25 years of maternal and child Health Projects

In the moment it takes to skim this sentence alone, eight children are born, and most are healthy. If you read this article to the end, the world population will have grown by about 700 people and some mothers and infants will have died needlessly. So please continue reading - after all, according to the Lancet (2020) the world's population will grow from 7.8 billion today to an estimated 8.8 billion people in 2050. In Africa alone, the population is expected to triple to about 3 billion by then, even with falling fertility rates and an aging population increasingly living in large urban centers with both public and private health services.

Clearly, health systems are not meeting women’s needs.   The Guttmacher Institute (Adding it Up, 2020) estimates that 218 million women in low and middle-income countries have an unmet need for modern contraception, that is they want to delay or limit births but are not currently using a method.  Fully meeting their needs for reproductive, maternal and child health would result in major health gains, including a reduction of about two-thirds of unintended pregnancies, unsafe abortions, and maternal deaths. Moreover, if all mothers and infants in these countries were to receive recommended care, there would be 1.7 million fewer newborn deaths each year.

Scenarios like these are the reason the Rotary Action Group for Reproductive, Maternal and Child Health, (RMCH) has made maternal, child health and family planning, along with women’s empowerment its priority. The improvement of women’s health, including providing access to family planning services, is one of the most cost-efficient and profitable investments for the improvement and development of the living conditions in low- and middle-income countries. This overall goal contributes to reaching the United Nations Sustainable Development Goals 3 and 5, that is to ensure healthy lives and promote well-being for all at all ages while ensuring gender equality.

When RMCH founding members met at the 1995 RI Peace Conference in Dakar, Senegal, PDGs Robert Zinser, Adedolapo Lufadeju and Buck Lindsey were impressed that all about 500 participants voted for founding a fellowship about ”Population and Development”.  Shortly thereafter, RMCH launched its first TRF funded projects in the most populous African country, Nigeria, whose population has reached 206 million and where maternal and infant deaths remain unacceptably high. With a mission to improve access to quality family planning services and reduce the burden of high maternal and child mortality, Lufadeju (Nigeria) and Zinser (Germany) piloted the “Child Spacing and Family Health” through contraceptive use in Kaduna State in Nigeria. With a US$50,000 grant from the Rotary Foundation (TRF), the project also trained 1,527 health workers in the provision of family planning products and services. In a second phase, the project was expanded to 6 states and broader health issues and received funding from TRF, Packard Foundation and the European Union.

In 2008 TRF supported RMCH and together with other donors, launched a project which started by addressing obstetric fistula but quickly expanded into a comprehensive strategy to reduce maternal and child mortality, by partnering with federal and additional state governments, while giving voice to communities.  Public and private funders in Germany, Nigeria, and Austria cheered its dramatic results: a 60 percent drop in maternal mortality and a 15 percent drop in infant mortality in participating hospitals. The International Federation for Gynecology and Obstetrics (FIGO) called the effort “a masterpiece.”

With lessons learnt over the years from over 10 projects, RMCH launched its most ambitious project yet, the Nationwide Family Planning Campaign in Nigeria. This project has attracted funding from the Rotary Foundation and BMZ for up to US$ 2,7 million. The goal is to improve the quality of health care, including infrastructure, supplies, information and patient care. To achieve these goals, midwives, nurses, doctors, medical records officers are trained to use their mobile phones to report on the state of health systems and results to sector leadership and policy makers.

Improving the quality of obstetric care requires monitoring and analysis of quality of care, quality of structure and quality of outcome. Improvements in the outcome (the health of mothers and babies) are achieved by analyzing the processes - the skills and qualifications of health personnel serving mothers and their infants and investing in better care. These processes can only be improved when in-service training and support is available through Rotary-sponsored efforts such as the Maternity Alliance for Structured Training (M.A.S.T.) in India and elsewhere. Other RMCH international service projects funded by TRF include the post-partum family planning project for helping mothers to space their births in Pakistan. In Uganda, the RMCH Asia section and Switzerland sections have implemented a project for Improving Reproductive Health Services, Maternal and Child health in Kitwe, and other efforts for replication are occurring in Rwanda.

Women’s empowerment adds value to this work as increasing women’s decision space and participation in the economy benefits all families.  In India, more than 30 Saheli Vocational Education Centers were established offering computer training and tailoring classes to girls and mothers. Additionally, these classes cover courses on reproductive health, child spacing, prenatal and early childhood nutrition. 

In Afghanistan, RMCH supports a vocational sewing machine project, funded by a Global Grant from TRF, which seeks to foster the participation of Afghan women in the new economy of their country. In Colombia, RMCH focuses on educating and empowering women and girls to reduce adolescent pregnancies and promote general awareness on sexual and reproductive health in cooperation with local governments and the school administration.

In Ethiopia more than 150 women in rural areas received access to micro credits after completing a training course on commercial independence and reproductive health; and in the Philippines RMCH supported medical apprenticeship courses for girls and young women enabling them to offer family planning services and a pathway to become a qualified nurse, linking livelihoods and wellbeing.

Recently, a new initiative entitled “The Big Pink” started by women Rotarians in Chennai, India is addressing the nexus between comprehensive health and women’s wellness, looking not only at maternal and reproductive health, but also at mental health, life education and menstrual health, diet and exercise. Over 300 maternal and child health projects have initiated since 1995. Clearly all these issues are related to and contribute to better outcomes for women and families.

Action Groups like RMCH are essential to support clubs and district to plan, initiate and implement effective projects at scale and jointly bring together experts and expertise from more professions to support projects, while attracting more Rotarians to engage in humanitarian activities in accordance with RI Code of Policies.   Feel free to consult our website (https://rotaryrmch.org/) or contact the RMCH Action Group RMCH@ROTARYRMCH.ORG