Before Najini Khan lay down to give birth, the 25-year-old Nepalese woman cleaned the house, fed the goat and cow, bathed her five-year-old daughter, and made dinner. Najini’s labor was long, strenuous, and lifethreatening. After giving birth to her daughter, the new mother began to bleed heavily. Postpartum hemorrhage is the leading cause of maternal deaths, the majority of which occur in the developing world. But a community health worker had prepared Najini for just such an emergency.
During prenatal visits to Najini’s village in western Nepal, community health worker Chandrakali Kurmi explained what to do if Najini began to hemorrhage. She outlined the steps of a community-based intervention developed by Jhpiego, a Johns Hopkins affiliate, to help save the lives of the majority of women in the developing world who give birth at home.
Kurmi counseled Najini, her husband, and other family members on the use of misoprostol, a lifesaving drug that helps stop bleeding, and the need to go to the local health facility if the bleeding persisted. That was exactly what happened to Najini after giving birth to a lively baby girl. As instructed, Najini took the three white pills—known in Nepalese as maatri surakchya chakki. The bleeding slowed, but continued. Her husband, Isharat, called health worker Kurmi and together they loaded Najini in a buffalo cart for the hour-long ride to the hospital, where the staff was prepared to respond to an obstetric emergency as part of a Nepal government initiative implemented by Jhpiego. Staff there removed a piece of placenta that remained in Najini’s uterus and stopped the bleeding.
Without the Jhpiego-supported prenatal care and emergency obstetric preparedness, Najini would likely have bled to death, as is the case for an estimated 100,000 women annually.
“I was able to survive because of this maatri surakchya chakki,” Najini said, referring to the misoprostol and the advice of the Jhpiego-trained community health worker. “I would never have known when to come to the hospital if the information had not come with these pills. I might have died, leaving my two girls to struggle alone.”
From the mountains of Nepal and the villages of Malawi to the crowded capitals of Afghanistan and Rwanda, Jhpiego has worked for nearly 40 years to prevent the needless deaths of women and their families. Jhpiego, an international health non-profit with headquarters in Fells Point, shares the health expertise and scientific knowledge associated with Hopkins, and collaborates with governments and health professionals so they can provide skilled, competent health care to their people. The organization employs 800 —200 in the United States and 600 overseas. Its budget is $110 million.
Through partnerships with businesses, foundations, corporations, and other NGOs, Jhpiego develops low-cost solutions to today’s health care problems. Its mission is to strengthen health systems and build the capacity of skilled health care providers so countries can improve health care services and reduce maternal deaths. Jhpiego’s experts in maternal and child health, HIV/AIDS, infection prevention, malaria, tuberculosis, and workforce education are working today in more than 50 countries around the world.
In Guyana, for example, Jhpiego has assisted the government in establishing a cervical cancer prevention program, which has resulted in the screening of more than 10,000 women for the leading cancer killer of women in the developing world.
In Indonesia, Dr. Mohammad Baharuddin, the Director of Budi Kemuliaan Hospital and Midwifery Academy, the largest and oldest maternity hospital in this nation of islands, adapted Jhpiego’s pioneering quality assurance program to improve care. As a result of Baharuddin’s leadership, more women are choosing to give birth in the hospital, with deliveries increasing from 3,000 in 2001 to nearly 8,000 now.
And in Afghanistan, Jhpiego helped the government establish a national midwifery education program. Since 2002, the number of skilled, competent Afghan midwives has increased from 467 to more than 2,000, and they are saving lives in a country with the second highest maternal mortality rate in the world.
“People in these rural communities prefer to deliver at home… but I try and explain that the facilities in the health center are much better for them and they can get more comprehensive care there,” said Sadiqa Husseini, a 24-year-old mother of two and 2009 graduate of a Jhpiego-supported midwifery school.
In 2011, Jhpiego will continue to assist Afghanistan in expanding its midwifery network; help develop a cervical cancer prevention program focused on mothers and daughters in Asia; and bring its expertise to neglected areas of West Africa.
“In the coming year, Jhpiego looks forward to working with countries and sharing innovations as they build successful independent health care systems,” said Jhpiego President and CEO Leslie Mancuso.
The Abell Foundation salutes Jhpiego’s worldwide staff and its President, Dr. Leslie Mancuso, for helping countries care for their own with competent, skilled providers and build stronger health systems because when you save the life of a mother, you help ensure her children will survive and her family will thrive.