Maternal, newborn and child health
Current portfolio
Many mothers in the Copperbelt region of Zambia are giving birth in healthcare facilities that lack skilled staff, medical equipment and basic supplies. In the Copperbelt province, the main causes of death for women in childbirth are excessive bleeding, high blood pressure and sepsis. Babies are dying from complications due to prematurity, asphyxia, and sepsis. These deaths are preventable if women and babies access high quality care quickly. The proposed project aims to improve the quality of care at primary health care level and increase the number of safe referrals to more specialist care, thereby improving chances of survival of mothers and new-borns.
King’s Global Health Partnerships draw on the academic, clinical, and international development expertise from King’s College London and three leading NHS Hospitals (Guys and St Thomas’s, King’s College Hospital and the South London and Maudsley NHS Foundation Trusts). In the Copperbelt Province of Zambia, KGHP has a longstanding partnership with the country’s only children’s hospital - the Arthur Davison Children’s Hospital - and the main adult hospital - Ndola Teaching Hospital.
The project will establish and embed quality training processes to enable staff to deliver low-cost, proven interventions that can reduce maternal and neonatal deaths. Training, development and support for staff at primary healthcare facilities will be led by senior staff from the Zambian hospitals, with advice and support from visiting UK health professionals. The project focuses on 11 health facilities identified as being off-track, where effective improvements in health care could provide significant results.
The project aims to:
King’s Global Health Partnerships draw on the academic, clinical, and international development expertise from King’s College London and three leading NHS Hospitals (Guys and St Thomas’s, King’s College Hospital and the South London and Maudsley NHS Foundation Trusts). In the Copperbelt Province of Zambia, KGHP has a longstanding partnership with the country’s only children’s hospital - the Arthur Davison Children’s Hospital - and the main adult hospital - Ndola Teaching Hospital.
The project will establish and embed quality training processes to enable staff to deliver low-cost, proven interventions that can reduce maternal and neonatal deaths. Training, development and support for staff at primary healthcare facilities will be led by senior staff from the Zambian hospitals, with advice and support from visiting UK health professionals. The project focuses on 11 health facilities identified as being off-track, where effective improvements in health care could provide significant results.
The project aims to:
- Ensure at least 70% of the primary healthcare facilities have improved their maternal and neonatal care to an acceptable standard
- Train 165 healthcare workers across 11 primary healthcare facilities
Over the last 25 years, the health sector in Rwanda has improved and rates of childhood mortality have fallen. But the country continues to struggle with high rates of maternal and newborn mortality and morbidity. One of the major barriers to further improvement in perinatal survival is the quality of clinical care, and the delivery of care across the country’s hospital network. The programme will support sustainable improvement in the quality of perinatal care, for delivering mothers and newborns in the first month of life, across 14 Provincial and District Hospitals, in order to embed better practices which reduce newborn and maternal mortality and morbidity.
Building on the Royal College of Paediatrics and Child Health’s track record working in partnership with the Rwandan Paediatrics Association, the Rwandan Ministry of Health and UNICEF Rwanda, the programme will support development of advanced neonatal intensive care units. Quality Improvement Teams will be created comprising a permanent cohort of Rwandan clinicians and rotating six-month deployment of UK clinicians, including paediatric doctors, neonatal specialists and nurses, obstetricians and midwives.
The teams will draw on globally accredited, evidence-based training and quality improvement protocols and methods to improve care delivery for mothers through labour and delivery, and for newborns in their first 28 days of life.
Over three years, the Royal College of Paediatrics and Child Health and the Rwandan Paediatrics Association aim to:
Building on the Royal College of Paediatrics and Child Health’s track record working in partnership with the Rwandan Paediatrics Association, the Rwandan Ministry of Health and UNICEF Rwanda, the programme will support development of advanced neonatal intensive care units. Quality Improvement Teams will be created comprising a permanent cohort of Rwandan clinicians and rotating six-month deployment of UK clinicians, including paediatric doctors, neonatal specialists and nurses, obstetricians and midwives.
The teams will draw on globally accredited, evidence-based training and quality improvement protocols and methods to improve care delivery for mothers through labour and delivery, and for newborns in their first 28 days of life.
Over three years, the Royal College of Paediatrics and Child Health and the Rwandan Paediatrics Association aim to:
- Achieve a reduction of at least 25% in rates of neonatal mortality
- Improve percentage of midwives able to identify and respond to labour/ foetal distress from 25% to 75%
- Increase the percentage of new-borns who have regained weight when discharged from 62% to 80%
Children living in Zambia are at risk of malaria, diarrheal diseases and poor health that can interrupt their school attendance and potentially cause long-term health problems. The majority of child health programmes focus only on early childhood, and the needs of school-aged children are often underserved.
Since 2015, Healthy Learners have worked in Lusaka, Zambia to train teachers as school health workers to deliver medical care and health education for children in school. Healthy Learners provide teachers with training and support to identify, treat or refer sick students. School health workers are able to treat simple and minor conditions at the school and provide fast-tracked referral to local government health clinics for more serious or complex issues.
School health workers use tablets equipped with diagnostic software developed by tech partner THINKMD enabling accurate clinical assessments, decision support, data collection and quality monitoring. Evidence has shown that this model improves reduces illness and increases effectiveness of national healthcare programmes, including coverage of deworming medication and vitamin A supplements.
Healthy Learners are working with the Ministries of Health and Education to establish the model as a national programme. They are now expanding their school health workers programmes to the Copperbelt region and each of the country’s provincial capitals.
Over three years, Healthy Learners intends to:
Since 2015, Healthy Learners have worked in Lusaka, Zambia to train teachers as school health workers to deliver medical care and health education for children in school. Healthy Learners provide teachers with training and support to identify, treat or refer sick students. School health workers are able to treat simple and minor conditions at the school and provide fast-tracked referral to local government health clinics for more serious or complex issues.
School health workers use tablets equipped with diagnostic software developed by tech partner THINKMD enabling accurate clinical assessments, decision support, data collection and quality monitoring. Evidence has shown that this model improves reduces illness and increases effectiveness of national healthcare programmes, including coverage of deworming medication and vitamin A supplements.
Healthy Learners are working with the Ministries of Health and Education to establish the model as a national programme. They are now expanding their school health workers programmes to the Copperbelt region and each of the country’s provincial capitals.
Over three years, Healthy Learners intends to:
- Train 2,300 teachers as school health workers
- Provide access to school health workers for 700,000 students
- Reduce the level of school absenteeism due to illness by 10%
- Increase coverage of deworming medication and vitamin A supplements by 50%
Since 2011, D-tree International has been training and supporting community health volunteers (CHV) in Zanzibar to provide maternal, newborn and child health care, with the assistance of digital technology.
The Zanzibar government has now incorporated D-tree International’s digital CHV programme into the formal health system at a national level. Since 2018, D-tree International has worked alongside the Ministry of Health to design and roll-out the CHV programme, named Jamii ni Afya (Community is Health). Once fully scaled, the Jamii ni Afya programme will ensure that all of Zanzibar’s 1.6 million people can access high quality health services.
D-tree has asked the James Percy Foundation to support the roll-out of the Jamii ni Afya programme in Zanzibar’s Central district. During the 3-year project, D-tree will train and support 122 Community Health Volunteers and 15 supervisors to use digital tools, with the aim of improving maternal and newborn health, nutrition, early childhood development and immunisation tracking.
Through its work in Central district, D-tree International hopes to:
The Zanzibar government has now incorporated D-tree International’s digital CHV programme into the formal health system at a national level. Since 2018, D-tree International has worked alongside the Ministry of Health to design and roll-out the CHV programme, named Jamii ni Afya (Community is Health). Once fully scaled, the Jamii ni Afya programme will ensure that all of Zanzibar’s 1.6 million people can access high quality health services.
D-tree has asked the James Percy Foundation to support the roll-out of the Jamii ni Afya programme in Zanzibar’s Central district. During the 3-year project, D-tree will train and support 122 Community Health Volunteers and 15 supervisors to use digital tools, with the aim of improving maternal and newborn health, nutrition, early childhood development and immunisation tracking.
Through its work in Central district, D-tree International hopes to:
- Increase the percentage of pregnant women who attend four or more ante-natal visits during pregnancy from 53% to 65%.
- Increase the percentage of babies delivered at a health facility from 60% to 80%.
- Increase the percentage of caregivers with adequate knowledge of Minimum Acceptable Diet from 23% to 50%.
Completed Projects
The 2016 Ethiopia Demographic and Health Survey (EDHS 2016) showed that child health outcomes are very poor in the Southern Nations, Nationalities and Peoples’ Region (SNNPR) and Oromia regions of Ethiopia. Against the national infant mortality rate of 48 per 1,000 live births and 67 for under-five mortality, in Oromia the infant mortality rate is 60 and the under-five mortality rate is 79 per 1,000 live births; in SNNPR infant mortality and under-five mortality are even higher, at 65 and 88 per 1000 live births respectively. Key factors in this include low immunisation coverage; lack of access to related services; and shortage of vaccines at health facilities, especially at health posts.
Coverage of maternal health services is poor in Oromia and SNNPR; antenatal care coverage was 50.7% in Oromia and 69.3% in SNNPR, and the proportion of deliveries attended by health personnel was 19.7% in Oromia and 28.6% in SNNPR according to EDHS 2016.
Utilisation of family planning is also low in the targeted regions, even though it is evident that by reducing the number of unintended pregnancies maternal mortality rates decrease. According to EDHS 2016, about 29% of married women in Oromia and 21% in SNNPR have an unmet need for family planning; the proportion of women who want to limit their childbearing is highest in SNNPR and Oromia (at 40% each).
This project addressed limited access to, and the low quality of, maternal, neonatal and child healthcare as well as family planning in the Kofele woreda, Oromia region and Aleta Chuko woreda, SNNPR, Ethiopia.
Key activities included (i) training (or retraining) all Health Extension Workers in the target area on integrated community case management of malaria, pneumonia and diarrhoea, on immunisation, and on family planning; (ii) community mobilisation sessions and orientation meetings with religious and clan leaders on institutional deliveries, family planning and child health; (iii) provision of immunisation defaulter tracing and referral tools, as well as colour coded health calendars; (iv) creating/improving linkages between health posts, health centres and referral hospitals for obstetric and newborn care,(v) training two nurses from every health centre on basic emergency obstetric and newborn care; (vi) improving data quality through training, and data quality audits; and (vii) Improving quality of care through supportive supervision and performance reviews.
This project acheived:
Coverage of maternal health services is poor in Oromia and SNNPR; antenatal care coverage was 50.7% in Oromia and 69.3% in SNNPR, and the proportion of deliveries attended by health personnel was 19.7% in Oromia and 28.6% in SNNPR according to EDHS 2016.
Utilisation of family planning is also low in the targeted regions, even though it is evident that by reducing the number of unintended pregnancies maternal mortality rates decrease. According to EDHS 2016, about 29% of married women in Oromia and 21% in SNNPR have an unmet need for family planning; the proportion of women who want to limit their childbearing is highest in SNNPR and Oromia (at 40% each).
This project addressed limited access to, and the low quality of, maternal, neonatal and child healthcare as well as family planning in the Kofele woreda, Oromia region and Aleta Chuko woreda, SNNPR, Ethiopia.
Key activities included (i) training (or retraining) all Health Extension Workers in the target area on integrated community case management of malaria, pneumonia and diarrhoea, on immunisation, and on family planning; (ii) community mobilisation sessions and orientation meetings with religious and clan leaders on institutional deliveries, family planning and child health; (iii) provision of immunisation defaulter tracing and referral tools, as well as colour coded health calendars; (iv) creating/improving linkages between health posts, health centres and referral hospitals for obstetric and newborn care,(v) training two nurses from every health centre on basic emergency obstetric and newborn care; (vi) improving data quality through training, and data quality audits; and (vii) Improving quality of care through supportive supervision and performance reviews.
This project acheived:
- Coverage of vaccinations for childhood diseases exceeded the targets of 96% in both districts
- 25,088 children sought and received treatment for their conditions in year 3 (an increase from 13,772 in year 1)
- Percentage of women giving birth attended by trained health personnel at a health facility rose in each district from 20% / 29% at baseline to 99% / 98%
- Percentage of women visited at least four times during their pregnancy by skilled personnel in each district increased from 42% / 53% to 98% / 100%
- Percentage of new mothers seen by a trained health provider within 48 hours of birth increased from 9% / 17% at baseline to 98 / 99%
Across Tanzania, the maternal mortality rate was recorded as rising from 432 per 100,000 live births in 2012 (as per the National Census Report), to 556 per 100,000 in 2015/16 (as per the Tanzania Demographic and Health Survey). The situation for women and pregnant mothers is becoming worse, not better. The Tanzanian Ministry of Health has identified the Simiyu region as a priority in tackling poor maternal and child health outcomes.
Uzazi Uzima II, meaning ‘Safe Deliveries’ aims to address this by increasing the use and availability of quality maternal and new-born health services within the Simiyu region.
This project achieved:
Uzazi Uzima II, meaning ‘Safe Deliveries’ aims to address this by increasing the use and availability of quality maternal and new-born health services within the Simiyu region.
This project achieved:
- 15% increase in births attended by a doctor, nurse or midwife
- 800 community health workers trained on community-based based reproductive, maternal, newborn and child health (RMNCH), WASH, and nutrition.
- Clubs set up in 145 schools to sensitise students on their right to access RMNCH, WASH, and nutrition services.
- Strengthened health management systems and increased demand for health services among community members.
James Percy Foundation
Registered with the Charity Commission 1144494
Registered with the Charity Commission 1144494