MAMMA [Web Address]

MOTHERS AGAINST MATERNAL MOTERLITY IN AFRICA - MAMMA

Toronto Ontario, M1C1A4 Phone: 000-000-0000 E-Mail: Jemima.Idinoba@mail.utoronto.ca,

Nazek.Quteishat@mail.utoronto.ca ,Ramandeep.Singh@mail.utoronto.ca

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Rationale:Along with the need for the implementation of development initiatives, comes the burden for these initiatives to be sustainable enough to leave a long termed development impact. Sustainability could be achieved in several ways and in this case we chose to deal with human sustainability. Focusing on women’s health and higher quality maternal care.

Maternal mortality rate in Sub-Saharan Africa amounts to nearly 56% of the 287,000 worldwide birth rates this being as a result of poor maternal health care, the lack of health care facilities as well as the scarcity of medical knowledge for proper birthing procedures and techniques. Ethiopia alone, by 2008 recorded 590 maternal deaths per 1000 births and while these figures are staggering reports have shown that not much is being done to reduce these numbers. Shortages in medically trained midwives, accessibility to medical health care and availability of medical supplies being key agents to these stats.

Women are key factors in the growth of their societies; African women consequentially are no exception. As a result, it is our goal as an organization to improve the maternal health of women and reduce their mortality rates during child birthing in order to enable them the rightful chance of contributing to the economic and domestic growth of their societies.

Key Area of Focus and why:

Maternal health, as defined by the WHO, is “the health of women during pregnancy, childbirth, and the postpartum period.” It encompasses the health care dimensions of family planning, preconception, prenatal, and postnatal care in order to reduce maternal morbidity and mortality.

Maternal health is the fifth goal of the Millennium Development Goals (MDGs) and as we all know, these goals must be reached by 2015 and that day is fast approaching. According to UN reports, maternal mortality has fell by 47% since 1990, however, out of all the MDGs, the least progress has been made towards the maternal health goal. 800 women still die due to complications during pregnancy or childbirth. 50 million babies worldwide are still delivered without skilled care. Only half of the women in developing regions have access to the recommended health care during pregnancy. And in comparison to developed regions, maternal mortality is 15 times higher in developing regions. Also, in developing regions,

 

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the urban-rural gap in skilled care is still very large. And yet, the Official Development Assistance for reproductive health care and family planning remains low.

As a result, It is clear that there is a long way to go in regards to the high maternal mortality rates.

Country of Implementation: Koraro, Ethiopia, East Africa

MAMMA (Mothers against Maternal Mortality in Africa) aims to focus on Ethiopia, located in the horn of Africa, as a start. We are choosing to conduct our first project in Ethiopia due to the various researches conducted suggesting Ethiopia as one of the countries with the highest maternal mortality rates along with health issues.

The process in choosing our NGO included looking at mortality rate statistics. These Statistics have shown that nearly 1500 women die from pregnancy-related complications and 99% of these deaths occur in Africa, more specifically Ethiopia. A study conducted in 2008, recorded 590 maternal deaths per 1000 births. Researchers noted, the main causes of maternal mortality were due to; internal bleeding which results in loss of blood also known as 'post-partum haemorrhage' (42% of cases) and also due to difficulty/pain in labour also known as 'Obstructed labour' which is in 15% of cases. However, we found that there was not enough accurate data on maternal mortality in rural areas; as stated in the study;"...there is limited evidence about how these institutions perform and how people use emergency obstetric care facilities in rural Ethiopia" (Girma, 2013). Most statistics found were from institutionalized areas of Ethiopia which have hospitals and health care facilities, however maternal mortality rates were still very high. Bringing our NGO pose the following question, 'If the maternal mortality in institutionalized areas of Ethiopia are increasing due to improper birth methods used by trained health care professionals, how is the maternal mortality in remote areas without trained individuals and institutions?'

 

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Due to this, we seek to focus more specifically on villages/remote areas of Ethiopia, as we want to promote the traditional health values wile making sure safety and precaution is implemented.

Why exactly focus on a village?

The reason as to why women in villages are by large affected the most is due to the fact that villages in general are isolated areas from the cities andcities contain hospitals. Maternal mortality continues to increase rapidly and there are three main causes of this;

1. Procedures done by midwives are incorrect, resulting in death;2. Lack of equipment;3. The decrease in midwife occupations in villages.

The third cause is essentially a result of the first two causes. If there are no equipment and continuous death of patients, no midwife would want to continue work.

Facts about Koraro: 1) Main crops Teff and Maize2) 11 villages in this area3) Villages are pretty far apart and no-roads makes it difficult to get from one place to another (very hard to travel to hospitals without car access)4) Villages are at least 100 KM away from local commercial centers (isolated very limited access to health services)5) Part of the millennium villages6) Women are more likely to be involved in jobs related to; managing cows, meat production, textiles, grains, fattening animals.

 

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7) Thanks to new techniques, the area under irrigation increased sevenfold to over 1,800 hectares, and farmers have diversified their crops and seen their income increase by 72% on average.*However, health is still an issue here! 

Vision:We envision a world where everyone has equal access to adequate maternal health

care.

Mission:To reduce maternal mortality rates by educating and training local midwives and

community health workers in local rural villages.

How we work? We work from a community-based approach/ down-up approach Encourage participation within community

Main goals (5): EMAAAPE – Educate M – Maternal health care AccessibilityA – Affordability A – Awareness P – Prosperity of health & wellness

Midwifery and Health Education Training

'Community Health Workers' are already available to many countries. These workers contribute to training people of local communities in countries such as Ethiopia are giving primary training on basic health services. 

 

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Considering the goals of community health workers are similar to our goals, we would like to partner with these workers, by being their resource of training. In addition to CHWs we encourage any and all women and mothers in our host villages to participate in the training.

What we plan to do:- CHW members will be chosen according to community-based selection- We will train these members in the best possible way we could by giving them training in (2) things specifically;

(1) Midwifery (to reduce high rate of maternal mortality in this area) and(2) Basic Health Services ( sanitary education and supplies, information on how to prevent Malaria/steps to prevent it, information on how to reduce HIV/AIDS

fluctuation, family planning services/talk about if family has enough resources to provide to family, basic bandaging/to prevent infection due to a cut, keeping a

record of child births and deaths of community members.

Training and Duration:

- The purpose of our NGO is to provide 'ACCESS' to reproductive services and education on health in villages. Therefore, women will be taken from the 11 different villages in Koraro, to a middle point; in a building which the Ethiopian health ministry has donated. - Duration of training will be 6 months; 3 months for midwifery training and 3 months for basic health education training. - Half day long trainings as mothers usually have other familial requirements to take care of. - Training will be given by our trainees from Canada, who include health professionals and students in 4th year courses of nursing and health studies.

 

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Strategic Training Plan: (Training day to day) 

Possible kits needed for this month: (Vitamins, tools, fake babies) 

Possible kits needed for this month: Images, videos, sanitary equipment, booklets and brochures in their language or verbally creating own booklet)

 

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Governance Structure:

Board of Directors:

7 members:

- Chair Person (Health Expert/Location Expert)

- Vice Chair Person (Health/Location Expert/ Regional Representative)

- Advisor (Location Expert/Development Expert)

- Treasurer

- Founders:

- Chief Executive (Nazek Quteishat)

- Marketing Director (Jemima Idinoba)

- Program Director (Ramandeep Singh)

Administrative Team:

- Chief Executive: In charge of total management of organization

- Marketing/Resource Director: In charge of total fund raising concepts, budgets, partner targets, resource managers, and annual report.

- Program Director: In charge of Ethiopian staff, training co-ordination, annual report. - Accountant: In charge of total budget, annual expenditure report looks after how much money is received and sent/ also writes up annual report.

- Two Resource manager: Gather equipment/kits and sends over.

 

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- Two Program officers (people who belong to the fields): They look over training, part of the profession (qualified nurse and health studies applicant) Responsible for making sure the trainers know what they are doing

- Marketing team

- Others: 2 resource managers, 2 field/program officers, secretary, marketing

officers.

Ethiopia (Part-time staff):

- Field/Program Officers (3 to start with)

Partnership:We have a partnership with UNICEF and the Ethiopian government, who already have a program in progress focusing on maternal health in medical centres in urban areas in Ethiopia. With our partnership, we hope to receive funding and equipment from UNICEF, as well as help in raising awareness about our programs and providing us with expertise from their program in order to better facilitate our collaboration. The Ethiopian government will be providing us with a space to hold our workshops in in the villages, as well as secure a space to rent out in Addis Ababa which will be our head office in Ethiopia. The Ethiopian government will also hold seminars, funded by our organization, informing local chiefs of our programs so that they will help spread the word to the locals who are interested as well as provide their opinions and insights about our programs. This will help us get the locals on board and interested in the programs we are offering and get their opinions, therefore helping better our programs in regards to the specific local contexts. The Ethiopian government will also help connect us to local organizations, such as the Ethiopian midwifery association, that are working on the same goal as ours.

 

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We have also partnered with Canadian universities, such as McGill, University of Toronto, University of British Columbia, McMaster University, etc. as well as Addis Ababa University in Ethiopia. They will be providing us with volunteers, who we will be offering internships, that will help in the training process. The Canadian universities will also have clubs for our organization, run by the students, that will hold fundraisers and help raise awareness for our NGO.

The Partnership for Maternal, Newborn, and Child health (PMNCH) have offered us a membership on their board where we will discuss ways in which to help better our programs and approach to reducing maternal mortality rates.

We also hope to partner with different local and international organizations and governments such as the Bill and Melinda Gates foundation in their “Maternal, Neonatal, and Child health” initiative, The WHO in their “making pregnancy safer initiative”, Save the Children in their “NO Child Born to Die” campaign, and the Canadian government in their efforts to reduce maternal mortality. We also hope to partner with medical organizations that will provide us with experts and professionals in the field of maternal health that will train our participants. These partnerships could include funding, lending expertise, equipment, lending resources, etc.

We will be coming out with annual reports and evaluations of our programs that will be distributed to our partners in order for them to see the progress that we have made, as well as where their contributions are going and how they are being used.

Funding:Our start up budget is 700,000 CND which will be divided 70:30 percent for program services and administration respectively. This is following the 70:30 rule of the Ethiopian government in regards to NGO revenue allocation. We will only use the 70:30 rule for revenue allocation for the start up period of our organization, the first 3 to 4 months, and we hope to later move to 80% of our revenue going to program services and only 20% for administrative services.

The revenue going to program services will go to medical and practical equipment for our programs, salaries for the participants of our programs for compensation as well as motivation, workshops, food and water, etc.

 

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The money going to administrative services will go to salaries, transportation, infrastructure, marketing/campaigning, accommodations, etc.

Our organization has already received 230,000 CND from our current partners and funders, however we still need 470,000 CND in order to insure the best programs, training, and environment for our participants.

Why fund MAMMA?Our organization’s main aim is to reduce maternal mortality rates in the areas we work in. Investing in the improvement of maternal mortality, not only helps to improve a mother’s health, her family’s health, as well as reduce child mortality, it also increases the women in the workforce and helps to promote the economic

 

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well-being of communities and countries. It also helps in improving the population pyramid of a country by introducing people into the workforce as well as keeping the current mothers in the workforce. This helps reduce poverty and increase rates of economic development and social progress in a country.

In the 2013 fall UN General Assembly, Prime Minister Stephen Harper identified maternal, newborn, and child health (MNCH) as Canada’s “Flagship development priority.” As a Toronto-based NGO, we hope to work with the Canadian government as well as international organizations to achieve our goal as well as the MDG goal of improving maternal health by reducing maternal mortality rates. (Foreign Affairs, Trade, and Development Canada.)

Our Value - What sets us apart?

- Sustainability

- Promoting local health practices

- Community based approach

- Training Certificate

 

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Short term goalsYear 1

Quarter Achievement

1 Hiring of Staff Office set up

Location base set up Marketing team strategic fundraising vision and planning

submitted

2 Begin training – 1st half Start fundraising and NGO

awareness campaigns

3 Training on-going – 2nd half

4 Annual report for donors Begin to prepare and organize

second leg of training

Long term goals (Next 3 years):

- Reduce maternal mortality rates by 1/2 (in first 3 years)

- Expansion (to more villages)

 

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References:

Bhattacharyya, K., & Murray, J. (2000). Community assessment and planning for maternal and child health programs: A participatory approach in Ethiopia. Human Organization, 59(2), 255-266. Retrieved from http:// search.proquest.com/docview/38910571? Accounted =14771

Dennis-Antwi, J.A. (2011). Preceptorship for midwifery practice in Africa: challenges and opportunities. Evidence-Based Midwifery, 9(4), 137-142. Retrieved from http://search.proquest.com/docview/926409325?accountid=14771

Girma, M., Yaya, Y., Gebrehanna, E., Berhane, Y., & Lindtjørn, B. (2013). Lifesaving emergency obstetric services are inadequate in south-west Ethiopia: a formidable challenge to reducing maternal mortality in Ethiopia. BMC health services research, 13(1), 459

ICM (2012) ' Standard ICM Competency-Based List for Basic Skills Training in Midwifery Schools' International Confederation of Midwives. pg.4-39. (http://www.internationalmidwives.org/assets/uploads/documents/Global%20Standards%20Comptencies%20Tools/English/Standard%20ICM%20Competency-Based_13%20Nov2012.pdf

 

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International Journal on Childbirth (2012) 'September workshops in Addis Ababa, Ethiopia, to support investing in midwives and midwifery training' Springer Publishing Company 2012. United States, New York. Proquest Central. Pg. 1. Link: http://myaccess.library.utoronto.ca/login?url=http://search.proquest.com.myaccess.library.utoronto.ca/docview/1220682964?accountid=14771

Lewis, David (2001) 'The Management of Non-Governmental Developmental Organization' London. Link: http://hr.law.vnu.edu.vn/sites/default/files/resources/management_of_non_governmental_development_organizations__an_introduction__.pdf

Kassaye, K. D., Amberbir, A., Getachew, B., & Mussema, Y. (2006). A historical overview of traditional medicine practices and policy in Ethiopia.Ethiopian Journal of Health Development, 20(2), 127-134.

Koblinsky, M., Tain, F., Gaym, A., Karim, A., Carnell, M., & Tesfaye, S. (2010). Responding to the maternal health care challenge: The Ethiopian Health Extension Program. Ethiopian Journal of Health Development, 24(1).

Mekonnen, Y., & Mekonnen, A. (2003). Factors influencing the use of maternal healthcare services in Ethiopia.

Menareport (2013) 'Ethiopia : Holt helps build maternal-child hospital in Shinshicho, Ethiopia'ProQuest.pg.1 (http://search.proquest.com.myaccess.library.utoronto.ca/docview/1438209227/abstract?accountid=14771) : Existing health care services

Mengesha, Z. B., Biks, G. A., Ayele, T. A., Tessema, G. A., & Koye, D. N. (2013). Determinants of skilled attendance for delivery in Northwest Ethiopia: a community based nested case control study. BMC public health, 13(1), 130.

 

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O’Heir, J.M. (1997). Midwifery education for safe motherhood. Midwifery, 13(3), 115-124. doi: 10.1016/S0266-6138(97)90001-2

Shiferaw, S., Spigt, M., Godefrooji, M., Melkamu,Y., Tekie, M. (2013). Why do women prefer home births in Ethiopia? BMC pregnancy and childbirth, 13(1), 5-5. doi: 10.1186/1471-2393-13-5

Susuman, A.S. (2012). Child mortality rate in Ethiopia. Iranian journal of public health, 41(3), 9-19. Retrieved from http://myaccess.library.utoronto.ca/login?url=http:// ut

l.summon.serialssoluti ons.com/2.0.0/link/0/eLvHCXMwVZ3BCQMxDARdQL7pIF- BdVbM-

R1ypICkAFsr9V9CJAiE60FodhmQSrltSIh3JvMdlGqNRl2VlrfgW97fG3Yyppf_Ajuu5XM8348X_X4BEDgQliFwRvfWgR6VxWzADdPuTaeIKtIGLo-JVLZNdq7auFt1uEwscf4CCeckjg

Worku, A.G., Yalew, A.W., Afework, M.F. (2013). Availability and components of maternity services according to providers and users perspectives in North Gondar, northwest Ethiopia. Reproductive Health, 10(1), 43-43. doi:10.1186/1742-4755-10-43

(World Health Organization. (2014). Maternal Health. Retrieved from http://www.who.int/topics/maternal_ health/en/)

( United Nations. (2013). United Nations Millennium Development Goals. Retrieved from http://www.un.org/millenniumgoals/pdf/Goal_5_fs.pdf)