Infographic: Saving Mothers, Giving Life

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The design of the Saving Mothers, Giving Life (SMGL) Initiative strives to ensure that every pregnant woman has access to safe normal delivery services.  If there is a problem during the birth, the woman should be able to get  life-saving emergency obstetric and newborn care within 2 hours.

The SMGL design builds on the existing district health networks, strategies, and facilities.  Health staff use effective, proven medical interventions in health facilities at the time of labor, delivery, and early postpartum (the 48-hour period after birth) to prevent maternal and neonatal deaths.

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The diagram is laid out in a circular format.  It begins with a pregnant woman standing in her doorway as a Village Health Worker (VHW) talks to her; the speech bubble says (in bullet form) “Deliver in a facility.  Birth plan.  Transport vouchers.  Danger signs.”

Next the pregnant woman, holding a document titled “Birth Plan,” says to the VHW “I am ready to deliver.”  The VHW replies, “Do you have any danger signs?”

Then the woman’s path can diverge.

She can walk along a path marked “if nearby” to a Health Facility.  To the right of the facility is a sign that says “Routine Delivery Care + Basic Emergency Obstetric Care.”  This signs refers both to the Health Facility to its left and to the one on its right which is similar but also has a Maternity Waiting Home.

The woman could instead drive along a road leading to the Maternity Waiting Home, on the back of a bicycle or motorcycle.  The road is marked “If farther away.”

Another, wider road leads from the health facility with the Maternity Home to a hospital, which is a larger facility with a sign that says “Comprehensive Obstetric and Newborn Care, Including Surgery.”  A car or ambulance is traveling along that road; the road is marked “If life-threatening obstetric emergency occurs”.   Above the road is a banner or arch indicating that the woman should be able to get from the health facility to the hospital “within 2 hours.”

Lastly, the woman walks out of the hospital, holding her newborn, back in the direction of her house.

Below this is a breakout of a facility room equipped and staffed to SMGL specifications.

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On the wall is a sign saying “Open 24 hours”

There is a lamp/light on the ceiling, tagged “Electricity”

There is a faucet and sink on the wall, tagged “Running water”

There is a nurse standing in the room holding a cell phone, which is tagged “Communication”

There is a shelf on the wall holding some medicine bottles and a syringe, tagged “Life-saving medications”

There is a bed.

Outside the room/building there is a motorcycle, tagged “Transportation”

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The SMGL design requires all health facilities to have:

• Delivery care available at all times
  Electricity and water available at all times
• Functioning communication system (phone, 2-way radio)
• Life-saving medicines (oxytocin, magnesium sulfate)
• Reliable transportation available
• Routine practice of Active Management of the Third Stage of Labor (drugs and treatment after the fetus is delivered)
• Most births taking place in health facilities
•   Community outreach

[Text for infographic of selected results of SMGL Phase 1]

The SMGL Initiative’s design can save lives.  SMGL was first implemented in 4 districts of Uganda and 4 districts of Zambia. During the one-year period of Phase 1 of the SMGL project (June 2012-May 2013) in the SMGL districts:

The percentage of all births that took place in health facilities increased 62% in Uganda (from 46% to 74%) and increased 35% in Zambia (from 63% to 84%).

The maternal mortality ratio in health facilities fell by 35% in both Uganda and Zambia. (Uganda: from 534 to 345 maternal deaths per 100,000 live births.  Zambia: from 310 to 202 maternal deaths per 100,000 live births)

The maternal mortality ratio throughout the districts (i.e., including both facility births and home births) fell by 30% in Uganda. (From 452 to 316 maternal deaths per 100,000 live births)

More information is available on the SMGL Initiative and on its impact.  This infographic was produced by the Centers for Disease Control and Prevention/Division of Reproductive Health, one of the SMGL partners.