Upload
adi
View
221
Download
0
Embed Size (px)
Citation preview
8/18/2019 Working Towards Improving Maternal Survival
1/96
1
8/18/2019 Working Towards Improving Maternal Survival
2/96
2
WORKING TOWARDS
IMPROVING
MATERNAL SURVIVAL
8/18/2019 Working Towards Improving Maternal Survival
3/96
3
PREVENTION
OF
MATERNAL / NEONATAL MORTALITY
8/18/2019 Working Towards Improving Maternal Survival
4/96
4
You Can Hold Back From The Sufferings Of The World,
You Have Free Permission To Do So
And ! s n Accordance Wi!h Your "a!ure,
Bu! Perha#s This $er% Holding Back s The One
Suffering Tha! You Could Have Avoided .
Franz Kafka
8/18/2019 Working Towards Improving Maternal Survival
5/96
8/18/2019 Working Towards Improving Maternal Survival
6/96
6
3% 4 M&te!n&( De&t1s
↓
Com-(i&tions P!e0n&n", C1i()2i!t1
*4 Su25S&1&!&n A!i&, Sout1 Asi&
Su25S&1&!&n A!i&, 6 $%4 De(ie! 7it1 S8i((e) C&!e
Sout1 Asi& 6 9%4
M D Ti- Ie2e!0 +%5*% Times 5 Dis&2i(ities
8/18/2019 Working Towards Improving Maternal Survival
7/96
7
#9% Mi((ion :&2ies :o!n Ee!" Ye&!,
$ Mi((ion Die Fi!st $ Wee8s
$%4 De&t1s C1i()!en ;n)e! Fie
Ne72o!n
8/18/2019 Working Towards Improving Maternal Survival
8/96
8
M&te!n&( Mo!t&(it" Mo!2i)it" Si0n&( T!&0e)ies Womens Lies
Re(et Femini@e) Wo!()s Poe!t"
Re&sons Nume!ous, Com-(eB
So(utions Co0ni@&ne O Re&(it"
Womens St&tus He&(t1 Int!i&te(" Ent7ine)
Essenti&( Inte0!&te Se!ies A))!ess
Womens Nee)s T1!ou01out Lie5"(e.
S&e Mot1e!1oo) C&nnot :e Seen In Iso(&tion
Ho(isti A--!o&1
Hi01 Te1 P!e5n&t&( C&!e No Sense EOC In&)eu&te
8/18/2019 Working Towards Improving Maternal Survival
9/96
8/18/2019 Working Towards Improving Maternal Survival
10/96
8/18/2019 Working Towards Improving Maternal Survival
11/96
11
PRE5PRE
8/18/2019 Working Towards Improving Maternal Survival
12/96
12
P#"a"-.
I II T#!t#
E-t%- %%" a*!# % D#ath 1!t T
G T N
A&%t%"
S#t- A&%t%" 13 MD La 1972 A+
8/18/2019 Working Towards Improving Maternal Survival
13/96
13
III T#!t#
Antepartu #eorr$age
% Placental Placenta Previa
Abruptio Placentae
% "t$ers
& 'nclassified $eorr$age
& Local
8/18/2019 Working Towards Improving Maternal Survival
14/96
8/18/2019 Working Towards Improving Maternal Survival
15/96
15
t$(( P#"a"-.
E-+a!a : ;ELLP 0(25 < , P#!a"
##&a+ ;a#%ha# 40
D!!#"at#$ I"ta'a!-*+a %a*+at%" 39
A$*+t R#!at%. D!t#!! S."$%# 29
P*+%"a. O#$#a R#"a+
8/18/2019 Working Towards Improving Maternal Survival
16/96
16
I"taat*
;R LR
#eorr$age AbP
,upture
($orioanionitis
III !)St&0e P!o2(ems
#eorr$age
,etained Placenta
*n0ury to 1enital +ract
PP#
*nversion
Ebolis
Anest$esia
Sepsis
#ypertensive disorders
8/18/2019 Working Towards Improving Maternal Survival
17/96
17
P%!tat*
PP#
PPE
#ELLP
Sepsis
Ebolis
"t$er !isorders
8/18/2019 Working Towards Improving Maternal Survival
18/96
18
DIRECT O:STETRIC COMPLICATIONS
% #eorr$age 234% 'nsafe Abortion 354% Eclapsia 364% "bstructed Labor 74% *nfection 74% "t$er 334
Aount o! &2out 9/$ o M&te!n&( De&t1s
8/18/2019 Working Towards Improving Maternal Survival
19/96
19
8/18/2019 Working Towards Improving Maternal Survival
20/96
20
INDIRECT O:STETRIC COMPLICATIONS
Pre&e8isting (onditions-
Malaria- Aneia .SS!/-
Liver !isorders
(ardiac 9 #aeatological
*ncreasingly #*: 9 A*!S
ot$ers
Aount o! #/$ M&te!n&( De&t1s
.Medical Surgical !isorders/
P!e0n&nt Women Not Immune To Me)i&(5su!0i&( Eme!0enies
:ut M&n&0ement Die!ent.
De&( T7o Wit1 Die!ent P1"sio(o0ies
8/18/2019 Working Towards Improving Maternal Survival
21/96
21
Po7e!u( ;n)e!("in0 C&uses De&t1 / Dis&2i(it".
Poverty- Malnouris$ent Social E8clusion- Low Education
*nfectious !iseases - :iolence
Women Currently Half Of All Adults Living With HIV/AIDS.Women Currently Half Of All Adults Living With HIV/AIDS.
Too Youn0, Too M&n" , Too C(ose
8/18/2019 Working Towards Improving Maternal Survival
22/96
22
For Working towards at survival
*ssues any
;eed Support of So Many < Long ter
*ediate E"( → (ritical care
8/18/2019 Working Towards Improving Maternal Survival
23/96
23
"bst) (ritical (are (oncept ,ecent
"b) ()() 'ni=ue ($allenge
!isease > +$erapy →+wo Lives !ifferent P$ysiologies
Also
Secondary to *nflaatory Mediators
Pregnancy Specific or "t$er ($aracteristics
Acute *llnesses or S$ock
(ascade of Events
8/18/2019 Working Towards Improving Maternal Survival
24/96
24
Multorgan Failure → Advanced Life Support
Massive #epatic ;ecrosis- ;eurological- (ardiac
,enal (oagulation Abnoralities
8/18/2019 Working Towards Improving Maternal Survival
25/96
25
Advocacy of ( S ↑ (opared to Labor
?ut
More ,apid !elivery→
P$ysiologic Stress@:aginal !elivery
Fluid S$ifts- ?lood Loss ↑ More ,apid-
!ifficult for (ritically ill to +olerate
8/18/2019 Working Towards Improving Maternal Survival
26/96
26
Siplified Acute P$ysiologic Scoring
Predicts #ospital Mortality
"bstetric Pt) * ( ' & Medical ,easons
& ,elated to Pregnancy !elivery
& Aditted for "b *ndications
"utcoes *n "b Pt
1ood "bstetric (are (ornerstone
Maternal Mortality ↓
4OMMITMENT7 ;IG; >UALIT? SERVI4ES
8/18/2019 Working Towards Improving Maternal Survival
27/96
27
Emo P!o0!&mme
N&tion&( P!o0!&mme
o
Re)uin0 M&te!n&( &n) Pe!in&t&( Mo!t&(it"
8/18/2019 Working Towards Improving Maternal Survival
28/96
28
8/18/2019 Working Towards Improving Maternal Survival
29/96
29
"bstetric Eergencies & *ediate Attention
W$y
& !eat$
!isability
8/18/2019 Working Towards Improving Maternal Survival
30/96
30
W1&t Is A M&te!n&( De&t1?
T1e )e&t1 o & 7om&n
71i(e s1e is -!e0n&nt
F!om &n" &use !e(&te) to
o! &00!&&te) 2" t1e -!e0n&n"
World Health Organization
(WHO)
7it1in $+ )&"s o
te!min&tion o t1e -!e0n&n"
o!
8/18/2019 Working Towards Improving Maternal Survival
31/96
31
8/18/2019 Working Towards Improving Maternal Survival
32/96
32
W$at *s Maternal !isability
S1o!t5 o! Lon05te!m I((ness
C&use) 2" O2stet!i Com-(i&tions
Most Serious & "bstetric Fistula(An Abnormal Passage Between Vagina and Bladder or RectumOften Caused b Obstructed !abor when it is "ot #reated with
Cesarean $ection)
8/18/2019 Working Towards Improving Maternal Survival
33/96
33
W1&t Do Women Die O?
T1e" DieO O2stet!i Com-(i&tions
T1&t Nee) Not :e F&t&(
8/18/2019 Working Towards Improving Maternal Survival
34/96
34
Most O2stet!i Com-(i&tions
Ou! Su))en("
*f woen do not receiveedical treatent on tie-
t$ey will probably suffer disabilityB
O! Die
Wit1out W&!nin0
8/18/2019 Working Towards Improving Maternal Survival
35/96
35
WHERE DO WOMEN DIE TODAY?
4 o M&te!n&( De&t1s To)&"
Ou! in
A!i&, Asi& &n) L&tin Ame!i&
8/18/2019 Working Towards Improving Maternal Survival
36/96
8/18/2019 Working Towards Improving Maternal Survival
37/96
37
WHAT HAPPENED NEGT?
:ette! Liin0 Con)itions
Re)ue) In&nt Mo!t&(it" in t1e ;.S.
:" oe! $%4
:et7een ##* &n) #99
8/18/2019 Working Towards Improving Maternal Survival
38/96
38
:;T
MATERNAL MORTALITY
C+$e well known triad
of fever- $aeorr$age and to8aeiapredoinatedBD
.%r&ine !oudon)
REMAINED THE SAME
8/18/2019 Working Towards Improving Maternal Survival
39/96
39
;nti( t1e (&te #9%s
+$ere was t$en a
Csteep and sustained declinew$ic$ $as continued in ost Western countries
at uc$ t$e sae rate
for over fifty yearsD.%r&ine !oudon)
8/18/2019 Working Towards Improving Maternal Survival
40/96
40
W1&t H&--ene)To Re)ue M&te!n&( Mo!t&(it"
In T1e West?
Effective treatent for obstetric coplications
was developed and used-
e)g)- antibiotics for infection-blood transfusions for $eorr$age
8/18/2019 Working Towards Improving Maternal Survival
41/96
41
Most O2stet!i
Com-(i&tions C&n Neit1e!:e P!e)ite)
No! P!eente) :ut I Women ReeieEetie T!e&tment
In Time,
A(most A(( C&n :e S&e)
8/18/2019 Working Towards Improving Maternal Survival
42/96
42
Ho7 Mu1 Time
Do We H&e? It is estim&te) t1&t, i unt!e&te), )e&t1
ou!s on &e!&0e in
2 $ours fro Postpartu #eorr$age
32 $ours fro Antepartu #eorr$age
2 days fro "bstructed Labor
days fro *nfection
8/18/2019 Working Towards Improving Maternal Survival
43/96
8/18/2019 Working Towards Improving Maternal Survival
44/96
44
Ho7 C&n We Im-!oe Aess To EmOC?
:" m&8in0 su!e
1e&(t1 &i(ities -!oi)e t1e
se!ies nee)e) to
s&e 7omens (ies.
&igh! ke% func!ions 'signal( a facili!%)s
a*ili!% !o #rovide &mOC
8/18/2019 Working Towards Improving Maternal Survival
45/96
45
EmOC e" Funtions(over +$ese Services
% Anti2iotis.intravenous or by
in0ection/
% OB"toi D!u0s .ditto/
% Antionu(s&nts
.ditto/% M&nu&( Remo&( o
P(&ent&
% Remo&( o
Ret&ine) P!o)uts
% Assiste) V&0in&(De(ie!"
% Su!0e!".(esarean Section/
% :(oo) T!&nsusion
8/18/2019 Working Towards Improving Maternal Survival
46/96
46
EmOC F&i(ities
% Antibiotics .intravenous or by in0ection/
% "8ytocic !rugs .ditto/
% Anticonvulsants .ditto/
% Manual ,eoval of Placenta
% ,eoval of ,etained Products
% Assisted :aginal !elivery
:ASIC
E"( Facilities Provide +$e First Si8
8/18/2019 Working Towards Improving Maternal Survival
47/96
47
% Antibiotics .intravenous or by in0ection/
% "8ytocic !rugs .ditto/
% Anticonvulsants .ditto/
% Manual ,eoval of Placenta
% ,eoval of ,etained Products% Assisted :aginal !elivery
% Surgery .(esarean Section/
% ?lood +ransfusion
COMPREHENSIVE
EmOC F&i(ities
E"( Facilities Provide All Eig$t
8/18/2019 Working Towards Improving Maternal Survival
48/96
8/18/2019 Working Towards Improving Maternal Survival
49/96
49
Ho7 C&n We Te((
We A!e M&8in0 & Die!ene?
I 7e 8no7 7e 1&e
-!oi)e) enou01
EmOC
&n) i 7e 8no7 t1&t
t1ese se!ies &!e 2ein0
use) 2" 7omen
sue!in0 o2stet!i
om-(i&tions
WE CAN :E CONFIDENT
THAT WE ARE SAVIN< WOMENS LIVES
8/18/2019 Working Towards Improving Maternal Survival
50/96
50
Ho7 Do We no7
W1i1 WomenWi(( EB-e!iene Com-(i&tions?
WE DONT
8/18/2019 Working Towards Improving Maternal Survival
51/96
51
:ut 7e )o 8no7 t1&t o &n"
-o-u(&tion o -!e0n&nt 7omen5!i1/-oo! &t (e&st #*4 7i(( eB-e!iene
&n o2stet!i om-(i&tion
T1is is &s t!ue o -!e0n&nt
7omen in t1e ;S &n) Eu!o-e
&s o 7omen in A!i&, Asi&
&n) L&tin Ame!i&
No2o)" no7s W1" T1is H&--ens.
It Is & F&t o Lie
8/18/2019 Working Towards Improving Maternal Survival
52/96
52
Ma@%0 a00#0! %2#"B! A--#!! T% 4a0#
R#-%"C" P%&+#
Ma/" D#-!%" S##/ a#
R#a-h" a#
R#-#'" T#+. A%at# T#at#"t
8/18/2019 Working Towards Improving Maternal Survival
53/96
53
?#a! a-/ 1922 Mahata Ga"$h ;a$ Sa$
'% Claim #hat Human ind Or Human $ociet
Are "ot i&ided %nto Water #ight Com*artments+
$ocial+ Political Religious+
All Act React ,*on One Another-.
8/18/2019 Working Towards Improving Maternal Survival
54/96
54
e" Ae!tin0 M D
'nderstanding Precisely → W$ere (oncentrateEfforts-
Eac$ Settings &
*nternational ;ational "rganizational (apacity 9
,esources E8ist)
8/18/2019 Working Towards Improving Maternal Survival
55/96
It I! N%t S% I23%0ta"t T% K"%9 E'#0.th"1
A! T% K"%9 Th# E=a-t Va+*# O6 E'#0th"1
T% A330#-at# What W# L#a0"7
A"$ T% A00a"1# What W# K"%9
;a""ah M%0# 55
8/18/2019 Working Towards Improving Maternal Survival
56/96
56
PREVENTION
RESOURESA++ L#'#+!
%*"t.
8/18/2019 Working Towards Improving Maternal Survival
57/96
57
;eed +o Know Essentials > Liitations
% F,'
% S,'3G4 Specialized (are
GH&IH4 #oe !eliveries
8/18/2019 Working Towards Improving Maternal Survival
58/96
58
Mat#0a+
Surgery
Anest$esia
?lood
Antibiotics
"8ytocics
"t$er Medication
8/18/2019 Working Towards Improving Maternal Survival
59/96
59
Th#0# 4a" N%t # S"1+#
8/18/2019 Working Towards Improving Maternal Survival
60/96
60
C&n We Re&((" Te((
I Se!ies A!e Funtionin0?
In ##,
;NICEF &n) Co(um2i& ;nie!sit" )ee(o-e)
' P!oess In)i&to!s to )o ust t1&t
+$ese were issued by ';*(EF9W#"9';FPA in 3JJI/uidelines for onitoring A&ailabilit
and ,se of Obstetric $er&ices
BAnd Are ?eing 'sed
8/18/2019 Working Towards Improving Maternal Survival
61/96
61
In 0ene!&(, -!oess in)i&to!s s1o7 "ou
t1e 1&n0es in t1e
on)itions
t1&t (e&) to &n outome.suc$ as deat$ or disability/
P!oess In)i&to!s
8/18/2019 Working Towards Improving Maternal Survival
62/96
62
Aess to
THE ' PROCESS INDICATORS
te(( us &2out 1&n0es in
;ti(i@&tion o &n) Ju&(it" o
EmOC Se!ies
8/18/2019 Working Towards Improving Maternal Survival
63/96
63
INDICATOR K #
Fo! ee!" *%%,%%% -o-u(&tion,
t1e!e s1ou() 2e &t (e&st
# Com-!e1ensie EmOC F&i(it"
$ :&si EmOC F&i(ities
8/18/2019 Working Towards Improving Maternal Survival
64/96
64
INDICATOR K +
8/18/2019 Working Towards Improving Maternal Survival
65/96
65
INDICATOR K 9
P!o-o!tion o A(( :i!t1s
in EmOC F&i(ities
At Le&st #*4
o A(( :i!t1s in t1e Communit"
S1ou() T&8e P(&e in EmOC F&i(ities
8/18/2019 Working Towards Improving Maternal Survival
66/96
66
INDICATOR K $Met Nee) o! EmOC Se!ies
At Le&st #%%4 o Women Estim&te)
to H&e O2stet!i
Com-(i&tions S1ou() :e T!e&te)in EmOC F&i(ities
8/18/2019 Working Towards Improving Maternal Survival
67/96
67
INDICATOR K *
Ces&!e&n Setions
As & Pe!ent&0e o A(( :i!t1s
Minimum *4
M&Bimum #*4
8/18/2019 Working Towards Improving Maternal Survival
68/96
68
INDICATOR K '
C&se F&t&(it" R&teP!o-o!tion o Women
Wit1 O2stet!i Com-(i&tions
A)mitte) to & F&i(it"
W1o Die
M&Bimum Ae-t&2(e Lee(
#4
8/18/2019 Working Towards Improving Maternal Survival
69/96
69
CALC;LATIN< ALL ' INDICATORS
%
8/18/2019 Working Towards Improving Maternal Survival
70/96
70
ACCESS TO EmOC
P!o2(ems
% Does In)i&to! K #
s1o7 "ou nee)
mo!e EmOC&i(ities?
% Does In)i&to! K +
s1o7 "ou nee)
2ette! )ist!i2ute)EmOC &i(ities?
Ation% Most ount!ies
&(!e&)" 1&e
enou01 &i(ities
t1e" m&" ust nee)
to u-0!&)e se!ies
to ensu!e
#Com-!e1ensie &n)
$ :&si EmOC
&i(ities -e! *%%,%%%
-o-u(&tion
8/18/2019 Working Towards Improving Maternal Survival
71/96
71
;TILIATION OF EmOC
% !oes *ndicator 6 s$ow t$at birt$s in your E"(
facilities are fewer t$an 3G4 of all birt$s in t$e
population
% !oes *ndicator 5 s$ow t$at CMet ;eedD is less t$an
3HH4 .*)e) t$at not all woen w$o e8perience
obstetric coplications are using E"( facilities/
% !oes *ndicator G s$ow t$at less t$an G4 of all
birt$s in t$e population are by (esarean section
P!o2(ems
8/18/2019 Working Towards Improving Maternal Survival
72/96
72
;TILIATION OF EmOC
% !o you $ave enoug$ =ualified staff% !o you need to train staff on anageent of
eergency obstetric coplications% !oes $ospital anageent need iproveent% W$ats t$e supply situation like% W$ats t$e e=uipent situation like
I &(( t1e &2oe is in -(&e, on)ut ous 0!ou-s
in t1e ommunit" to in) out 71" 7omen &!e not
omin0 o! &!e
AtionCo((et Mo!e Ino Fi!st
8/18/2019 Working Towards Improving Maternal Survival
73/96
73
J;ALITY OF EmOC
!oes *ndicator s$ow t$at ore t$an 34 ofwoen treated for obstetric coplications are
dying at your E"( facilities
P!o2(em
8/18/2019 Working Towards Improving Maternal Survival
74/96
74
J;ALITY OF EmOC
% Find out if your E"( facilities are really
functioning
% ($eck staff nubers- skills- anageent
capacity- supplies and e=uipent
% Lobby your $ealt$ inistry for ore support < and
get t$e counity to lobby wit$ you
Ation
8/18/2019 Working Towards Improving Maternal Survival
75/96
75
An" Count!"
C&n Ae!t
M&te!n&( De&t1 An) Dis&2i(it"
I It M&8es
8/18/2019 Working Towards Improving Maternal Survival
76/96
76
HOWS MDD↓
"ur "bservations(ounity Services & G6 :illages
3J7I 3J→2G :illage 3JJ2 → 2HHI ;o Pregnancy ,elated !eat$ 3JJ (erebral Malaria
Suicide
3JJG 27 :illage 3JJ < PP# on way to $ospital
3JJI → 2HHI ;o) M ! PL ,!
2HHG S ( !
8/18/2019 Working Towards Improving Maternal Survival
77/96
77
Ho7s Ct)..
Prevention Eergencies
Eergencies >
+iely Appropriate Manageent
8/18/2019 Working Towards Improving Maternal Survival
78/96
78
8/18/2019 Working Towards Improving Maternal Survival
79/96
79
8/18/2019 Working Towards Improving Maternal Survival
80/96
80
8/18/2019 Working Towards Improving Maternal Survival
81/96
81
8/18/2019 Working Towards Improving Maternal Survival
82/96
82
8/18/2019 Working Towards Improving Maternal Survival
83/96
Ho7s Ct)
8/18/2019 Working Towards Improving Maternal Survival
84/96
84
Ho7s Ct)..
Institution&( Study ,eport & 3 States 9 '+
?odi et al G72 MM,
M
8/18/2019 Working Towards Improving Maternal Survival
85/96
85
Pu2(is1e) Stu)" ;.. ou!n&(
#3+53= #=5+%%+
#eorr$age HI)754 3I)HI4
Sepsis 36)I64 HI)624
#ypertensive !isorders 2I)5G4 35)64
"t$ers GH)J74 H)J74
S) ()M)-
*)()+)
Ho7s Ct)..
8/18/2019 Working Towards Improving Maternal Survival
86/96
86
Ct. Institution
Ectopic Status Ouick !ecision
1 + ; ?lood
Septic Abortion- *ntrapartu 9 Postpartu Sepsis-
(orner Stone →
Early Surgical E8ploration
Eliination of *nfected ;ecrotic +issue As Soon As Possible
Laparotoy→ Peritoneal +oilet ↑
#ysterectoy >
8/18/2019 Working Towards Improving Maternal Survival
87/96
87
Ho7s Ct)H"-e!tensie Diso)e!s M&0nesium Su(-1&te
!iagnosis of #ELLP
*ntervention
*nductionRet&ine) P(&ent& → Ouick- ?lood- () F) < I 4
Ru-tu!e ;te!us↓
H yrs H-5GH !el) 3I ,'32 yrs 2G-HH !el) 3 ,'
( F ↓
He&!t Dise&se↓
( F↓
8/18/2019 Working Towards Improving Maternal Survival
88/96
88
Care + ndividual Hu!s vor% Toers
-inks Women + HC S%s!em
A##ro#ria!e &ffec!ive n!erven!ions
8/18/2019 Working Towards Improving Maternal Survival
89/96
89
?e$ooves "n All Well *ntentional
Wit$out (ultural Social Professional !iscriination
Attept ,ational
Woen #ealt$ ↑ → !eveloped Society
Society Must Make *t Possible For Woen +o Live #ealt$ily
8/18/2019 Working Towards Improving Maternal Survival
90/96
90
Arise Awa0e and $to* "ot #ill #he /oal %s Reached
We arch Ahead
And
12*erience Will #ell ,s Wrongs and Rights.
Swai :ivekanand)
AM!! Progra
8/18/2019 Working Towards Improving Maternal Survival
91/96
91
AM!! Progra
% AM!! Progra Was Establis$ed in 3JJJ at (olubia'niversitys Sc$ool of Public #ealt$- #eilbrunn
!epartent of Population and Faily #ealt$
% AM!! Progra *s !edicated to *proving t$e Availability-
Ouality and 'tilization of Life&saving "bstetric Services
in !eveloping (ountries
% AM!! Partners Pro0ects in (lose to GH (ountries- Wit$in
a Fraework +$at Links +ec$nical Knowow Wit$Manageent (apacity and #uan ,ig$ts
% AM!! *s Funded by a 1enerous 1rant Fro t$e
?ill and Melinda 1ates Foundation
AM!! Partners
8/18/2019 Working Towards Improving Maternal Survival
92/96
92
AM!! Partners
Pro.ec! Par!ners/
% 'nited ;ations ($ildrens Fund .';*(EF/ pro0ects in?anglades$- ?$utan- *ndia- ;epal- Pakistan and Sri Lanka
% 'nited ;ations Fund for Population Activities .';FPA/
pro0ects in *ndia- Morocco- Mozabi=ue and ;icaragua
% ,egional Prevention of Maternal Mortality .,PMM/;etwork teas and pro0ects in3J sub&Sa$aran African
countries
% (A,E pro0ects in Et$iopia- ,wanda- +anzania- Peru and
+a0ikistan% Save t$e ($ildren pro0ects in Mali and :ietna
% ,eproductive #ealt$ for ,efugees .,#,/ (onsortiu
pro0ects in 32 countries
8/18/2019 Working Towards Improving Maternal Survival
93/96
93
AM!! Partners
Technical Par!ners/
% Faily #ealt$ *nternational
% o$n Snow *nternational
% *ndian *nstitute of Manageent
at A$edabad .**MA/
% #P*E1"
% Engender #ealt$.forerly A:S( *nternational/
8/18/2019 Working Towards Improving Maternal Survival
94/96
,avindra ;at$ +agore !ecades ?ack Said
8/18/2019 Working Towards Improving Maternal Survival
95/96
95
,avindra ;at$ +agore !ecades ?ack Said
'%f #he World Has #o Be 3ull Of iser !et %t Be
But !et #here Alwas Be A Ra Of Ho*e+
A $mall !oo*hole Which /i&es irection+
3or Ha&ing A World Of Ha**iness
3or #he Whole Human 4ind -.
8/18/2019 Working Towards Improving Maternal Survival
96/96