BRUSSELS, Feb. 13, 2018 – The Clinton Health Access Initiative, Inc. (CHAI) has been awarded a Horizon Birth Day Prize by the European Commission and the Bill & Melinda Gates Foundation. CHAI is one of three winners, from among 48 applicants, being recognized for a demonstrated and scalable solution to reduce or prevent death during pregnancy and childbirth.
CHAI was recognized for its Integrated Maternal and Neonatal Health (MNH) Approach, which achieved dramatic reductions in mother, newborn and stillbirth mortality rates within 18 months of implementation in Northern Nigeria, and was developed in collaboration with the Nigerian Government and funded by the Norwegian Agency for Development Cooperation (Norad). The Horizon Birth Day Prize Contest is an initiative of the European Commission, which also presents the first place prize. CHAI was awarded one of the additional prizes in the contest by the Bill & Melinda Gates Foundation. The €1 million award was presented at a ceremony in Brussels.
CHAI’s Integrated MNH Approach focuses on averting the majority of preventable deaths that occur in the 48-hour window around delivery, whether a birth happens at home or in a health facility. The approach involves implementing the interventions necessary to ensure potential complications are identified early to prevent them from becoming life-threatening. Simple interventions are applied immediately to ensure survival, and when required, cases are quickly referred to the appropriate level of the health system.
“We thank the EU and the Gates Foundation for this prize. The award recognizes the work that this approach has done to reduce maternal and neonatal mortality in Nigeria. The approach was undertaken at the service of the Nigerian Government and in particular the communities in Northern Nigeria where we worked; without their partnership, support and ownership, this would not have succeeded. We must also thank the Norwegian Government for making this program possible through their funding commitment to the Nigerian people,” says Dr. Owens Wiwa, CHAI’s Executive Vice President, Regional Director of West and Central Africa.
Nigeria has one of the highest maternal and neonatal mortality rates in the world. Annually, the country accounts for 19 percent of all maternal deaths, and 10 percent of all newborn deaths, globally. The northern states of Kaduna, Kano and Katsina, where the program was implemented, have some of the highest maternal and neonatal death rates in the country.
The program was first piloted at small scale in Ethiopia and then implemented at large scale in 30 districts in these three states, which have a combined population of 10 million. It addresses critical gaps in care by integrating the entire health system, from the home – where over 80 percent of births occur – to the hospital. At the core of the program is the community health center, which connects a pregnant woman to each level of the system. She begins with a first, essential, antenatal care visit, and continues with periodic checkups throughout her pregnancy. If a high-risk pregnancy is identified, it is tracked and a birth plan prepared to include transportation to the nearest facility when she goes into labor.
Whether birth takes place in a facility or at home, women should have access to the skills, commodities and equipment necessary to ensure that both mother and child survive. The program therefore includes a mentoring program for traditional birth attendants, who are most often present during home births. The attendants act as first responders to minimize complications, or when complications arise, to stabilize and treat them while waiting for emergency referral and transport to the nearest hospital.
As a result of this program, neonatal mortality dropped by 43 percent, maternal mortality dropped by 37 percent and stillbirths dropped by 15 percent. These declines are comparable to those achieved in the previous 15 to 20 years, but were achieved in 12 to 18 months.
Vital to the program’s success are the management systems put in place to sustain it for the long term. These include tracking births that take place in the community as well as the hospital and strengthening supply chains so essential medicines and equipment are available at all levels of care. CHAI is now scaling up the approach in Ethiopia and is partnering with other African governments to apply a similar approach.
Statements from our partners
From the Nigerian Federal Ministry of Health: The Federal Ministry of Health commends the Norwegian Government’s support to the Government of Nigeria’s efforts at increasing access to quality MNH services, especially across the 30 Local Government Authorities (LGAs) in the three states where the comprehensive MNH approach was undertaken. The efficient and effective methodology adopted by CHAI during the implementation of the project is commendable. The interventions were tailored to improve the standards, with which services were delivered at the grassroots, enhance elimination of ineffective implementation of activities while driving efficiency to achieve results. The Federal Government and the three focal state governments have the responsibility to ensure that gains made on the program are not lost and key learnings are embedded within government plans going forward.
From Marte Bøe Wensaas, Senior Advisor with the Department for Education and Global Health at Norad: “Norway is pleased to have taken part in the program. We hope the Nigerian Government will take the learnings from this program to scale similar interventions in other states and communities. That way more lives can be saved.”
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About CHAI | The Clinton Health Access Initiative is a global health organization committed to strengthening integrated health systems and expanding access to care and treatment in the developing world. CHAI’s approach focuses on improving market dynamics for medicines and diagnostics; lowering prices for treatment; accelerating access to lifesaving technologies; and helping governments build the capacity required for high-quality care and treatment.
Press inquiries can be directed to Corina Milic, press@clintonhealthaccess.org.
About the prize | The Horizon Prize for the Birth Day is awarded to a solution that best demonstrates a reduction in maternal and/or newborn morbidity and mortality and/or stillbirths during facility-based deliveries. The solution should be novel, safe and scalable. The prize is an initiative of the European Commission, which has committed €1 million, with the Bill & Melinda Gates Foundation pledging another €1 million and a further €500,000 donated by the MSD for Mothers program of Merck Sharp & Dohme Corporation.
Further resources
A government-led approach to dramatically and sustainably reduce maternal and neonatal mortality (blog post)
Advancing survival in Nigeria: A pre-post evaluation of an integrated maternal and neonatal health program (article in Maternal and Child Health Journal)
