Collaborative Action in Lowering of Maternity Encountered Deaths

CALMED - image from RGB&I Image Gallery
CALMED - image from RGB&I Image Gallery

“Women are not dying because of diseases we cannot treat, they are dying because the societies have yet to decide that their lives are worth saving” - Prof Mahmoud Fathalla, Past President FIGO.

The Problem

About 300,000 women and many more children worldwide die each year in pregnancy and childbirth – 90% in the deprived developing world, especially SE Asia and Africa.

Most of these deaths could be prevented through faster access to medical help, and improved local medical knowledge and practices.

The Causes

When problems occur, a high proportion of lives are lost through the 3 delays:

  • delay in recognising danger in the community,
  • delays in transport to medical centres and
  • even when at hospital, delay in accessing medical staff trained in maternal best practices

The Solution

Collaborative action is needed to deal with the problem at all levels: liaising with government, training health workers at community level,  recognition of the need for rapid access to medical help, and  training health professionals in modern maternal lifesaving techniques.    ‘Calmed’ addresses all these issues by working with Rotary to send high quality medical teams to share their skills with their local peers, who in turn cascade them right down to village level, continuing long after the team departs.

Does it Work?

The Evidence Based Calmed programme  and subsequent evaluation ensures sustainable quality.   Sikkim (our first visit) has shown an encouraging fall in maternal death rates in the year following the introduction of the Calmed model.

Evolution of the Programme

The ‘hands on’ training model allows continued modification and development as new techniques are found to be effective.  Our continued visits are starting to incorporate local trainers from previous visits, helping sustainability and the spread of the Calmed model.

About the ‘Calmed’ Programme

Rotary International has now made 3 Programme Grants to facilitate ‘Calmed’ training missions to states in India where the maternal death rate is highest – Sikkim, Bhuj and now Madhya Pradesh.

The First Vocational Training Team (VTT) visited Sikkim State in 2013 to test the ‘Calmed’ approach to training members of the medical and allied professions, including Public Health Workers.  A team of UK Obstetricians and Gynaecologists visited the State for a two week period to pass on skills and ‘Best Practice’ from the UK.

The Second VTT / Calmed expedition went to Bhuj in Gujarat state in November 2014.  The same methodology was repeated to the local medical profession and ASHAS, again leaving behind a cascade training model to grow through the new local Master Trainers.

The Third VTT / Calmed visit (in Setember 2016) is to visit another needy part of India with high maternal death rate – the state of Madhya Pradesh.  Here the death rate for mothers is high even by Indian standards, and implementation of the Calmed approach to improving childbirth care will make a real impact on the problem.

Further Information

For further information, please visit the Calmed website.

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