards – Sierra Leone, 2014

98 99CARMMA homepage

CAMPAIGN FOR THE ACCELERATED REDUCTION OF MATERNAL MORTALITY IN AFRICA (CARMMA)

CARMMA infographics – Ghana, Nigeria and Malawi, 2013


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AFRICAN HEALTH STATS

African Health Stats website homepage African Health Stats interactive website


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Useful links:

MamaYe! www.mamaye.org

Options Consultancy Services www.options.co.uk

Advocacy International www.advocacyinternational.co.uk

Africa Health Budget Network www.mamaye.org/en/budget-network African Health Stats www.africanhealthstats.org

CARMMA www.carmma.org

MDSR Action Network www.mdsr-action.net

For further information contact:[email protected]

AdvocacyNigeria

Thank you to all our partners and local host organisations!

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mamaye.org@MamaYeAfrica MamaYeAfrica

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