Women's Health and Safe Motherhood

JSI has been at the forefront of women's health since its inception in 1978. Through the MotherCare and other projects, JSI staff have conducted research and documented trends in maternal health and safe motherhood. Today, JSI programs in the U.S. and around the world are improving health outcomes for women. The following publications present some of the documentation from key JSI projects. For publications related to family planning, please visit the Family Planning section.

For JSI-authored articles in peer-reviewed journals please go to Journal Articles.

Please note the following are listed in chronological order starting with the most recent publication.

General | Reproductive Health for Refugees | Safe Motherhood

GENERAL

JSI Adolescent Breast Cancer Curriculum (PDF, 188 KB)

This curriculum is for use in high school classrooms or in special sessions for youth to introduce breast cancer as a health topic. It focuses on health disparities affecting Latino populations. Using the curricula will help adolescents learn about breast cancer prevention, screening, treatment, and support services. It draws upon educational resources from Susan G. Komen for the Cure and the National Library of Medicine. John Snow, Inc., 2010.

Trend in Reproductive, Maternal, Neonatal and Child Health Indicators, The Ethiopia Last Ten Kilometers Project Areas, Southern Nations, Nationalities and People's Region 2005-2009 (PDF, 1.07 MB)

The report analyzes the trend in the reproductive, maternal, neonatal, and child health (RMNCH) care seeking behaviors and practices in 30 L10K Project woredas of the SNNP region of Ethiopia to assess the impact of the health extension program (HEP). For the report, data from the L10K baseline survey conducted between December 2008 and January 2009 and the 2005 Ethiopian Demographic and Health Survey is used. The study indicates that the HEP has demonstrated significant achievements in latrine construction and use, distribution of insecticide treated bed nets (ITNs), use of family planning, antenatal care services, and immunization coverage; however, the program is lagging behind in certain areas including the provisions for safe and clean delivery, postnatal and neonatal care services. The HEP needs to improve maternal and neonatal health service delivery strategies. JSI/Ethiopia L10K Project. 2009.

Ethiopia L10K Baseline Household Health Survey Summary Report (PDF, 539 KB)

The Ethiopia Last Ten Kilometers (L10K) Project in collaboration with the Regional Health Bureaus of Amhara, Oromiya, SNNP and Tigray conducted a baseline household health and community survey to benchmark the reproductive, maternal, neonatal and child health (RMNCH) outcome indicators in its project areas. The survey which was conducted during the period December 2008 - January 2009 gathered information from 204 communities or kebeles and 6,277 women using a two-stage cluster sampling methodology. This report presents the survey results that describe the availability, perceived quality, awareness, knowledge, demand, access and utilization of RMNCH services in the L10K project areas. This report is the first-of-its-kind to describe the neonatal health care practices in rural Ethiopia. Implications of the survey findings for the health extension program of the Ethiopian Government are discussed. JSI/Ethiopia L10K. 2009.

The Boulder County Unintended Pregnancy Study (PDF, 1.94 MB)

Unintended pregnancies account for the majority of all pregnancies in the United States, though the issue remains an ambiguous concept that is imperfectly measured. Generally, it refers to pregnancies that were not planned at the time of conception and includes pregnancies identified as either unwanted or mistimed at the time of conception. In support of the need for new research, the Temporary Assistance for Needy Families (TANF) program provided funds to Boulder County Public Health for research to explore general definitions and impressions of unintended pregnancy, factors associated with unintended pregnancy, and best practices for unintended pregnancy prevention. This report presents the data on rates of unintended pregnancy/paternity among Boulder County residents aged 13-28 (focusing on 15-24), as well as other indicators of sexual risk-taking behaviors in Boulder County. The profile served as the first step in promoting data-driven decision making. The report also identifies factors associated with unintended pregnancy/paternity in Boulder County and describes best practices in primary and secondary prevention of unintended pregnancy/paternity. Yvonne Hamby, Lori Nichols, Morgan Anderson. John Snow, Inc. 2009.

Indonesia Health Services Program Aceh Final Report 2005-2008 (PDF, 2.12 MB)

In the wake of the destruction caused by the December 2004 earthquake and tsunami in Aceh, JSI's Health Services Program, already operating in Indonesia, as asked by USAID to help communities along the west coast of Aceh - the area hardest-hit by the disaster.

This report provides an overview of HSP's support, which focused primarily on strengthening the health system's responses to maternal and child health issues. The program worked closely with the Ministry of Health to provide technical assistance in the areas of district planning and budgeting, advocacy, community mobilization, behavior change communications, supportive supervision and improving quality of and access to midwifery services. HSP also addressed psychosocial protection of women and children, and helped to put in place a household-to-hospital continuum of care for the mentally ill. JSI Research & Training Institute, Inc./Indonesia Health Services Program, 2008.

Massachusetts Teen Pregnancy Prevention Program Evaluation Report (PDF, 243 KB)

Massachusetts has one of the lowest teen birth rates in the U.S. High rates exist in certain cities and towns of the state, however. To help address this disparity, the MA Department of Public Health funds 18 sites to provide science-based teen pregnancy programs in their areas. "Science-based" means each program provides balanced abstinence and safe sex messages using a curriculum that has been shown effective in one or more rigorous, published studies. JSI was contracted to perform a cross-site evaluation of the project, implementing "pre- and post- test" surveys among participants. This report provides results for the first two years of data collection, July 2006 through June 2008. Eugenie Coakley, Susan Grantham, Fong Lui, Joseph Musolino, Leah Nigro, Julia Przedworski. JSI Research & Training Institute, Inc. 2008.

Latinas Rompiendo Barreras de Salud (Latinas Breaking Health Barriers). Focus Group Report (PDF, 190 KB)

Latina Rompiendo Barreras de Salud (Latina Breaking Health Barriers) is a community-based participatory research project funded by the Massachusetts Department of Public Health to engage Latinas in identifying barriers, challenges, and gaps in their reproductive and family planning knowledge and use of services. Through this project, JSI and its partner Health Quarters researched traditional practices and products used by Latina for reproductive health that are brought to the U.S. from their country of origin, purchased in bodagas or botanicas, or made at home. Results will be used to validate practices that are useful and beneficial and to educate women of those that may not work and could even be harmful. The final report of three Focus Groups presents the study findings. A survey is also being conducted to gather information from a larger segment of the community. JSI Research & Training Institute, Inc. 2008

Community Mental Health Treatment, Protection and Promotion for Women and Children in Aceh: Findings From an Evaluation of Programs Supported By The Health Services Program (PDF, 390 KB)

This report presents results from the successful Indonesia Health Services Program (HSP) Mental Health and Psychosocial initiative that took place following the devastating earthquake and tsunami in December 2004. In response to this disaster, HSP began work in Aceh to address the psychosocial and protection needs of women and children.

Key findings include the development of a household-to-hospital continuum of mental health care and a mental health system that has assisted with the restoration of health, human rights and human dignity. Survey findings concerning the new mental health program concluded that 90% of patients and caretakers reported improvements in mental health or social functioning. Developed by JSI Research & Training Institute, Inc. in conjunction with Columbia University Mailman School of Public Health and support from the USAID funded HSP Project. JSI Research & Training Institute, 2007.

Russia Maternal and Child Health Initiative Final Report (PDF, 737 KB)

This final technical report presents the results and lessons learned from JSI's successful Russia Maternal and Child Health Initiative (MCHI), funded by USAID. Over the three-year life of the project, MCHI introduced evidence-based principles and interventions into 16 regions across the Russian Federation, including the Russian Far East. Through training, capacity building, and policy development, MCHI revolutionized the provider/client dynamic and garnered widespread support for its activities and accomplishments--including improved service quality and integration, increased awareness of women and mothers of MCH services and issues, and increased use of modern contraceptives. The effective MCHI model will be sustained through JSI's affiliate, the Institute for Family Health, a Russian organization that will carry on the "legacy" of the MCHI approach. Laurel A. Cappa and Natalia Vartapetova. JSI/MCHI, March 2007.

Russia: Integrating Family Planning Into the Health System. A Case Study of the Maternal and Child Health Initiative (PDF, 1.96 MB)

This case study looks specifically at the integration of family planning into the other Women and Infants' Health (WIN) and Maternal and Child Health Initiative (MCHI) project activities. The objectives were to provide a new evidence-based model for reproductive health care services and to increase access to, demand for, and quality of these services, as well as to increase the practice of preventive health behaviors among women in the community. As a result, access to client-centered counseling has increased, unplanned pregnancies have decreased, and the abortion rate has declined. Laurel Cappa, Natalia Vartapetova, Tatyana Makarova, Polina Flahive. JSI/DELIVER Project, 2007.

Russia MCHI Leveraging Study (PDF, 194 KB)

The Maternal and Child Health Initiative (MCHI) was extremely successful in strengthening maternal and child health services in the Russian Federation through the adoption of internationally recognized standards. One of the factors that helped to achieve such results in a relatively short period was MCHI's ability to leverage resources for program implementation. This study was conducted in 2006 to document MCHI's leveraging processes and achievements. The study found that MCHI was extremely successful in leveraging a range of resources to support program implementation, expansion, and future sustainability. Hare, L., Makarova, T., JSI/MCHI, September 2006.

Prevention of Mother-to-Child Transmission of HIV and Family Planning Practices in HIV-Infected Women in Russia Facility Survey: Report of Main Findings (PDF, 1.07 MB)

This report presents the findings from a facility study of prevention of mother-to-child transmission of HIV (PMTCT) and family planning services provided to HIV positive women in Russia. The study was conducted in 8 Russian regions in facilities both participating and not participating in The JSI Russia Maternal and Child Health Initiative (MCHI) program interventions. The aim of the study was to provide a socio-demographic profile of HIV-positive women coming to facilities for abortion or delivery, to obtain quantitative information on current practices and knowledge that will allow the appropriate authorities to strengthen training programs, improve clinical services, and to provide a firm basis for policy discussions. Natalia Vartapetova, Anna Karpushkina, JSI/MCHI. 2006.

Healthy Mother/Healthy Child Project Completion Report (DOC, 31.05 MB)

This final report presents the results from the successful Egypt Healthy Mother/Healthy Child (HM/HC) project. In conjunction with the Egypt Ministry of Health, over the life of twelve-year project, HM/HC helped reduce maternal mortality by 52% and infant mortality declined by almost 20%. Through both upgraded and new maternal and child healthcare facilities, more than 22 million people have improved access to essential services. Both a summary and detailed analysis of the key project achievements can be found in the HM/HC Completion Report. 2005.

Final Report: NGO Networks Project, Pro Redes Salud Project (PDF, 496 KB)

Final report of the Guatemala NGO Networks Project (Pro Redes Salud) which expanded basic care to people in the Mayan highland regions, unified the civil society and improved the MOH NGO granting program. From 2000 to 2004, the project extended high-quality services to 317,000 rural residents, and surveys showed significant improvements in health care coverage. NGOs were unified into networks, a national NGO federation had been formed, and innovations had been adopted by the MOH for improvements in the national MOH NGO program. JSI/Pro Redes Salud, 2004.

Perspectives and recommendations for USAID/Tanzania on community-based distribution (CBD) programs (PDF, 52 KB)

USAID/Tanzania has a unique opportunity to help set new directions for Tanzania's CBD program. CBD fits well into the overall USAID/Tanzania strategy, and can contribute to a solid family planning program. Tanzania is large, heavily rural and still in the early stages of demographic transition. CBD is particularly appropriate as an access strategy for isolated rural areas, and in conjunction with promotion of LTPMs and other public health interventions.

Social Franchising Health Services: A Philippines Case Study and Review of Experience (PDF, 742 KB)

This monograph documents the work of the USAID-funded TANGO Project to establish a franchise of Well-Family Midwife Clinics throughout the Philippines. Included are lessons learned in developing a sustainable franchise, as well as examples of social franchising from other countries and programs. JSI/TANGO Project, 2004.

Russia: Improving Women's Health Care (PDF, 1.32 MB)

This 8-page publication describes JSI's Women and Infant Health (WIN) Project in Russia and how the Project effectively used monitoring and evaluation data to demonstrate the success of WIN's evidence-based, client-friendly model for women's health services.

This is the first in a series of evidence-based papers called Evaluation Matters, written at the end of JSI's international projects.

Evaluation of the WIN Project: Evidence of Effectiveness (PDF, 1.31 MB)

From 1999 to 2003, the Women and Infant Health (WIN) Project worked in close collaboration with the Ministry of Health of the Russian Federation to improve the quality of maternal and newborn services and to increase access to and demand for high quality reproductive health services in three Russian cities. This report compiles the findings from the project's varied baseline and endline facility and household surveys and routine facility monitoring system in a data-based description of project results. JSI/WIN Project, August 2003.

Improving Health Care Delivery Systems in Eritrea: Technical Assistance and Support (TASC) Final Report (PDF, 1.68 MB)

This document provides a final report on TASC?s efforts to improve health care and practices during its period of operation in Eritrea. TASC/Eritrea was responsible for the implementation of three technical components: maternal health, child health and nutrition, and employed strategies related to three cross-cutting components: human resources development, logistic management systems improvement, and information, education and communication (IEC).

Russia WIN Project: A Guide to Implementing Effective Health Care for Women and Infants (PDF, 459 KB)

The recommendations of this Guide are based on the three-year experience of the Women and Infants' Health Project (WIN) in 20 medical facilities in Russia.

This Guide presents the WIN Project's methodology for developing a quality improvement process as well as detailed overviews of WIN training courses and communications approaches.

This Guide also will be useful for medical providers who want to improve the quality of services in their facilities in the region as well as for individual health care institutions--wherever health professionals are introducing state-of-the-art recommendations into their own systems and procedures. JSI/WIN Project, 2003.

Russia Women and Infant's Health Project Final Report (PDF, 1.31 MB)

The Russia WIN Project, funded by USAID, was a comprehensive reproductive health project designed to improve maternal and newborn health care in two pilot regions of the country. The final report presents the accomplishments of the four-year project, including improved service quality, increased number of women exclusively breastfeeding, increased family planning use and a decline in abortion rates in project areas.

The WIN Project activities have been expanded and are now being implemented in 14 oblasts across Russia. JSI/WIN Project, 2003.

Safe Motherhood Strategies: A Review of the Evidence

This book, CD-Rom and website result from collaboration between DFID, the European Commission, the Institute of Tropical Medicine, Antwerp University and John Snow International-UK. In order to further its commitment to the reduction of maternal mortality, and to ensure that its strategy and policies are based on the available evidence, the EC commissioned 19 scientific background papers which reviewed the published and gray literature on particular topics. Those papers are contained within this website. 2001.

Client perceptions of reproductive health services in Vladivostok and Novosibirsk, Russia (PDF, 3.69 MB)

The purpose of this study was to gather formative information on client perspectives concerning family planning, maternity care, breastfeeding, and contraception and to incorporate these findings into the training courses for service providers. Information was collected through focus groups with women on clients' preferences, role in decision making, expectations, and level of satisfaction with the quality of services in Novosibirsk Oblast, Vladivostok, and Primorsky Krai. Participants showed knowledge of reproductive health and general satisfaction with services. Recommendations center on improving provider-patient communications, developing consumer health education resources and communication channels, and increasing patient role in decision making. March, 1998.

"We Want to Know Eeverything About It:" Albanian women speak about family planning (PDF, 64 KB)

Very little research had been done in Albania to understand knowledge, attitudes, and practices regarding contraceptive use. In 1996, SEATS Project staff collaborated with the Albanian Ministry of Health and Environment (MOH) and the Albania Family Planning Association (AFPA) to conduct focus group research with women of reproductive age. This research included separate discussions with married women, unmarried university students, postpartum women, and women who had recently received abortions in order to better appreciate the informational needs of these primary audiences for information, education, and communication (IEC) activities in the SEATS/Albania project.

Recommendations for programming include emphasizing messages on contraceptive safety and price, developing youth-friendly services that include counseling on STD/HIV protection, providing updated information, again emphasizing contraceptive safety, to service providers, including allied health personnel who can refer women to RH services, and producing print materials for women on FP and contraception. Enilda Gorishti, MD and Joan Haffey, MPH, SEATS Working Paper #1 1997.

Reproductive Health for Refugees

Astarte Technical 2-Pager (PDF, 163 KB)

The Astarte two-pager explains how the project works to meet the reproductive health needs of communities affected by crisis, building leadership among local NGOs.

The Long Wait: Reproductive Health Care in Haiti (PDF, 18.02 MB)

This report draws on findings from an assessment of Haiti's reproductive health response in crisis and beyond. The report highlights persistent gaps in family planning and adolescent sexual and reproductive health, particularly in remote areas. In spite of deteriorating infrastructure and short-term funding cycles, a number of local initiatives offer promising approaches to fill reproductive health gaps.

Please visit the JSI Astarte Project website for more information on JSI's work on reproductive health for refugees. JSI/Astarte Project. May 2009.

Sexual and Gender-Based Violence Against Refugees, Returnees, and Internally Displaced Persons: Guidelines for Prevention and Response. (PDF, 536 KB)

This booklet is an addendum to the Field Guide for Displaced Settings. The 2003 updated UNHCR Guidelines offer advice on how to design strategies and carry out activities aimed at preventing and responding to gender-based violence. JSI/RHRC, 2004.

Gender-Based Violence in Populations Affected by Armed Conflict: Checklist for Action (PDF, 80 KB)

This small booklet is an addendum to the Field Guide for Displaced Settings. It reviews methods for humanitarian aid programs, involved in preventing gender-based violence. This material was adapted from a checklist developed by UNHCR, Geneva in 2003. JSI/RHRC, 2004.

Gender-based violence in populations affected by armed conflict: a field guide for displaced settings

This booklet defines gender-based violence, describes different forms that it takes, and outlines ways that humanitarian aid programs can help to address gender-based violence in populations affected by armed conflict. This material was produced by the Gender-Based Violence Global Technical Support Project of the Reproductive Health Response in Conflict (RHRC) Consortium. JSI/RHRC, 2004.

Synopsis: Sexual and Gender-Based Violence Against Refugees, Returnees, and Internally Displaced Persons: Guidelines for Prevention and Response. (PDF, 536 KB)

A Guide to Monitoring and Evaluation of Capacity-Building Interventions in the Health Sector in Developing Countries (PDF, 774 KB)

This guide was developed to assist health planners and evaluators to gain a clear understanding of the concepts of capacity and capacity building. It looks at ways to critically evaluate the strengths and limitations of current approaches to capacity measurement, as well as design a capacity-building monitoring and evaluation plan that outlines a systematic approach to measuring capacity and assessing the results of capacity-building interventions in the health sector. Anne LaFond and Lisanne Brown, MEASURE Evaluation Project/JSI Research & Training Institute, Inc., 2003.

Small Grants, Large Gains (PDF, 968 KB)

Included in this report are an extensive overview of the RHRC program and in-depth summaries of RHRC projects. This material was produced by JSI Research & Training Institute, Inc., on behalf of the Reproductive Health for Refugees Consortium. JSI/RHRC, 2002.

Gender-based violence: emerging issues in programs serving displaced populations (PDF, 4.15 MB)

This book delineates the Gender-Based Violence program, including the program model and history, program development and training, and reports on GBV programs in the different countries. This material was produced by the GBV Global Technical Support Project and JSI Research & Training Institute on behalf of the Reproductive Health for Refugees Consortium. This material is also available in French and Portuguese. JSI/RHRC, 2002.

Safe Motherhood

Private Delivery Care in Developing Countries: Trends and Determinants (PDF, 352 KB)

This study uses Demographic and Health Surveys (DHS) data to examine trends in growth of delivery care provided by private facilities and determinants of private sector use within the health care system. Results show a significant trend toward privatization of delivery care over the 13 years covered in the study, with considerable variation in the characteristics driving this increased use across countries. These results also warn against making generalizations on the effects of privatization on maternal health use. John Snow, Inc., 2010.

Pregnancy Smoking Cessation Program Quality Assurance Monitoring & Evaluation (PDF, 8.04 MB)

In spring 2009, Vermont Department of Health, Tobacco Control Program contracted with JSI Research & Training Institute, Inc. to conduct quality assurance monitoring and evaluation of its pilot smoking cessation during pregnancy incentive program currently operating in the Rutland and Newport district offices. The objective of the incentive program is to support and encourage quitting smoking early and throughout the pregnancy by recruiting women who smoke among the clients seeking WIC nutritional services.

The final report details JSI's study approach, findings and conclusions following a literature review, and quality assurance monitoring and evaluation activities of the VDH Pregnancy Smoking Cessation Program. JSI Research & Training Institute, Inc., 2009.

Community-Based Maternal and Neonatal Care: Summative Report (PDF, 791 KB)

The community-based maternal and neonatal care (CB-MNC) program of the Nepal Family Health Project (NFHP) was designed to address key health needs of mothers and newborns in Nepal who live in rural locations and have limited or no contact with facility-based health services. This document presents the summary details of a comprehensive monitoring and evaluation effort conducted with assistance from Johns Hopkins University through the NFHP. The studies found a significant increase in skilled birth attendance and dramatic declines in maternal and neonatal mortality. Nepal Family Health Program/JHU/John Snow, Inc., December 2007.

Your Pregnancy Week-by-Week Client Booklet (PDF, 438 KB)

This booklet was developed for women in the Central Asian Republics as a guide for what to expect during pregnancy, week-by-week, and how to manage common problems. It includes information on how the baby is growing, how the mother's body is changing, and provides tips for staying healthy.

MotherCare Matters. Vol. 9 No. 2: Improving Provider Performance - An Exploration of the Literature (PDF, 380 KB)

This issue gives an overview of a wide range of interventions that have been implemented in developed countries and resource-poor settings, with a major emphasis on maternal health and family planning. Edna Jonas. August 2000.

National Maternal Mortality Study - Egypt (PDF, 2.16 MB)

The National Maternal Mortality Study: Egypt 2000 documents the impact of JSI's Healthy Mother/Child Project on the reduction in maternal mortality in Egypt. It also examines avoidable factors that contribute to maternal deaths so as to improve maternal health programs in the country. Produced by the Doctorate of Maternal and Child Health Care Ministry of Health and Population, Egypt. June 2001.

Issues in Programming for Safe Motherhood (PDF, 215 KB)

In this booklet, we present select issues in programming for safe motherhood derived
from collected data in the field. Our purpose is to examine past experience from a
practical programming perspective. John Snow, Inc. 2001.

MotherCare Matters Vol. 9 No. 3: Behavioral Dimensions of Maternal Health & Survival (PDF, 396 KB)

This issue describes and assesses MotherCare's methods for improving the health and survival of mothers and newborns. September 2000.

MotherCare Matters Vol 8, No. 2: Scaling-Up MotherCare (PDF, 278 KB)

MotherCare combined several scaling-up to increase its effect on maternal and neo-natal health over ten years of working in Guatemala and Bolivia. This issue defines and describes these efforts and their results. August 1999.

Download Spanish (PDF, 292 KB)

MotherCare Matters Vol 8, No. 1: Safe Motherhood Indicators -- Lessons Learned in Measuring Progress (PDF, 246 KB)

Measuring maternal mortality is extremely difficult. This issue examines the methods that MotherCare utilized to overcome the many challenges. May 1999.

Policy Brief 1: Essential Obstetric Care and Subsets - Basic and Emergency Obstetric Care: What's the Difference? (PDF, 53 KB)

Marge Koblinsky. Essential Obstetric Care and Subsets - Basic and Emergency Obstetric Care: What's the Difference. MotherCare Policy Brief #1. Arlington, VA: John Snow, Inc., 1999. (M750)

This policy brief discusses of maternal mortality indicators and complexities therein.

Policy Brief 1: Essential Obstetric Care and Subsets--Basic and Emergency Obstetric Care: What's the Difference? (PDF, 53 KB)

This policy brief discusses of maternal mortality indicators and complexities therein. Marge Koblinsky, Mary Ellen Stanton. 1999.

Policy Brief 2: Safe Motherhood Indicators--Measuring Progress (PDF, 51 KB)

This policy brief provides definitions and talking points for programs and persons advocating for maternal health. 1999.

Africa initiatives: Addressing obstetric and neonatal complications in Africa from community and facility perspectives: Descriptive reports from Ghana, Malawi, and Uganda (PDF, 288 KB)

The World Health Organization estimates that approximately 600,000 women die from obstetric complications each year. Between 10 and 29 percent of all deaths of women in their reproductive years in developing countries are due to obstetric complications or diseases aggravated by pregnancy. MotherCare assembled health representatives from Ghana, Malawi, and Uganda to describe community activities and interventions directed to improving access to quality maternity care, assess hospital and health center capacity, and describe linkages and partnerships between communities and providers. This report contains the three descriptive country assessment reports developed by country representatives.

Assessing Safe Motherhood in the Community: A Guide to Formative Research (PDF, 6.75 MB)

This manual is a guide to assessing community aspects of safe motherhood. It is intended for investigators who have the responsibility for designing community research on safe motherhood, and for program managers who will work with them to ensure that the research is oriented toward program needs. Nancy Nachbar, Carol Baume, and Anjou Parekh. Arlington, VA: John Snow, Inc., 1998.

Community mobilization for private midwives: Curriculum and guide for trainers (PDF, 741 KB)

The Community Mobilization Curriculum and Guide aims to increase the effectiveness of private midwives by expanding their active involvement in the community. Should be used with the Business Management Skills for Private Midwives: Curriculum and Guide for Trainers. Originally designed for private sector midwives in Uganda but can be used throughout the developing world. November, 1997.

Making Motherhood Safe (PDF, 10.56 MB)

To assist policymakers and program managers to design and implement programs to reduce maternal mortality, this paper discusses the lessons for reducing maternal mortality derived from experience and research in both developing and industrial countries. It draws from the experiences presented at two workshops attended by participants from Africa, Asia, and Latin America. The evidence shows that community-based approaches such as family planning and training and the deployment of midwives have helped reduce maternal deaths in high-mortality settings. Also, a World Bank analysis identified prenatal care and delivery services as among the most cost-effective government interventions for improving adult and child health. This paper recommends priorities and program strategies for making family planning services and maternal health care more effective by improving quality, increasing access, and educating the public about the importance of such services. Anne Tinker, Marjorie A. Koblinsky. 1993.