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Nehnwaa Child Survival Project
Challenges:
Liberia's civil war devastated its roads and health care system. Dire shortages of health workers and roads claimed by jungle or turned mud in the rainy season condemn thousands of women to die unnecessarily at home from obstetric complications, giving Liberia the world's third highest maternal mortality ratio (994). Lifetime risk of maternal death is 1 in 12. Husbands haul wives with obstetric complications to health facilities 5 to 10 kilometers away in wheelbarrows. Curamericas Global has launched the USAID-funded Nehnwaa Child Survival Project with in-country partner Ganta United Methodist Hospital (GUMH) in north-central Liberia to improve the health of women and children in one of the worst-hit regions, Nimba County, by training and deploying mobile Primary Health Care Teams, Community Health Workers (CHW), and Trained Traditional Midwives (TTM), and by deploying an obstetric emergency (OE) response system, utilizing cell phones and renewable energy technology, Freeplay Energy's solar/hand-cranked cell phone charger. There is no published evidence of projects that explicitly use cell phones for OE response in the developing world- this project breaks vital new gound. Lack of electricity in the villages has impeded cell phone penetration; the Freeplay Energy chargers solve this problem. CHWs and TTMs trained to recognize obstetric emergencies equipped with cell phones and chargers will call in obstetric emergencies, or signal when a high-risk pregnancy goes into labor. GUMH staff will respond with a 4WD all-terrain vehicle (for patient transport to GUMH) or motorcycle (for home-based treatment) and/or emergency coaching via cell phone. The system will have 24/7 coverage with trained GUMH staff to answer, assess the situation following clear question and answer algorithms, and, if necessary, have the nearest available vehicle take the patient to the closest health facility. This system will be field-tested with drills and assessed for CQI via debriefing after each use. A rigorous M&E system will document efficacy.
