MSD FOR MOTHERS PROGRAM REPORT

Transcription

1 2015 MSD FOR MOTHERS PROGRAM REPORT

2 MSD FOR MOTHERS DESIGNING AND TESTING SOLUTIONS TO SAVE WOMEN S LIVES DURING PREGNANCY AND CHILDBIRTH. ADVOCATING FOR THE CHANGE THAT WOMEN DESERVE. 2 / MSD FOR MOTHERS PROGRAM REPORT / OCTOBER 2015

3 A MESSAGE FROM LEADERSHIP WE ARE PLEASED TO SHARE THIS UPDATE ON THE PROGRESS OF MSD FOR MOTHERS*, MSD S 10-YEAR INITIATIVE TO REDUCE MATERNAL MORTALITY. Now in our fourth year, MSD for Mothers is working alongside 75+ partners on 50+ programs that are helping pave a smoother path to safe motherhood for women in 30 countries around the world. Together we are investing in two areas we believe will have the greatest impact on ending preventable maternal deaths, especially in countries with the highest maternal mortality burden: Improving the quality of care women receive in health facilities at the time of childbirth Improving access to high-quality modern contraceptives Saving women s lives from pregnancy and childbirth complications is complex, demanding innovation every step of the way. As MSD has learned from tackling other global health challenges like river blindness, HIV/AIDS and cervical cancer, we must take a comprehensive approach that goes beyond any single intervention if we are to achieve substantial and sustainable gains in health. We re striving to make transformative contributions in three ways: ENABLING HEALTH PROVIDERS Equipping health providers with the skills, tools and technologies they need to deliver high-quality maternity and family planning services wherever women seek care. DEVELOPING AND DELIVERING LIFESAVING PRODUCTS Placing lifesaving maternal health products in the hands of women and their providers. EMPOWERING WOMEN Empowering women to make informed choices about contraception and get the quality care they need for a healthy pregnancy and safe childbirth. So where are we now? To date, our partnerships have helped 5+ million women gain reliable access to quality maternal healthcare and modern contraceptives. This number grows every day. And as we generate data on what is succeeding and as importantly, what is not we are advocating to bring programs to scale and help improve the lives of millions more women across the globe. We are grateful for our creative partners and emboldened by our shared vision of a world where no woman dies giving life. Be well, DR. NAVEEN RAO LEAD, MSD FOR MOTHERS DR. PRIYA AGRAWAL EXECUTIVE DIRECTOR, MSD FOR MOTHERS *MSD for Mothers is known as Merck for Mothers in the U.S. and Canada. MSD FOR MOTHERS PROGRAM REPORT / OCTOBER 2015 / 3

4 BY THE NUMBERS Four years into our 10-year initiative, our partnerships have made impressive strides to help improve maternal health worldwide: 5+ TOTAL MILLION NUMBER OF WOMEN WITH IMPROVED ACCESS TO QUALITY MATERNAL HEALTHCARE AND MODERN CONTRACEPTIVES 3.5+ MILLION WOMEN WITH IMPROVED ACCESS TO MODERN CONTRACEPTIVES 5,400+ PROVIDERS AND COMMUNITY HEALTH WORKERS TRAINED 1.5+ MILLION WOMEN WITH IMPROVED ACCESS TO QUALITY MATERNAL HEALTHCARE 2,500+ FACILITIES STRENGTHENED TO PROVIDE QUALITY CARE 50+ PROGRAMS 75+ PARTNERS 30 COUNTRIES 4 / MSD FOR MOTHERS PROGRAM REPORT / OCTOBER 2015

5 MATERNAL MORTALITY NEARLY HALVED IN UGANDA AND ZAMBIA MSD for Mothers is proud to be a founding partner of Saving Mothers, Giving Life (SMGL), an ambitious public-private partnership to reduce maternal and newborn mortality in sub-saharan Africa. In less than three years, SMGL has seen maternal mortality drop by 45% in target facilities in Uganda and 53% in target facilities in Zambia. KEY ACHIEVEMENTS U.S. SENEGAL UGANDA ZAMBIA INDIA Implemented evidencebased practices to treat the leading causes of maternal death in five states that account for one quarter of the nation s four million births and inspired government support of quality improvement efforts in eight additional states Decreased stock outs of contraceptives to less than 2% in all public health facilities (from more than 80% in 2011) and helped increase the contraceptive prevalence rate to 20% nationwide (from 12% in 2011) Expanded a social franchise network of private providers offering quality-assured maternal health services to 140 health facilities, covering one third of the country Designed communitymanaged, entrepreneurial maternity homes, and initiated partnership to develop them and evaluate whether they are an effective solution to help women receive timely, quality care Improved the quality of private maternity care through social franchising, training, quality improvement and government accreditation in three high-burden states with a total population of 300+ million MSD FOR MOTHERS PR OGR A M REPORT / OC TOB ER 2015 / 5

6 GLOBAL PARTNERS & PROGRAMS OUR INDIA UNITED STATES SAVING MOTHERS, GIVING LIFE Hindustan Latex Family Planning Promotion Trust American Congress of Obstetricians and Gynecologists District II American College of Obstetricians and Gynecologists Jhpiego and the Federation of Obstetric and Gynaecological Societies of India Association of Maternal and Child Health Programs Every Mother Counts Pathfinder International and World Health Partners Association of Women s Health, Obstetric and Neonatal Nurses Peace Corps White Ribbon Alliance for Safe Motherhood and Gram Vaani California Maternal Quality Care Collaborative Project C.U.R.E. Government of Norway President s Emergency Plan for AIDS Relief Camden Coalition of Healthcare Providers U.S. Agency for International Development SENEGAL Fund for Public Health in New York IntraHealth International Maternal Health Task Force U.S. Centers for Disease Control and Prevention Maternity Care Coalition UGANDA Association of Obstetricians and Gynaecologists of Uganda HealthPartners Uganda Population Services International and PACE Save for Health Uganda Northern Manhattan Perinatal Partnership ZAMBIA Africare and the University of Michigan Boston University and Zambia Center for Applied Health Research and Development Transaid 6 / MSD FOR MOTHERS P ROGRAM RE P ORT / OCTOBE R 2015 U.S. Department of Defense U.S. Department of State

7 GLOBAL GIVING Al-Hayat Chaînes de Vie (Morocco) British Pregnancy Advisory Service (U.K.) Centre de Coopération Internationale en Santé et Développment (Haiti) Comunità di Sant Egidio ACAP ONLUS (Mozambique) Concern Worldwide USA (Malawi) Doctors with Africa Cuamm (Ethiopia) Ethno-Medizinisches Zentrum e.v. (Germany) Health[e] Foundation (Rwanda) INMED Partnerships for Children (Jamaica) Jhpiego (Myanmar) John Snow Inc. (Ukraine) Lebanon Family Planning Association for Development and Family Empowerment (Lebanon) Maternity Foundation (Ethiopia) Medics Without Vacation (Democratic Republic of Congo) mothers2mothers (Malawi) Organización Para Ayuda Entre Los Pueblos (Democratic Republic of Congo) Pan American Development Foundation (Argentina, Colombia, Mexico) Pathfinder International (Nigeria, Peru) Project HOPE (Indonesia) Sinergias (Colombia) Sociedad Mexicana de Salud Pública (Mexico) Swiss Tropical Public Health Institute (Tanzania) Turkish Family Health and Planning Foundation (Turkey) UMATI (Tanzania) Universidad Central de Venezuela (Venezuela) U.S. Fund for UNICEF (South Africa) Väestöliitto, The Family Federation of Finland (Finland) World Lung Foundation (Tanzania) Zuellig Family Foundation (Philippines) OTHER PARTNERS Bill & Melinda Gates Foundation Columbia University Mailman School of Public Health The ELMA Foundation Family Care International Ferring Pharmaceuticals London School of Hygiene & Tropical Medicine M4ID Population Council Vecna Cares United Nations Foundation Wellframe Women Deliver World Health Organization RESEARCH GRANTEES Gynuity Health Projects Maternova Rice University MSD FOR MOTHERS PROGRAM REPORT / OCTOBER 2015 / 7

8 8 / MSD FOR MOTHERS PROGRAM REPORT / OCTOBER 2015 ENABLING HEALTH PROVIDERS

9 CHALLENGE Health providers are not always equipped with the skills, tools and technologies to deliver high-quality maternal healthcare ENSURING EVIDENCE- BASED CARE AT U.S. HOSPITALS After rapid declines in maternal deaths, the rate of maternal mortality in the U.S. has more than doubled in the past 25 years. An estimated 60,000 women nearly die from pregnancyand childbirth-related causes each year. We forged a partnership with leading doctors, nurses and quality improvement associations to accelerate the development of nationallyendorsed, evidence-based practices to treat the three leading causes of maternal death in the U.S.: excessive bleeding, high blood pressure and blood clots. Following the rapid progress in five states, the U.S. government is supporting quality improvement efforts in eight additional states. 60,000 2X 64 th THE APPROXIMATE NUMBER OF WOMEN WHO NEARLY DIE DURING PREGNANCY OR CHILDBIRTH EVERY YEAR IN THE U.S. THE MATERNAL MORTALITY RATIO HAS MORE THAN DOUBLED SINCE 1990, EVEN AS DEATHS GLOBALLY HAVE DECLINED BY 45% THE U.S. GLOBAL RANK BASED ON MATERNAL MORTALITY RATIO BEHIND NEARLY EVERY OTHER DEVELOPED NATION PROGRESS IN THE U.S MILLION 8 hospitals with improved quality of obstetric care in five states women with access to improved quality obstetric care one quarter of all women who give birth annually states that will be participating in government-supported expansion of quality improvement efforts MSD FOR MOTHERS PROGRAM REPORT / OCTOBER 2015 / 9

10 STRENGTHENING LOCAL, PRIVATE MATERNAL HEALTHCARE In low-and-middle-income countries, about 40% of women receive antenatal care, delivery services and family planning from private health providers. We are committed to saving more lives by ensuring quality care wherever a woman seeks care. Antenatal Care 44% Private Delivery Services 40% Private Family Planning 37% Private DATA ARE CRITICAL TO IMPROVING QUALITY We are developing a new digital tool to guide clinical decisions in real time, giving health providers immediate support to manage labor and delivery care. The tool will capture data on the care health providers offer, allowing clinicians and managers to use automated data to inform quality improvements efforts at facility, district and national levels. PROGRESS IN INDIA Working in Jharkhand, Rajasthan and Uttar Pradesh Expanded a successful maternity social franchise network to Rajasthan 750 hospitals and + clinics strengthened Helped private maternity providers meet streamlined quality standards for labor and delivery services and advocated for their inclusion in national accreditation guidelines Brought care closer to women in remote areas by enlisting private community health workers, introducing telemedicine and leveraging private distribution channels to deliver supplies at the last mile 10 / MSD FOR MOTHERS P ROGRAM RE P ORT / OCTOBE R ,700 + health workers trained 167,000 deliveries in strengthened health facilities 246,500 women with improved access to quality care + +

11 BUILDING PRIVATE MIDWIVES CAPACITY TO SERVE MORE WOMEN In 2009, Jane joined PACE s ProFam network, a franchise of local clinics, to expand her business and serve more women. At the time, she only had a one-room clinic, but she knew she wanted more. Before I joined ProFam and the MSD for Ugandan Mothers (MUM) program, I wasn t as busy as I am now. It s that simple. They have provided training in how to help me make my services more affordable so they can be available to more women. management, enabling Jane to continue to expand her services to meet the needs of women in her community. Now, Jane s clinic serves about 30 women a day and delivers about 25 newborns a month. Why do so many women attend her clinic? Jane says her clinic provides a lot of love. People call me Mama ProFam. Because of ProFam With help from ProFam and the MUM program, she s doing just that. and the MUM program s Jane has been trained on the management of obstetric emergencies, family planning services, cancer screening and infection prevention as well as business I do. trainings, I m more confident in everything Photo credit:julius Caeser Kasujja PROGRESS IN UGANDA Working in 42 districts more than a third of the country Expanded and introduced maternal health services into a social franchise network of private providers Helped private maternity providers offer quality-assured emergency obstetric care and provided business management training Expanded a social franchise network to urban areas in Kampala to help decongest overcrowded public hospitals hospitals and clinics strengthened health workers trained 22, ,000 + deliveries in strengthened health facilities women with improved access to quality care MSD FOR MOTHERS PROGR A M REPORT / OC TOB ER 2015 / 11

12 DEVELOPING & DELIVERING LIFESAVING PRODUCTS 12 / MSD FOR MOTHERS PROGRAM REPORT / OCTOBER 2015 Photo credit: IntraHealth International

13 Even the most capable health provider may not be able to save a woman s life if essential products are not available CHALLENGE ADVANCING A LIFESAVING MEDICINE PRIVATE SECTOR MODEL TRANSFORMS SUPPLY CHAIN FOR FAMILY PLANNING A few years ago, supplies of contraceptive products were chronically running short, describes Dr. Bocar Mamadou Daff, Director of the Reproductive Health and Child Survival Unit at the Senegalese Ministry of Health. Women were being turned away empty handed. I heard that women were rowing canoes across the Doué River to buy contraceptives on the other side because the shelves at their health post were empty. The Informed Push Model turns the contraceptive order and delivery process upside down. The project shifts responsibility for forecasting, ordering and delivering supplies from overworked health providers to skilled private suppliers. In July 2015, the first patient enrolled in a clinical trial to evaluate the effectiveness of heat-stable carbetocin, a reformulated medicine to prevent excessive bleeding after childbirth. Unlike the current standard treatment, heat-stable carbetocin is designed to be stable at room temperature, even in hot climates where most maternal deaths occur. As Mr. Ndiaye, Head Nurse at Tiaba Niassène health post, enthusiastically described, We must have everything on the Push. If it weren t for the Push, I would have to close my post today to go collect medicines. [Now] I stay at the post and the medicines come to me. If the results of the study are positive, we will work together with our partners with the aim of making the medicine available in developing countries that have a high burden of maternal mortality at an affordable and sustainable public-sector price. Photo credit: IntraHealth International PROGRESS IN SENEGAL ELIMINATING STOCK OUTS OF MODERN CONTRACEPTIVES Adapted principles used in the commercial sector to develop an innovative supply chain model Completed costing analysis to identify options for expanding the model nationally 80% 2% decline in stock out rate of contraceptives since percentage point increase in contraceptive prevalence rate since ,300 + Working in all 14 regions of the country Expanded the Informed Push Model to public health facilities nationwide 3.2 MIL public health facilities benefitting from the model women with improved access to modern contraception MSD FOR MOTHERS PR OGR A M REPORT / OC TOB ER 2015 / 13

14 14 / MSD FOR MOTHERS PROGRAM REPORT / OCTOBER 2015 EMPOWERING WOMEN

15 CHALLENGE Women are not always armed with the tools and knowledge to be stewards of their own health USING MOBILE PHONES TO EMPOWER WOMEN TO BE INFORMED HEALTH CONSUMERS We re developing three phone-based tools to help pregnant and postpartum women receive the care they need, when they need it. 1 Rating care A voice-based platform will help women learn about the maternal healthcare they deserve and rate the services they receive. 2 Learning about family planning options Individuals seeking family planning services will be able to call a free hotline to learn about different options, identify the best ones, receive a referral to a nearby health facility and later rate the quality of care received. 3 Monitoring health after childbirth A postpartum app will help women in the U.S. and the U.K. know what to expect during the postpartum period (when 60% of maternal deaths occur), identify warning signs and maintain good health after childbirth. Photo credit: White Ribbon Alliance India MSD FOR MOTHERS PROGRAM REPORT / OCTOBER 2015 / 15

16 PIONEERING COMMUNITY-BASED PROGRAMS RESPONSIVE TO WOMEN S NEEDS In Zambia, many women live miles from the closest health facility with few, if any, affordable and safe transportation options. We are supporting new, community-managed models of maternity homes residences near health facilities where pregnant women who live in remote areas can stay until the late stages of their pregnancy and immediately after childbirth. And we re exploring creative, entrepreneurial ways to make these homes sustainable. 16 / MSD FOR MOTHERS PROGRAM REPORT / OCTOBER 2015

17 COMMUNITY HEALTH WORKERS OFFER A LIFELINE FOR PREGNANT WOMEN IN PHILADELPHIA When Jackie met Sharice, Sharice was pregnant, homeless, jobless and recently diagnosed with diabetes. Sharice was completely overwhelmed by the fragmented system, says Jackie Torres, a community health worker at Maternity Care Coalition (MCC) in Philadelphia. She kept asking me, How am I supposed to take care of my baby, when I can t meet my own needs? Increasingly, women in the U.S. are entering pregnancy with a more complex set of needs and there are huge disparities in maternal health outcomes across race. Thanks to MCC s Safe Start MOMobile program, Sharice and many other women are getting the support and care they need. Jackie became a trusted source and critical link to existing resources, helping Sharice secure a place to live, find healthy food and better communicate with her health providers. Sharice recently said to me, Before I met you, I didn t have a plan. Now I have goals for my life, says Jackie. To see this woman who faced such extreme challenges making these huge strides is incredible. Philadelphia, PA New York, NY Camden, NJ In the U.S., some of the areas hardest hit by maternal mortality are low-income communities where chronic diseases like obesity, high blood pressure and diabetes are on the rise. Our partners are developing new models of care involving community health workers specially trained to help pregnant women with complex health problems have a healthy pregnancy and safe childbirth and maintain lifelong good health. MSD FOR MOTHERS PROGRAM REPORT / OCTOBER 2015 / 17

18 LEVERAGING THE BEST OF MSD TO SAVE WOMEN S LIVES EVERY DAY, MSD EMPLOYEES PROVIDE THEIR BUSINESS AND SCIENTIFIC EXPERTISE TO AMPLIFY OUR IMPACT 40 Global Health Fellows working directly with partners on three-month assignments in the field 50+ Expert advisors providing technical support to strengthen programs 35,000+ Hours contributed During my fellowship, I worked with the White Ribbon Alliance, a MSD for Mothers-supported NGO in India. The initiative focused on raising the voice of the voiceless and leveraging market efficiency to lower preventable maternal mortality in India. The immersive learning experience over 90 days helped me uncover latent skills, appreciate organizational complexity and energized me to become an alliance builder and a change catalyst. I have learned to listen, seek first to understand and collaborate effectively across functions and cultures. The MSD Fellows brought a business mindset to our challenge of delivering health services and now we are have a better plan to sustain our work for the long term. HANNA BALDWIN, CHIEF OF PARTY, MSD FOR UGANDAN MOTHERS SIVA MURTHY, DIRECTOR, U.S. PAYER MARKETING ONCOLOGY COLLABORATING WITH GLOBAL COLLEAGUES TO RESPOND TO LOCAL NEEDS In countries as diverse as Ethiopia, Indonesia, Mexico and Tanzania, we are supporting programs to train health providers in maternal care services, link pregnant women to care and raise awareness of safe motherhood. 30 PROJECTS 24 COUNTRIES 18 / MSD FOR MOTHERS PROGRAM REPORT / OCTOBER 2015

19 I greatly appreciate the opportunity to share the tools we use to evaluate real world evidence. By demonstrating the value of an innovative supply chain model that eliminates stock-outs of contraceptives from an economic perspective, our team could provide further insight to the government s decision to expand access to family planning. ERIK DASBACH, EXECUTIVE DIRECTOR, OUTCOMES RESEARCH Working with MSD for Mothers is one of the most engaging assignments I ve had at MSD. We are able to implement innovative and disruptive solutions which will make a real difference in the world. MICHELLE MOSOLGO, EXECUTIVE DIRECTOR, INFORMATION TECHNOLOGY From my years of experience in hepatitis, I ve seen the valuable role that community health workers can play to improve access to lifesaving care. It s been a privilege to share my experiences with MSD for Mothers as we explore new ways of helping pregnant women with chronic disease receive the care they need for good long-term health. EIRUM CHAUDHRI, EXECUTIVE DIRECTOR, MEDICAL AFFAIRS MSD FOR MOTHERS PROGRAM REPORT / OCTOBER 2015 / 19

20 We are honored to play a role in global efforts to achieve the Sustainable Development Goals. Through our ongoing commitments to address important health challenges, including maternal health, HIV/AIDS, cervical cancer and neglected tropical diseases, we are mobilizing the best of MSD to help save and improve lives around the world. Kenneth Frazier, MSD Chairman and CEO TOGETHER, WE CAN HELP END PREVENTABLE MATERNAL DEATHS