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Since CARE takes an integrated approach to fighting poverty, our reproductive and maternal health efforts are combined with other projects — including girl's education, water and sanitation, micro-enterprise and children's health — to maximize the benefits to communities and households.
Reproductive Health
CARE's Reproductive Health Program works to increase the accessibility, quality and use of reproductive health information and services in more than 30 countries through a variety of partnerships. CARE's reproductive health projects encompass family planning, maternal and newborn health services, and the prevention, detection and management of sexually transmitted infections including HIV/AIDS.
In designing our projects, CARE uses a framework that outlines the six key elements of any reproductive health project:
- Conduct a thorough analysis to understand the problems in that context;
- Promote healthy behaviors at the individual, household, community and institutional levels;
- Empower communities to advocate on their own behalf;
- Ensure that the "current best (optimal) health technologies and approaches" are being utilized, relevant for the local setting;
- Advocate for supportive policies; and
- Assist in building the capacity of institutions to be able to provide quality reproductive health services.
Maternal Health
Addressing the high death rate among women during pregnancy and childbirth is one of the key goals of the United Nations' Millennium Development Goals. CARE works to contribute to this goal by concentrating efforts to enhance maternal health programs, with an increased focus on the specific needs of the newborn.
Below are just a few examples of how CARE works with communities and delivery facilities to promote better maternal health and reduce the number childbirth-related deaths:
Improved transportation promotes timely health care in Tanzania
Limited transportation can prevent women from receiving timely, and often lifesaving, maternal heath care. In Tanzania, CARE worked with local communities to develop emergency transportation systems that included everything from boats to ox-carts to address the specific transport barriers within each community. At the time of project evaluation in 2001, more than half of the communities had up-to-date action plans to address maternal health problems, and more women were being referred for emergency obstetric care at the facilities. This program promoted the involvement and participation of local community members in addressing their health problems and contributed to a healthier maternal population.
Stronger community relationships improve access to health care in Bangladesh
Working with partners, CARE implemented the Dinajpur Safe Motherhood Initiative — a three-pronged program to improve maternal health through a combination of efforts at the community- and clinic-level. The program focused on promoting birth planning, community mobilization, facility improvements, and better recognition of the "social aspects" of emergency obstetric services. As a result, utilization of health services increased from 16 to 40 percent.
Verbal autopsies improve women's health in India
In the event of a childbirth-related death, interviews with caregivers and next of kin provide a "verbal autopsy" that is used to target key problems that might help prevent future unnecessary deaths, and increase overall maternal survival. CARE collected verbal autopsies of maternal and neonatal deaths in Allahabad and discovered that the main problems included 1) delays in getting referrals from birth attendants; 2) lack of transport; and 3) delayed or limited of blood for transfusion. For the women who died, over 80 percent of their newborns died within 28 days. CARE used this information to educate women on danger signs and birth planning, involve men in community actions to support pregnant women. We were also able to update the birth attendant training curriculum on the importance of timely referrals and provide additional training for private medical practitioners.
BABIES program improves newborn care in Peru
CARE worked with the Ministry of Health in Peru to promote the survival of newborns by using hospital data to improve the quality of essential newborn care. The program used the BABIES methodology, which addresses the newborn's birth weight and age of death to provide a deeper understanding of the causes of neonatal mortality and help determine appropriate interventions at the facility and community levels. CARE's work in newborn health has expanded to other countries in Latin America — Bolivia, Nicaragua, and Guatemala — where we work at the community and facility levels to address the high rate of neonatal mortality. The program focuses attention on providing essential newborn care services.
Enhancing post-partum care in Guatemala
The period after delivery is critical to the survival of women and newborns, especially within the first 24 hours. CARE's maternal health program focuses on health care during the post partum period — particularly for women who deliver at home. In Guatemala, CARE incorporated a post-partum care component into its Title II project. As a result use of post-partum care services jumped from 7.5 to 39 percent in the first week. Health center referrals by traditional birth attendants for postpartum care increased from 1 to 20 percent, and 75 percent of the project personnel provided information on partum care and newborn care, using international protocols.
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