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How to save our mothers

Dr. Koki Agarwal, Director of the United States Agency for International Development’s Maternal and Child Survival Program, visited UMBC to inform how her organization is saving lives in developing countries across the world.

Agarwal works with Jhpiego, a non-profit based in Baltimore and affiliated with Johns Hopkins University. Through this partnership, she boasts victories such as reducing the maternal and newborn death rates.

Dr. Agarwal informed us, “Jhpiego works in over 50 countries to prevent the needless deaths of women and their families.” She began the presentation telling the audience a personal story of how she recently became a grandmother and the blessings of access to first-rate medical care.

Her daughter, she informed us, needed an emergency Caesarian section and without the proper attention, she could’ve died like plenty of other women in developing countries. “[It is] important to reach the women who don’t have access to [maternal health] in the countries where I work,” Dr. Agarwal said.

The Maternal and Child Survival Program, supported by both Jhpiego and USAID, seeks to provide global health, with a special interest in sub-Saharan Africa and South Asia.

While the program has a keen focus on maintaining the health of expecting mothers, Dr. Agarwal included, “in Nepal, we’ve been doing a lot of work on gender-based violence.” MCSP also provides resources like family planning, maternal and newborn health services, nutrition and addresses gender inequity.

Dr. Agarwal proved that gender inequity is a public health issue by mentioning “gender inequities, disrespect and mistreatment during services and choice and decision-making power all affect women’s decisions to receive service.”

MCSP attempts to implement realistic changes in countries, such as the use of magnesium sulfate (household Epsom salt) to provide hemorrhoid relief and the kangaroo method (immediately placing the newborn baby to the mother’s skin after birth) for pre-mature babies.

Dr. Agarwal also educated the audience on preventing hemorrhages by giving mothers a dose of oxytocin within thirty minutes after birthing and how breastfeeding within the first hour of birth and exclusively for six months after birth can reduce the risk of newborn deaths.

Dr. Agarwal’s desire is “to go back to a country and see how much of the work [MCSP has] done has been continued.”

Along with offering pre-service training, in-service training, mentoring and supervision for healthcare providers, Dr. Agarwal and her colleagues also connect with the governments of the countries they work in, although they are “not allowed to improve foreign infrastructure” under the United States’ provision.

Dr. Agarwal identified underlying causes of maternal and newborn mortality in developing countries, such as “poverty, malnutrition, illiteracy, tradition, gender inequity, and corruption.” “For every woman who dies,” Dr. Agarwal said, “30 women suffer life-long morbidity.”

Dr. Agarwal identified promising statistics: almost 2.9 million children have received 3 doses of DPT/Penta3 vaccines; from 1990 to 2015, the maternal mortality rate has dropped 43 percent; newborn deaths have declined from 4.4 million in 1990 to three million in 2015.

While there is still work to be done, such as training healthcare providers to ask women if they have experienced gender-based violence, Dr. Agarwal emphasized that MCSP is actively working to save our mothers.