By Past District Governor Dr. Himansu Basu, Rotary Foundation Cadre Technical Coordinator in Maternal and Child Health
Three mothers and twenty babies die every five minutes; the majority of these deaths occur in Africa and the Indian subcontinent. I was always aware of the huge global burden of maternal and new born deaths, many of which are preventable.
When my Rotary district was chosen to be a part of the Future Vision Pilot in 2010, we saw an opportunity to support a project focused on maternal and child health. I realized that to make a meaningful and sustainable impact, the programme would have to be strategic with measurable impact and evidence-based components. It became clear that such an innovative programme would need to be tested as a pilot with close monitoring and evaluation.
Many of my friends and supporters in global professional organisations, governments, NGOs and of course Rotary at all levels helped develop the initial programme. Through these collaborations, the Calmed (Collaborative Action in Lowering of Maternity Encountered Deaths) programme was conceived.
It became obvious that although maternal and child health was a designated area of focus for Rotary International, the problems were not very visible to many Rotarians and non- Rotarians. Many didn’t know about the high life time risk of woman dying at childbirth: 1 in 40 in Nigeria, 1 in 250 in India and 1 in 5900 in the United Kingdom.* Even though these deaths were largely avoidable, they continued to occur in areas with limited resources.
Leveraging the Rotary Network
As part of the pilot, we also identified a need to mobilize and strengthen resources available within Rotary, including professionals (doctors, nurses, midwives, hospital workers and volunteers) who would support effective maternal and child mortality reduction programmes.
As chairman of International Fellowship of Rotarian Doctors, it was natural for me to promote the Calmed programme to a global audience through Rotary International conventions, regional and district conferences, international institutes and other meetings. I accepted the Medical Directorship role with the Rotarian Action Group for Population and Development, a RI group of technical experts who advise on Rotarian-led maternal and child health programmes.
As a Rotary Foundation Cadre Technical Coordinator in Maternal and Child Health, I remain engaged and connected with Rotarians seeking assistance with programmes and projects related to reproductive, sexual health and family planning.
What is the Calmed programme?
The Calmed programme utilizes the train the trainer model to build medical expertise in emergency obstetric and new born care. The programme also raises awareness of pregnancy and child birth related issues in rural villages with limited access to larger health care facilities.
The third component of the programme analyses all maternal deaths to identify avoidable causes and makes recommendations for corrective action (Maternal Death Surveillance Response- MDSR). As the state of the art programme evolves, we continue to add new elements and technologies such as Kangaroo Mother Care (KMC), anti-shock garments (NASG), Golden Hour concept, etc. to address identified needs.
Calmed Vocational Training Teams:
There are three Rotary Global Grant funded Calmed programmes that are currently taking place in:
- Sikkim, India l Target population 0.7 million – introduced in 2013, with repeat visits in 2014 and 2016.
- Bhuj, Gujarat, India l Target population 2.5 million – introduced in 2014 with a second visit in 2016.
- Madhya Pradesh, India l Target population 3.5 million – preparatory work is in place and the visit is planned for October, 2016.
So far, these teams have trained 39 approved Master Trainers (goal is 100). These Master Trainers have trained 264 doctors and nurses (goal is 500) in emergency obstetric and new born care, as well as 95 ASHA trainers.
Impact of Calmed Vocational Training Teams:
The primary aim of the programme is to enhance trained workforce in the emergency care of pregnant women and babies and to improve participation of village women groups in raising awareness for health care issues during pregnancy and childbirth. Doctors and nurses in target areas have reported increased confidence in tackling emergencies since the inception of Calmed. A three year follow up from Sikkim shows progressive reduction of maternal deaths to a quarter of yearly deaths in the population since Calmed was introduced 3 years ago.
What can you do?
- Invest in women and children’s health as it is vital for sustainable economic and social development.*
- Unleash the power of vocational expertise of Rotarians and professionals, the Calmed VTT programme is a template for action.
- Share Calmed’s success stories and consider introducing the programme in areas with high rates of maternal and child mortality.
The Rotary Calmed programme is an award winning programme having received two coveted national awards – The Times Sternberg Award in 2015 and Rotary GBI Champions of Change Award of 2015-16.
*[World Bank 2014], *[PMNCH, 2013]