Maternal and Child Health

“Immediately after the program launched, I would hear about these moms and babies dying and think, ‘We’ve been here before.’ It was like the early days of the HIV epidemic all over again. I wondered if we had made a mistake, but then we saw those numbers turn around completely and trend in the opposite direction. I knew we were on to something.” – Jenny Schechter, Executive Director

In Togo, the national maternal mortality ratio is an unacceptably high 368 deaths per 100,000 live births; child mortality is equally staggering at 78 deaths per 1000 live births. That’s 15 times the rate for developed countries. The majority of these deaths are from diseases that are entirely treatable at very low costs, diseases like malaria, diarrhea, and pneumonia. Unfortunately, Togo lacks the functioning healthcare system required to deliver effective treatments to women and children in need. Essential healthcare systems, including personnel, supplies, and training, are currently absent or insufficient throughout much of the country.

In 2012, after being approached by a group of women who had successfully delivered HIV-free babies through our prevention of mother-to-child transmission program, Integrate Health began to consider how the HIV model could be applied to the child mortality crisis. We began with a baseline study that allowed us to really look at the problem in depth. We conducted intensive interviews, hosted community meetings, and talked to the people directly impacted who could provide the most input. Our MCH program built best practices and community insight into a model that already worked.

Integrate Health demonstrated the initial effectiveness of this model through an interrupted time series study. Over 18 months, preliminary data revealed an observed 70% reduction of under-five mortality in the communities where we worked. Additional results will be gathered from 30-month data to be collected via an annual household survey of reproductive-age women in early 2018.