Research on reducing maternal deaths, but…

MINISTRY of Health Permanent Secretary - technical services Kennedy Malama speaking at the health symposium in Lusaka recently.

‘EVIDENCE for impact: Translating research into gains for primary and community health in Zambia’ was the theme for the US government-funded three-day health symposium, through USAID, in Lusaka from March 20 to 22, 2018.
The health symposium gathered over 300 participants from government agencies, public and private research institutions, development partners, United Nations agencies, academia, civil society organisations, community-based organisations, and individual researchers and scientists.
The evidence for impact survey on the maternal health in Zambia leading to the health symposium started in November 2017, through a steering committee constituted by the Ministry of Health, in partnership with co-operating partners, spearheaded by the Population Council running with a campaign slug of ‘Saving Mothers Giving Life’ (SMGL).
Launched in 2012, the SMGL initiative is a public-private partnership aimed at supporting the Zambian government on an ambitious goal of reducing maternal and newborn mortality rate by 50 percent through implementation of high impact maternal health interventions in selected districts countrywide.
According to the outlined concept note, the SMGL initiative was birthed after realisation that achieving complete sexual and reproductive health, especially for women and young people, was a key pillar of socio-economic development.
Through close collaboration with several international public and private partners, SMGL strengthens the provision of vital life-saving services during labour and delivery and improves access to health facility services for Zambian women.
Midterm results in 2015 revealed a remarkable 53 percent decrease in institutional maternal mortality in target facilities and a 43 percent increase in the number of births that took place in health facilities.
Although it was noted that Zambia had made strides towards achieving health-related Sustainable Development Goals (SDGs) such as covering all major health priorities ranging from tackling non-communicable diseases (NCDs), mental health, injuries and environmental issues, there still remained gaps and challenges to fully attain equitable and sustainable progress.
It was therefore agreed that the focus of the symposium should also be on reproductive, maternal and newborn, child, and adolescent health and nutrition services in primary care and community settings.
“The theme of the symposium, ‘Evidence for impact: Translating research into gains for primary and community health in Zambia’, resonates very well with the Ministry of Health Strategic Plan for 2017 to 2021, whose focus is on strengthening health systems and services using the primary health care (PHC) approach, with the community as the pillar of the health system,” Minister of Health Chitalu Chilufya indicated during the official opening of the symposium.
The minister, whose remarks were read by his Permanent Secretary in charge of technical services, Kennedy Malama, said Government has placed significant importance on research as the source for evidence-based decision-making.
He said Government has since created the National Health Research Authority mandated, among other things, to co-ordinate and ensure utilisation of data from national health research.
According to Dr Chilufya, Government has made progress in reducing maternal mortality ratio from 591 deaths per 100,000 live births in 2007 to 398 deaths per 100,000 live births in 2014. However, he noted that this death ratio rate was too high.
He said there is need to implement targeted evidence-based interventions to ensure no woman dies while giving birth and each child should be given a chance to grow and survive into adulthood.
“Government has set high but achievable ambitious targets such as reducing maternal mortality ratio to below 100 per 100,000 lives and under-five mortality rate to less than 56 per 1,000 live births,” Dr Chilufya said.
These targets, he said, can only be achieved through utilisation of research-evidence streamlined in key strategic interventions that Government has put in place such as child immunisation programmes using the ‘Reach every community/ child strategy’, paediatric HIV programming using the Change Package; focused antenatal care; Emergency Obstetric and Newborn Care services.
Other measures Government has put in place include adolescent-friendly spaces in all health facilities; as well as nutrition interventions focusing on women in the reproductive age group, adolescent girls and the first 1,000 most critical days of a child’s life.
The minister urged researchers to uphold integration, ownership, accountability for results and resources, transparency, sustainability, focus on both process and results, and unpack the health care system in order to ensure interventions are responsive and relevant to the various levels of the health care system.
Global Health USAID assistant administrator Ariel Pablos-Mendez said the Saving Mothers Giving Life initiative has proved to be working in Uganda and Zambia with maternal mortality ratio declining by 45 percent and 53 percent in the two countries’ target facilities, respectively.
“The world is contemplating, for the first time in history, the possibility of ending preventable child and maternal death. The results in Zambia and Uganda have confirmed that we can save more women and newborns even in resource-poor settings,” he said.
Population Council country director Michael Mbizvo, whose organisation played a leading role in the Saving Mothers Giving Life survey, said the research findings indicating reduction in the maternal mortality rate should be consolidated by continued efforts in good health service provisions, mainly in rural areas.
“I would like to appreciate the commitment of the Government in wanting to use research findings to formulate policies to strengthen programmes as well as advocate for best practices and improve service delivery,” he said.
Dr Mbizvo said research is dynamic and that treatment needs change from time to time. Researchers and programme directors should work together to have demand for evidence on which decisions should be made.
“Research should be ahead of the problem instead of responding to challenges. The need for research never ends and we need to respond appropriately and acknowledge that there are problems and see what research can do to help us address those problems,” he said.
And Population Council associate for reproductive health programme in Zambia Benjamin Bellows said the SMGL initiative successfully measured the impact of reproductive health on service uptake, equity, quality of care, cost-effectiveness, and sustainability.
Mr Bellows observed that the research community was going forward in Zambia and that there was need for collaboration to be more integrated and synchronised.
Asked on how much the American government, through USAID, had spent on the SMGL initiative, Mr Bellows could not say but indicated that the financial value borne by USAID was immense in conducting the survey and hosting the health symposium.
“It is a huge investment in the right direction. It is focusing on improving maternity care for our mothers and babies. From the research findings, we can reduce stunting [in children] and improve people’s health within community structures,” he said.

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