Tackling Extreme Poverty Through CHildren And Mothers PartnershipS

(CHAMPS)

CCIH 29th Annual Conference June 27, 2015

Adrian V. Kerrigan Senior Vice President For Partnerships

CMMB: Who We Are

Founded in 1912, CMMB is the oldest and largest U.S.-based Catholic nonprofit organization focused primarily on international healthcare.

Our mission: to work collaboratively to provide quality healthcare programs, without discrimination, to people in need around the world.

CMMB’s strategic focus is on women and children, with attention to HIV, health and nutrition, water and sanitation, and economic empowerment.

CMMB has been involved extensively in building sustainable health programs and strengthening health systems across the globe, placing volunteers, and delivering essential medicines in over 110 countries.

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An Introduction to CHildren And Mothers PartnershipS

(CHAMPS)

Extreme Poverty Leads to Poor Health

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• In high poverty areas, health systems are weak, with resources insufficient for quality preventive and recuperative health services for women and children.

• For families in resource-poor communities, information and options with respect to healthy behaviors and where to get quality care is often inadequate, leading to low demand for care services, delayed uptake, and poor treatment compliance.

• Additionally, high poverty levels in these communities limit families’ ability to travel to access health care and other services—and to afford treatment upon arrival.

• High poverty often leads to malnutrition and poor sanitation, which makes people more vulnerable to severe diseases.

Extreme Poverty Specifically Impacts Health Services

Delays or even failure in the diagnoses and treatment of potentially life-threatening illnesses that could otherwise be avoided through prevention

Delayed and otherwise poor quality responses to health emergencies

Major gaps in knowledge and service among health personnel and facilities

Shortages or stockouts of critical medication

Women and Children are the Most Affected

Maternal and infant mortality rates remain distressingly high in the countries where CMMB has initiated local CHAMPS programs—Haiti, Kenya, Peru, South Sudan, and Zambia. On average across these countries, • 72 children of every 1,000 do

not survive to their fifth birthday

• 654 women die in childbirth for every 100,000 live births.

Malnutrition is a contributing

factor in about 45 percent of all child deaths.

Need for Long-Term, Comprehensive Approach

Many efforts to address these problems have:

• Been too focused on the short-term • Not used an integrated approach

The efforts have too exclusively targeted health, and not the broader

conditions that contribute to poor health.

Communities and local leaders have too infrequently been empowered to lead these processes, and have been consulted but not meaningfully engaged,

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How Will CHAMPS Make A Difference?

Through CHAMPS, CMMB has made 15-year commitments to vulnerable communities to implement integrated, holistic programs targeting the leading causes of morbidity and mortality among their women and children, convening local and international partners in support of the work.

Each local CHAMPS program is linked to a referral hospital or other large

health facility within the existing system. Critical components of this initiative include (but are not limited to):

• Providing nutrition and economic empowerment • Strengthening health systems

Continuous communication among partners will ensure efficient, effective use of resources.

Short-term goal: At least 20 local CHAMPS programs in Latin America, the Caribbean, and Africa by 2020.

Nutrition and Economic Empowerment in Action

Côtes-de-Fer, Haiti

Côtes-de-Fer Situation

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Community assessment of health, economy, livelihood, water and sanitation highlighted a number of serious malnutrition and economic development issues; for example:

• Many people in Côtes-de-Fer do not

have enough protein in their diet

• Meat and other potential protein sources (such as fish, milk, or cheese) are often out of reach for many residents due to financial constraints and transportation issues (particularly given that very few roads in the area are paved, and none are well-maintained).

CHAMPS Côtes-de-Fer Nutrition and Economic Empowerment Program

In response, CMMB developed a five-year CHAMPS work plan for the first phase of activities aimed at improving access to health care and community-based services.

These activities include a Nutrition and Economic Empowerment Program which has five main components aimed at improving nutritional intake and supplementing family income among participants: • Animal Husbandry • Home Gardens • Community Gardens • Nutrition Education • Microenterprise

Nutrition and Economic Empowerment Program

Strengthening Health Systems

Strengthening Health Systems

Improve women’s and children’s access to health care services, by: • Providing better support to clinics in underserved communities: • Improving responses to health emergencies: • Expanding integrated outreach services to communities: Expanding

enrollment in insurance systems (as applicable): Improve the quality of such services, particularly through:

• Improving skills and knowledge among through capacity building of local health personnel:

• Improving diagnostic and management capacity among community health facilities

• Increasing human resources for provision of health care services: Improving supply chain management:

Expand services through community health workers (CHWs) with the

objective of improving community empowerment over vital health issues.

Mwandi, Zambia

Mwandi, Zambia

Challenges: • Power outages, no generator, no telephone or radio • Lack of basic equipment (e.g. No sterilizers) • Significantly understaffed & underfunded with many

unfilled positions These difficulties have had a negative impact on a

number of health-related issues. • Vast majority of expectant mothers in Mwandi

receive antenatal care only in the last month of pregnancy

• Half of surveyed mothers who had children under 5 years of age confirmed upper respiratory infections in their child within the past two weeks & only a little over half of those children (53.09%) got advice or treatment from a health facility or a health care provider.

Mwandi, Zambia

Solutions: CMMB’s CHAMPS partners will

• Supply needed equipment • Ensure better training and education are provided to

CMMB will: • Collect information on staffing levels and supplies of health commodities • Advocate the recruitment of health staff to address manpower issues. • Provide tools and training to improve supply chain management. • Train health professionals and community health workers (CHWs) • Hold meetings with traditional leaders to promote healthy behaviors. • Map stakeholders and conduct conferences to train such groups and

structures. • Develop a stakeholder directory to share information on community networks,

expedite proper service delivery, and advocate the development of more infrastructures to improve access to health care.

Huancayo, Peru

Huancayo, Peru

Challenges: Prenatal care includes basic clinical

elements, but educational and counseling dimensions are lacking • 85.3% of pregnant women

surveyed did not have any counseling

• Fewer than half of surveyd mothers could name 3 key occasions during the day when they should wash their hands

• Only 39.9% of surveyed pregnant women had received tetanus vaccination

• 95.1% of 2 yr olds are not screened for height, weight or other measurements

Huancayo, Peru

Solutions: Conduct workshops for CHWs on topics vital to health promotion and

preventing maternal and child morbidity and mortality. Train and support facility-based health providers to offer education and

counseling on danger signs, the most common gynecological complications, birth preparedness • Through an inter-institutional agreement with the Regional Health Directorate

in Huancayo, CMMB also will train health professionals in the “Helping Babies Breathe” method, and provide four training mannequins.

Provide enhanced training and supervision for community health agents so that they are able to convey key messages to woman regarding prevention and screening of cervical cancer.

Develop suitable communications materials to raise awareness of these services, and help provide supplies to carry out screenings for diabetes and cervical cancer.

Côtes-de-Fer, Haiti

Côtes-de-Fer, Haiti

Challenges: Côtes-de-Fer currently has only three health facilities, most of which do

not have the resources to deal with the problems in the region. Most people must travel great distances to reach the facilities. Solutions: CMMB is building the Bishop Joseph M. Sullivan Center for Health, which

will be a cost-effective facility providing primary healthcare Official groundbreaking ceremony held on January 13, 2015 Dematteis Construction Group (DCG), CMMB’s primary construction

contractor, has begun laying the foundation for the Center. CMMB is stepping up efforts to provide the necessary material and human

resources to support the Center once it has been built, • Train local Sisters of Charity of St. Louis to help operate the Center • Build a water collection and filtration system that will serve both the Center

and the surrounding community.

Mutomo, Kenya

Mutomo, Kenya

Challenges: According to a recently-completed CHAMPS assessment, 74% of respondents had never seen a doctor, while 71.4% had never seen

a nurse or midwife; 96% had never seen a community health worker. 51.3% did not deliver their children at a health facility, thereby increasing

the risk that complications and infection could cause morbidity and mortality to either the mother or the baby; • the most common reason cited (43.5%) was that the relevant facility was too

far away. 30% of children under five years of age had had a fever in the preceding

two weeks, compared to the national average of 24%.

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Mutomo, Kenya

Solutions: Improve the skills and knowledge of health

care workers by: • Conducting needs assessments • Providing recurring training sessions • Conducting 12 monthly Continuing Medical

Education classes • Conducting exchange visits to other facilities in

Kenya to learn best practices

Improve the diagnostic and management capacity of the facilities for maternal, neonatal, and child health (MNCH) and non-communicable diseases (NCDs), by mapping service deliver points, outreach mechanisms, critical medication needs, and prioritizing equipment needs.

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Nzara, South Sudan

Nzara, South Sudan

Challenges: Local residents face major challenges in accessing quality health care,

especially with respect to maternal and child health care services. These problems include: • Long distances on poor roads that are sometimes impassable • Lack of transport to reach the few available health facilities • Understaffed/ poorly staffed health facilities; and poor health facility

infrastructure, equipment, and supplies. Many of these problems are due in part to decades of civil war, as well as

raids by warlord Joseph Kony’s Lord’s Resistance Army, which have devastated the area’s infrastructure.

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Nzara, South Sudan

Solutions: Advocating among local, state, and

national government authorities for • Increased levels of skilled staff at all

health facilities • Effective supply chain management

Conducting a further assessment of staffing gaps and needs.

Providing hospital management and support to guarantee basic services are provided at local institutions

Recruiting and placing volunteers and short-term technical experts in Nzara based on emerging needs, as appropriate.

Call To Action

Call To Action

Through CHAMPS, CMMB is making a long-term commitment to the world’s most vulnerable communities that will improve the health of women and children for generations to come.

Through comprehensive, holistic efforts to improve nutrition, provide economic empowerment, and strengthen health systems, CMMB seeks to reduce sickness and death among women and children in targeted communities.

CMMB seeks additional partners to support this life-saving initiative, thereby giving women and children—and their respective communities—the opportunities to thrive that they deserve.

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Thank you