NEW YORK – While the world’s leaders set new global health goals and appraised existing ones at the United Nations (UN) last week, implementing these noble goals falls on the shoulders of people like midwife Ashu Martha Agbornyenty.

Agbornyenty works in poor communities in Cameroon, where the deaths of women and newborn babies are relatively common due to a lethal combination of poor resources, a shortage of health workers and a preference for traditional birth attendants.

The 24-year-old’s passion for uplifting both Cameroonian midwives and their pregnant patients won her the  Changemaker Award presented at a Goalkeepers event hosted by the Bill & Melinda Gates Foundation (BMGF) in New York last week.

Agbornyenty’s For Mom & Baby Foundation, that distributes kits containing essential birth supplies to pregnant women in crisis-stricken areas, runs workshops to prepare women for labour, and writes about the work of midwives and  pregnancy through a blog, Marthie’s Midwifery Diary.

“In the area where I work in Cameroon, there is a political crisis and a lot of the women deliver in bushes,” Agbornyenty told a media briefing last week.

“We partner with hospitals to provide medication to prevent postpartum haemorrhage, which is the leading cause of maternal mortality.

“I am also a young midwife leader working to curb the dropout rate of midwives. When I started as a midwife there was no one to guide me and I wanted to drop out. So far, I have personally guided 185 student midwives to stay in the profession and 40 of these are under my direct mentorship.”

Best practice to save lives

The UN held a summit last week to assess progress to achieve the Sustainable Development Goals(SDG) – 17 global goals adopted in 2015 to address poverty, development and climate by 2030.

The SDG targets were set in 2015, and the halfway assessment is depressing: just 15% of the 17 targets are on track to be achieved by 2030, and eight are going backwards. The target was to end all preventable child deaths by 2030, and cut the maternal mortality rate to less than 70 out of every 100,000 births – but the world is far off track to achieve these.

However, a series of relatively simple interventions could save the lives of millions of mothers and babies and put the world on course to achieve the SDGs related to child deaths and maternal mortality, according to the Gates Foundation’s Goalkeepers 2023 report.

The BMGF has funded research into the biggest killers of mothers and newborns – notably postpartum haemorrhage, the number-one cause of maternal death; anaemia and sepsis – and proposed a package of cost-effective measures to address these.

The key solutions involve: providing a V-shaped drape to health workers to enable them to easily measure a mother’s blood loss during and after labour; giving women in danger of haemorrhaging all five recommended treatments at once instead of sequentially; and replenishing an anaemic pregnant woman’s iron reserves via a five-minute intravenous infusion of iron.

BMGF CEO Mark Suzman said that the interventions had not been invented by his foundation, but that “somebody needed to sponsor the research to see whether, by implementing the various interventions together, you get a statistically significant outcome.”

The Foundation is currently working with the World Health Organization (WHO) to get these interventions introduced as best practices and rolled out as policy at global, regional and national levels – with the potential to save the lives of two million mothers and babies by 2030, added Suzman at a media briefing last week.

PEPFAR re-authorisation

Suzman also said that his foundation was confident that the US Congress would reauthorise the President’s Emergency Plan for AIDS Relief (PEPFAR), which has been being stalled by allegations that some PEPFAR grantees have used grants to provide and support abortion. 

“While we are concerned, we are confident and cautiously confident that the US will be providing the necessary determination,” said Suzman, who described the abortion allegations as “factually untrue”.

PEPFAR was launched in 2003 by President George W. Bush and reauthorized three times so far. According to its most recent report,  PEPFAR has saved 25 million lives primarily through its sponsorship of antiretroviral (ARV) medicine for people with HIV. Millions of people, particularly in Africa, are entirely dependent on PEPFAR for their ARVs.

The Gates Foundation has invested heavily in preventing HIV, and Suzman described PEPFAR as one of the most successful global health collaborations in recent history.

Image Credits: BMGF.