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Women helping women: How $2 can save mothers' and babies' lives in the developing world

Published: Thursday, May 9 2013 12:00 a.m. MDT

Women and babies in the West almost never die from complications related to delivery, according to Allison. “But any woman who has had a Cesarean section or had a doctor use a vacuum or forceps to facilitate delivery should understand that were it not for those interventions, they could be dead.”

Clean birth

Clean birth kits normally contain just six items: a bar of soap, a plastic sheet to deliver on, a razor blade to cut the umbilical cord, clean string for tying the umbilical cord, gloves and a pictorial instruction sheet that illustrates the sequence of delivery events and proper hand-washing.

Research conducted by USAID in Tanzania shows the positive impact of the kits on women’s and children’s health. In a study of 3,200 participants, including some who used the kits and some who did not, the organization found that women who used the kits were substantially less likely to develop genital tract infections, and their infants were substantially less likely to develop cord infections. USAID estimates that if clean birth kits were used in 90 percent of home births, it would save the lives of 6,300 women and 102,000 newborns each year.

While clean birth kits have incredible potential for improving the health outcomes of mothers and babies, the $2 cost of a single kit is negligible. While prices vary around the world, most Americans could pay for a kit with the change in their sofas.

Two dollars covers not only the cost of the materials in the kit, but also the cost of putting the kit together. Danielle Ehret, a neonatal and perinatal resident at Boston Children’s Hospital, works with an organization called Ayzh to distribute clean birth kits in Bangladesh. Ayzh, Ehret explained, decided to have the kits assembled locally as a way of creating work opportunities for women who may otherwise struggle to find gainful employment. In this way, her organization’s clean birth kit program is assisting women on a number of levels.

Dhanda, who started distributing clean birth kits through Worldwide Healing Hands, has found modifications need to be made to kits sent to different countries to accommodate local practices and beliefs.

“In Nepal, it is traditional to cut the baby’s umbilical cord with a coin,” Dhanda said, “but money is about the dirtiest thing out there and using it to cut a cord can lead to infection for the baby.”

Out of respect for Nepalese custom, Dhanda arranged for the razor blades to be replaced with plastic rupees.

“Everything women around the world need to have a clean birth already exists. We don’t have to invent everything,” said Dhanda. Listening to what women need and understanding their traditions and practices is essential for the project to be successful, she said.

Roadblocks to distribution

While clean birth kits represent an easy, cost-effective way of improving maternal and infant mortality rates, there hasn’t been much of a push for this project, according to Jim Patell. Patell is a Stanford professor who teaches a popular class called Design for Extreme Affordability in which students produce low cost medical devices for use in the developing world.

One of the consequences of Millennium Development Goal five, which addresses infant and maternal mortality, is that there is a push to get women to deliver in hospitals instead of at home, an orientation that limits resources for making and distributing clean birth kits.

Allison has seen this firsthand in her work with the Women’s World Health Initiative in Senegal. She tells of a well-meaning Japanese NGO that built a state-of-the-art hospital in a central village in the area she works. “It has all the latest X-ray and ultrasound machines,” said Allison, but “it stands there locked and empty because there aren’t qualified health care workers to staff it and the people have no ability to pay for care.”

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