Volunteer Info Presentation 12-8-10

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Presentation by Dana Allison, Executive Director to WWHI volunteer staff December 8, 2010

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WWHI History and Introduction Organization Global Issue Why Women? Where we work On the ground Needs Assessment Where WWHI is today Program Possibilities Timeline Questions

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Work with UNHCR Dr. Youssoupha Ndiaye Studied other models extensively Millennium Development Goals not being met So It Began…

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Women’s World Health Initiative Organization Incorporated January 2009 – first staff meeting August 2009 3 founding members now 32 staff and board members Increased our revenues by 900% Trajectory of growth off the charts

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Board Chairperson Carri Hulet - The Langdon Group Board Vice Chairperson Stephanie Mackay – Columbus Foundation Executive Treasurer Richard Ence – Thatcher Company Executive Secretary Chuck Larson – JUB Engineering Keri Gibson, M.D. – University of Utah Community Clinics Jacque M. Ramos Esq. - J Ramos Law Firm Seraphine Kapsandoy – R.N., BSN, Primary Children’s Hospital Zendina Mostert, MS, B.A. – Nonprofit Program Advisor

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Millennium Development Goals In 2000, international community pledged to, “spare no effort to free our fellow men, women and children from the abject and dehumanizing conditions of extreme poverty” Goal #5 related to maternal health Target 1 Reduce by three quarters the maternal mortality ratio Target 2 Achieve universal access to reproductive health

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Current Picture From 1990 to 2005, the maternal mortality ratio declined only 2% in Sub-Saharan Africa One woman still dies nearly every minute of every day from treatable or preventable complications related to pregnancy and childbirth For every one woman who dies, 20 develop debilitating injuries, infections or disease related to or exacerbated by pregnancy and childbirth Developing countries account for 99% of maternal deaths

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“When women thrive, all of society benefits and succeeding generations are given a better start in life.” -Kofi Annan WHY WOMEN?

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Woman’s income more likely than a man’s to go toward food, education, medicine, and other family needs1 Women in many countries make important family decisions about nutrition, healthcare, and use of resources One girl in seven in developing countries marries before the age of 15 Children have a 14 times higher chance of dying in first year of life without a mother. Why Women? 1. Jowett M. “Safe Motherhood interventions in low income countries: an economic justification and evidence of cost-effectiveness.” Health Policy 53(3): 201-28. 2000.

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Why Women? – Economic Strategies Women contribute to economic growth; their UNPAID work at home and on the farm equals about 1/3 of global GDP Women operate the majority of small businesses and farms in developing countries

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Return on investment in maternal mortality reduction It is estimated that US$15 billion is lost every year due to maternal mortality1 In countries where most maternal deaths occur, a package of essential services is estimated to cost less than US $1.50 per person2 USAID Congressional Budget Justification FY 2002; Program, Performance, and Prospects – The Global Health Pillar.http://www.usaid.gov/pubs/cbj2002/prog_perf2002.html. “World Health Report 2005: Make Every Mother and Child Count,” WHO (2005).

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Disparities continue 62% of midwives Africa-wide are not retained Only 16% of women who want to prevent pregnancy, can At current rate – goals won’t be met until 2045 Lacking Results

Story of Awa : 

Story of Awa

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WHERE WE WORK: SENEGAL, WEST AFRICA

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Where we work: SENEGAL Population 11.7 million CapitalDakar Language French

Senegal Health System Statistics : 

Senegal Health System Statistics

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Senegal Relative political stability Partnerships with local healthcare workers in place Average age of first birth is 12-14 years old in rural Senegal. Senegal, West Africa 1/21 lifetime chance of dying from birthing a child. Canada, North America 1/11,000 lifetime risk of dying from birthing a child.

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Where we work: SENEGAL 5 mothers and 41 newborns in Senegal die each day from complications related to giving birth1 1. USAID-funded Demographic and Health Survey (DHS),2005 For every maternal death, at least 10 more suffer from serious obstetric complications only 12 percent of women used contraception

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Causes of Maternal Mortality Hemorrhage Poor nutrition and related conditions such as hypertension and anemia. Lack of access to obstetric care. Low quality of care. Lack of medication distribution and compliance. Poor medical facilities and equipment. Continued domestic labor throughout pregnancy Endemic diseases such as malaria and parasitosis.

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Only 58% births are attended by skilled birth attendant * disproportionately unattended in rural areas Only 2% births by Cesarean Section

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Difficult to access with only unfinished minor road access No maintained roads to villages in Saraya District High rates of poverty Maternal Mortality Rate ~850/100,000 Where we work: Saraya District

Demographics and Region : 

Saraya District is part of the Kedegou region. The district is 6,835 square km Official population - 36,000 50-60,000 people due to mining and border influx. Village Leadership: Chief = head of every village Rural Counsel = heads of 20 villages Saraya is the center village and disperses mail and medicine to the outer villages. Demographics and Region

Saraya, Senegal Statistics : 

64.5% births happen in their homes Only 27.2% of births are assisted by a formally-trained birth attendant 20.4% of the women in the region receive no prenatal care while most have 1 visit. Saraya, Senegal Statistics

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“On the Ground” What has been done? What are they doing already? What can we build on? Where should we focus?

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WWHI Mission and Vision WWHI will act as a catalyst in the stabilization of communities and countries through educating, empowering, and saving countries’ best resource - women WWHI will invest in and educate women in vulnerable populations to change their own communities by building sustainable local health care systems focused on decreasing maternal and infant mortality and early detection of preventable disease. Mission Statement Vision Statement

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4-pronged, and comprehensive– Train local midwives and other healthcare workers Increase capacity of local doctor Integrate innovative technology modalities to increase access to quality health care and education Integrate economically driven incentives simple medical interventions to ensure sustainability. Values

Saraya Health District : 

Saraya Health District

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Area of focus: Saraya region of Senegal Purpose: Assess factors that may contribute to maternal mortality Assess gaps in healthcare services as related to obstetric care Assess the barriers to healthcare access Get acquainted with the people, region, and culture Needs Assessment

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What was done: Visited Hospital Health posts Villages Conducted key informant interviews and focus group with Women and men in the community Midwives Healthcare providers Healthcare workers Community leaders

General Findings : 

General Findings

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Women have many children unmitigated Birth control access and education is limited but desired 4 Prenatal visits suggested. Given basic care and limited prenatal supplements (vit A, iron and tetanus shots) Very low compliance due to a) cost b) distance c) lack of understanding d) low quality care General Findings

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Very little communication between healthposts Only women who access care are tracked Limited emergency services available Travel at great cost and long distances for emer. care Majority of women deliver at home, alone due to cost and distance Access care often too late Comorbid malaria, malnutrition or anemia cause many complications Cost of care high Findings cont.

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Perceived needs: a) better communication methods b) more constant source of supplies c) better healthcare worker reimbursement d) more quality care in hospital through training e) better education on birth control and family planning f) better transportation in emergencies g) water in the maternities h) decreased domestic labor and chores for pregnant women Findings cont.

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Healthcare Delivery System Tambacounda Regional Hospital Fully Staffed – Surgical Saraya District Hospital Doctor/Midwife/Nurse/PHCC 7 Healthposts - Nurses 25 Caisses CHW/Matron 25 Caisses CHW/Matron 25 Caisses CHW/Matron

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Birth without support

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Imagine if all mothers and their infants could expect a life of health and strength? Imagine if WWHI can facilitate security for families by assisting their efforts?

Return to the Story of Awa… : 

Return to the Story of Awa…

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Program Possibilities Technology – mobile Improve outcomes Training/Triage Medical reporting and tracking Healthcare Delivery System Water Birth Control and Family Planning Village Health Payment System

Timeline and Implementation : 

Timeline and Implementation Measureable Impact – Program Evaluation Demonstrate success and build trust with local population Short term and long term Proposed Timeline February – present program to board March – present program to stakeholders in Senegal April – begin implementation measures

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Where do you fit in? Strong organization = Strong Programs Garnering wide support Capital Campaigns Program Development Communicating successes of forgotten population Ultimately – saving the lives of women and children

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With limited resources we have accomplished much as an organization. You make all the difference for these children and mothers. Thank you for your past and continued support!!!

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Questions?