Saving Mothers, Giving Life Initiative

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Overview

Saving Mothers, Giving Life (SMGL) was a 5-year initiative that tested a multi-system approach to rapidly reducing maternal deaths. From 2013 to 2018, SMGL operated in study districts in Uganda and Zambia. The initiative was supported by a multi-sector public-private partnership including CDC. CDC’s Monitoring and Evaluation results show that the maternal mortality ratio in these districts fell by 44% in Uganda and 41% in Zambia during this period.

SMGL’s Multi-System Approach to Reducing Maternal Deaths

The Saving Mothers, Giving Life Initiative began with a bold goal: to reduce maternal deaths by 50% by focusing on the period around labor, delivery, and the first 48 hours postpartum when many maternal and newborn deaths occur.

Women who experience obstetric complications can encounter one or more of the “3 Delays” that can lead to maternal deaths. SMGL aimed to reduce the “3 Delays” by working to strengthen the whole health system serving pregnant and delivering women in the project districts so that:

  • every pregnant woman has access to clean delivery facilities with skilled care.
  • any woman experiencing a pregnancy or birth complication can reach high quality lifesaving emergency obstetric care within 2 hours.
First Delay
Delay in deciding to seek appropriate services

First delay - Deciding to seek medical care

 

The pregnant woman, her family, and her community need to be able to recognize she is experiencing a complication and be able to act swiftly to get her to skilled care. 

Birth preparedness, promoting facility delivery, and transportation access are needed.

Second Delay
Delay in reaching medical care

Second delay - Reaching medical care

 

Any pregnant woman needs to be able to reach Emergency Obstetric and Neonatal Care facilities in 2 hours or less.

Access to these facilities is improved when there is emergency transportation, maternity waiting homes, and more facilities (new or upgraded) available.

Third Delay
Delay in receiving timely, appropriate care

Third delay - Receiving timely, appropriate care

 

When a woman with an obstetric complication reaches an emergency facility, she needs to receive high quality treatment immediately.

Facilities need to have the appropriate equipment, supplies, and trained staff ready at all times.

High quality care requires many aspects of the health system to work well and to work together. SMGL’s multi-system approach made improvements in each of the following components of maternity care:

  • Skilled caregivers at birth
  • Safe facilities and hospitals for delivery
  • Supplies for and provision of basic and emergency obstetric services
  • Systems for communication, referral, and transportation that are available 24 hours a day, 7 days a week
  • Quality data, surveillance, monitoring, and evaluation

SMGL made these improvements by working in a number of organizational areas, such as:

  • Upgrading health facilities
  • Improving health provider skills
  • Increasing family planning availability
Saving Mothers, Giving Life Initiative Approach

Saving Mothers, Giving Life Initiative Approach
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To do this, SMGL worked at a number of organizational levels:

  • Individual & family
  • Community
  • Individual health facility
  • Regional/district health system
A Timeline of CDC SMGL Activities
A Timeline of CDC SMGL Activities: SMGL occurred across two phases. SMGL’s first year was a “proof of concept” phase. Phase 2, the “scale up” covered the remainder of the initiative.

SMGL’s first year (Phase 1, 2012–2013) was a proof of concept phase.
Phase 1 Evaluation Results

Phase 2, the scale up phase, covered the remainder of the initiative (2013–2018).
End-of-Project Evaluation Journal Articles

The 5-year Saving Mothers, Giving Life initiative was supported by a multi-sector public-private partnership

Every Mother Counts
Zambia flag
Merck
American college of obstetricians and gynecologists
US Department of Defense
Uganda flag
Norwegian Ministry of Foreign Affairs
Project Cure
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