Community Follow-Up to Prevent Recurrence of Fistula

Female genital fistula remains a global burden, and in Nigeria there are an estimated 12,000 new cases annually. Attention has focused on surgical repairs, community mobilization, and government guidelines. These target the condition, but not the "whole person." Women with fistula may experience psycho-social consequences, and difficult deliveries that leave women with nerve damage. Noncompliance with post-repair recommendations can result in fistula recurrence. Integration of community follow-up into holistic fistula care can help to address these needs.

Strengthening a Referral System through a Community-Owned Maternal and Newborn Transport Model Using Motorbike Ambulances in Luwingu, Lupososhi, and Lunte Districts, Northern Province, Zambia

Less than 25% of Zambia's population live within 15 km of an emergency obstetric facility, amplifying inequities for women accessing life-saving care during pregnancy and delivery. In 2018, the Ministry of Health (MoH) and Clinton Health Access Initiative (CHAI) implemented a community referral and transport intervention as part of the integrated reproductive maternal and neonatal health program in Northern Province, covering 143 health facilities. Northern Province is sparsely populated, characterized by long distances to health facilities, poor terrain, and inadequate public transport. There have been numerous community interventions to bridge gaps in maternal transport but they are often not sustained beyond partner support.

Leveraging Private Sector Partnerships to Sustainably Connect High-Risk Mothers to Emergency Transport and Appropriate-Level Quality Care in Kakamega County, Kenya

Delays in timely access to care drive a third of all maternal deaths in Kenya. Hospitals and health system managers lack means to rapidly identify at-risk mothers, service gaps, and gather clinical information on incoming patients, resulting in mothers being "bounced around" between facilities to find the appropriate level of care. Kakamega County has partnered with Jacaranda and Rescue.co to improve maternal survival by expediting access to emergency care.

Strengthening Management of Emergency Maternal Health Complications at the Emergency Unit of Public Health Facilities in Bangladesh

In Bangladesh, ante-and postpartum hemorrhage (APH, PPH) and pre-eclampsia/eclampsia (PE/E) contributed about 55% to overall maternal deaths (Bangladesh Maternal Mortality and Health Care Survey, 2016). Improved detection and management of maternal complications is crucial to avert these preventable deaths. The U.S. Agency for International Development (USAID)'s MaMoni Maternal and Newborn Care Strengthening Project (MNCSP) supported district- and subdistrict-level hospitals with the formation and training of emergency management teams and the availability of essential drugs through the government system to manage maternal complications in the emergency department. After initial stabilization, mothers with complications are referred to inpatient wards of hospitals or to other facilities for further management. Ongoing supervision helped to resolve technical and logistical issues and strengthen recording and reporting. There were no prereferral case management and reporting systems in the emergency units prior to this intervention.