Maternal Health Care

Results of MSF Intervention in Burundi & Sierra Leone

We focus the debate on the report "Safe Delivery: Reducing Maternal Mortality in Burundi and Sierra Leone", which shows that results of the MSF package of emergency obstetric care implemented in Kabezi, Burundi and in Bo, Sierra Leone. Obstetric intervention in these districts by MSF is composed of an ambulance system that transports women with pregnancy-related complications from a local health facility to a MSF hospital. Once the women arrive at the hospital, medical staff provides them with a free-of-cost Minimum Package of Emergency Obstetric and Neonatal Care. Running costs for this programme is €1.50/person in Bo and €3.20/person in Kabezi. Results are outstanding: the program shows a drop in maternal mortality of 74% in Kabezi and 61% in Bo as compared to national levels. Both results are above the Millennium Development Goals targets for 2015.

The remarkable success of the Emergency Obstetric Care Package by MSF inevitably makes us wonder if using the same approach in other countries with similar rates of maternal mortality to those of Burundi and Sierra Leone would have the same effective results. Is this strategy a “one-fits-all” solution or do we need to consider other context-dependent factors, and further adapt our interventions accordingly?

In light of this question, we interviewed four MSFers with relevant experience in the field of maternal healthcare, both in research and fieldwork. We first show the field experiences of Annette Aronsson and Natalie van Gijsel in Pakistan and Sierra Leone respectively. They highlighted the positive outcomes of MSF medicalized logistics and the importance of cultural sensitivity in challenging contexts. Secondly, we asked for the perspectives of Rony Zachariah and Kristine Bolme. While for Rony key operational factors are good-quality obstetric care and a good referral system, Kristine goes beyond the “technical lens” and reflects on the role of reputation and trust-building when we talk about outcomes. You can access their interviews by clicking on their names or going to the menu in the right.

So, we invite you to explore what these four MSFers have to say about providing good-quality maternal healthcare everywhere we go. We sincerely hope that, likewise them, you will have your say about how to keep on making a radical change in the lives of millions of women that are nowadays unable to access decent and timely obstetric care.


By: Association Intern