This week, Partners In Health published the first issue of “PIH Reports,” a new series that explores innovations in global health care delivery. Each issue focuses on a single subject, drawing on the expertise of our clinicians in the field.
For the inaugural issue, Dr. Hind Satti, country director for PIH/Lesotho (PIH/L), Dr. K.J. Seung, deputy director for PIH/L, and Megan M. McLaughlin of Harvard Medical School provide an in-depth look at how maternity waiting homes at remote clinics in Lesotho are increasing the number of facility-based deliveries, making childbirth safer in a country burdened with significant challenges.
In 2010, nearly 300,000 women around the world died in childbirth. The vast majority of these deaths occurred in developing countries. Lesotho has one of the highest maternal mortality ratios in the world. The concept of maternity waiting homes isn’t new, but their efficacy in reducing maternal mortality is debated. Yet, as detailed in the report, by engaging traditional birth attendants, conducting extensive community outreach, and providing comprehensive accompaniment, maternity waiting homes can be an extremely effective intervention.
The report provides a wealth of data demonstrating how maternity waiting homes at seven remote PIH/L-supported clinics have led to dramatic increases in the number of women giving birth in a health care facility. Take for instance Bobete Health Center, which saw average monthly deliveries increase from 3.8 in the year preceding the program to 18 in the second year following the program’s implementation.
“In PIH/Lesotho, the maternity waiting homes are one component of a comprehensive maternal health program called the Maternal Mortality Reduction Program,” write the report’s authors. “The goal of the Maternal Mortality Reduction Program is to ensure that 100% of women in the PIH catchment area deliver at a health facility that is adequately staffed and resourced to provide high-quality basic obstetrical care and can refer to a higher level of care for emergencies.”