The Innovating for Maternal and Child Health in Africa (IMCHA) initiative

The program is expected to:

address critical knowledge gaps and increase awareness among policy decision-makers about affordable, feasible, and scalable primary healthcare interventions to improve maternal and child health delivery and outcomes;
promote gender-sensitive health systems and solution-oriented research, and enhance the uptake of relevant and timely research that informs policy and practice;
strengthen collaborations between Canadian and African researchers, working in partnership with African decision-makers, to implement and scale up high-quality and effective medicines, services, and technologies that improve maternal and child health outcomes.

In the Mara region of Tanzania too few women were attending the 4 recommended antenatal care visits and when women delivered in health facilities, adequate supplies were not always in place in health facilities and families had to purchase these on the spot. An IMCHA research team tested if providing birth kits to pregnant women that included misoprostol and other essential supplies relieved families of financial barriers for women and their families and contributed to safe births. As a result of the proven impact, the Regional District Medical Office proceeded to implement the research team’s recommendations by providing such kits for pregnant women through the Medical Supplies and Drugs department.

In rural Ethiopia, geographic distance from health facilities can impede women from reaching a health facility in time to deliver, once her labour starts. An IMCHA research team tested upgrading maternal waiting homes to increase their use. Maternal waiting homes allow women to travel to the health facility before she goes into labour, ensuring that she will be surrounded by a skilled birth attendant when she needs to deliver. The maternal waiting homes are comfortable (for instance having coffee, an important part of Ethiopian culture). This, combined with the team’s communication, education and information strategy, led to an increase of up to 30% of facility-based births. Other districts are exploring building maternal waiting homes near their health facilities as well.

Mortality for premature babies in Malawi in one of the highest in the world. Two nurse champions spent time in local hospitals in an IMCHA research team intervention areas to mentor nurses in kangaroo maternal care, breastfeeding practices, and on how best to support caregivers. The research team looked particularly at survival of infants with respiratory troubles, which accounts for a large portion of neonatal mortality. The team also trained health workers to communicate better as a team and with parents regarding the use of life-saving technologies (such as the Bubble Continuous Positive Airway Pressure). As a result, the adoption of kangaroo mother care in the hospitals increased by more than 30 percentage points (from less than 50% to more than 80%). The research team found that the life-saving technologies were best implemented when health workers were trained to communicate better.

Many women and men in Nigeria are not aware of some risk factors during pregnancy that are within their sphere of control. An IMCHA research team in Bauchi State, Nigeria, identified 4 risk factors for poor pregnancy outcome: domestic violence, lack of communication between partners, women continuing to do physically demanding tasks during pregnancy, and a lack of knowledge about danger signs. The team used Nollywood style video-edutainment, streamed on tablets, to routinely visit every pregnant woman and her spouse in the intervention area, discuss these factors, and bring health information to people’s doorsteps. The research team demonstrated the positive impact of the home visits, documenting, for example, a reduction in complications of pregnancy and post-partum sepsis by 20% in intervention areas facility wards, and a reduction of gender-based violence during pregnancy. The State Government’s plan for health services now includes a roll out of home visits across the entire Bauchi State.

Perinatal depression affects women and adolescent girls in Nigeria with adverse effects on their, and their child’s health. This is often undiagnosed and not addressed in maternal health services. With too few psychiatrists in Nigeria, the team recognized that addressing mental health at primary health care level, would require non-specialists to be part of the care package. An IMCHA research team tested integrating mental health screening into routine antenatal care at primary health care level in Oyo State, Nigeria. The team put a special emphasis on adolescents during and after pregnancy. Detection of perinatal depression in interventions areas increased from 2% to 40% after training of maternal care providers in mental health and the use of a screening tool by the RT in the intervention areas. As a result of the teams’ work to destigmatize mental health, a Mental Health Desk was established at the Oyo State Ministry of Health. The Ministry is planning to incorporate the use of the screening tool for perinatal depression developed by the research team into routine assessment of mothers receiving antenatal care in all public health facilities of the State.

In rural Mozambique, geographic distance from health facilities can impede women from reaching a health facility in time to deliver, once her labour starts. An IMCHA research team developed and tested the use of motorcycle ambulances to get women to facilities faster. Combined with their outreach efforts, there was an 88.9% increase in deliveries at the Marrere Hospital, allowing women to receive care from trained health workers on time. The prototype of the motorcycle was developed by a Mozambique national while in Canada, and was tested on the prairies of Saskatchewan.