Despite advances towards maternal mortality ratios (MMR) and neonatal mortality rates (NMR) reduction globally (44% reduction in MMR between 1990 and 2015), nine countries achieving their Millennium Development Goal 5A targets (one in Africa), and a decrease in the number of children who died before age 5 from almost 9.9 million in 2000 to 5.6 million in 2016, significant investment, innovation, and cross-sector collaboration are required to further reduce MMR and NMR in low and middle income countries (LMICs).

According to the World Health Organisation (WHO), of the estimated 303,000 maternal deaths that occurred globally in 2015, 99% were in developing countries. In 2016, of the 2.6 million babies who died within their first month of life, 39% were in southern Asia and 38% were in Africa. Five countries, India, Pakistan, Nigeria, the Democratic Republic of Congo, and Ethiopia accounted for half of all newborn deaths. Of the 2.6 million still births in 2015, 98% occurred in LMICs and of the approximately 15 million babies born prematurely (babies born alive before 37 weeks of pregnancy are completed) each year, 60% are born in Sub-Saharan Africa (SSA) and South Asia.

The continued poor maternal and newborn health (MNH) outcomes in LMICs are a result of underdeveloped health systems plagued by poor health service delivery, health workforce shortages with disparities observed between urban and rural areas, lack of infrastructure, medical products, and technologies as well as inadequate financing. In addition, demand side barriers prevent women from seeking care. These include: poverty, distance, lack of information, and cultural practices. However, if women’s and newborn lives are to be saved and if  global MNH targets as stipulated under Sustainable Development Goal 3 (SDG 3) are to be achieved, access to antenatal care during pregnancy, skilled attendant during pregnancy, at childbirth, and during the postnatal period, as well as maternal care and support in the weeks after delivery are key imperatives.

It is against this backdrop that various maternal and child health stakeholders participated at the Acting On The Call, Overcoming Critical Barriers To Maternal And Child Survival Summit in Addis Ababa recently.

Speaking at the summit, Mokhtar Hamed, GE Healthcare Africa General Manager, Primary and Referral Care said: “In many parts of Africa, the private sector, plays an integral role in the provision of healthcare services and is often the first port of call for all socio-economic classes. Despite this, most policy and planning is based on the notion of healthcare delivery by the public sector. Current healthcare systems in Africa are fragmented and lack transparency, as a result, sub-optimal healthcare delivery and outcomes are common place. There is an opportunity for collaboration between private and public sector providers to support the delivery of better health outcomes.”

He added that technology must be viewed as an enabler, not a panacea. “To deliver quality outcomes, entire health ecosystems need to be addressed in terms of training and capacity building of healthcare workers; power solutions; water solutions; availability of essential commodities; and healthcare information technologies.”

In Africa, GE Healthcare’s Primary & Referral Care initiative, is focused on reengineering primary healthcare (PHC) by designing and implementing integrated PHC interventions. Through its integrated maternal and newborn health (MNH) intervention, GE is addressing MNH challenges and improving outcomes in rural settings on the continent with a long-term view of reducing MMR and MMR.

The intervention takes the view that the health system building block, Human Resources for Health (HRH), is the backbone of any health system. Core is capacity building of healthcare workers, specifically clinical as well as applications training. Primary & Referral Care employs a programmatic approach focused on the development of a well-trained healthcare workforce, supply of appropriate medical technologies, as a buttress, and performance measurement via a defined monitoring and evaluation (M&E) framework. To mitigate issues of sustainability and scalability, GE partners with national and sub-national governments; local capacity building organisations; funding; and M&E partners for programme implementation.

At the summit in Addis Ababa, GE Healthcare highlighted this innovative approach as well as the power of partnerships in developing effective, sustainable and scalable MNH programmes. GE also displayed appropriate maternal and newborn technologies, which were designed for low-resource settings. The equipment included:

One: Lullaby Warmer Primer, which is a newborn thermoregulation device that has a rugged design and can withstand voltage fluctuations.

Two: Reus Prime, which is a newborn resuscitation device that provides effective suction and controlled resuscitation in a compact solution.

Three: Carestation 30, which is an anaesthesia delivery system that provides general inhalation anaesthesia and ventilatory support for patients during surgery. This machine is lightweight and easy to manoeuvre.

Four: Phototherapy LED, which is a newborn jaundice management device that has specially selected LEDs that emit a narrow wavelength of blue light that maximises the rate of bilirubin  breakdown. Most phototherapy devices use compact fluorescent bulbs that need to be replaced often, but LEDs have a longer shelf life.

The power of partnerships was emphasized to private sector and government stakeholders, who attended the summit. The intensity and urgency of the challenges facing the healthcare landscape in Africa demand a level of professional depth that is most effectively provided, even by the largest organisations, through collaborative market relationships to ensure increased access to products, services, technologies, and training, and as a result, improve outcomes.

“To meet WHO’s definition of quality, defined as the extent to which healthcare services provided to individuals and patient populations improve desired health outcomes, requires a holistic approach to address existing quality issues and improve outcomes. The availability of well-trained and motivated healthcare workers; the availability of equipment and supplies; the availability of functional referral linkages; and the availability of health information technologies are all imperative in achieving quality care. Therefore, the need for meaningful and sustained shared value partnerships between stakeholders is critical,” said Hamed.

Image above: The GE Lullaby Warmer Primer. Credit: GE