Babies and Mothers Alive USA
This organization has already been registered
Someone in your organization has already registered and setup an account. would you like to join their team?Profile owner : m*******r@b*******************e.o*g
Mission Statement
Create partnerships that improve reproductive, maternal, and newborn health
About This Cause
In 2001, Drs. Daniel Murokora and Marc Sklar met in the Rakai District of Uganda; where they collaborated on research on screening methods for cervical cancer, a major killer of women in the developing world. Historically, Rakai was at the epicenter of the HIV/AIDS pandemic, with prevalence rates reaching 20% in the late 1980s; so, it was not an accident that they found themselves as partners in this region. Both Dan and Marc, are public health physicians, trained as obstetrician-gynecologists. Over 15 years they had each worked on many programs throughout sub-Saharan Africa and shared a frustration with top-down decision making, driven by short-term funding cycles, that failed to strengthen local health delivery systems over the long term. Together Dan and Marc founded Babies and Mothers Alive (BAMA), formerly Brick by Brick, in 2003. With just $5000 to start, their initial focus was limited to partnering with Ugandan Universal Primary Education School communities to rebuild crumbling infrastructure and create supportive learning environments. Through their start-up phase, they saw the power of building partnerships, rooted in trust, with both district government and beneficiary communities. Frustrated with the inefficiencies of local construction companies, they established a social-enterprise, Brick by Brick Construction Company, that is now a thriving independent business, employing 50 skilled masons with fair wage jobs. This experience informed BAMA’s program model with an impact investment approach that focuses on data driven decision-making in program design and implementation. Over the last seven years we’ve grown into a Ugandan-led Non-Government Organization with a broad spectrum of innovative programs in maternal, reproductive and newborn health, partnering with the Rakai and Kyotera District Governments, as well as the Ministry of Health and other relevant central government agencies. Our BAMA Program model builds longstanding, trusted partnerships with local district government with the shared view that sustainable development depends on the sexual and reproductive health and rights of women. We empower health providers within the government health system to become champions of maternal and child health and rights. Our corps of 30 Mentor Midwives has trained 300 of their peers, and 150 Mama and Papa Ambassadors, trained Community Health Workers, are our eyes and ears at the village level, increasing utilization of maternal and newborn health services. Through decades of work we have learned that it is only by building our programs in full collaboration and partnership with local and national government that dramatic improvements in the quality of health care within the public system can be sustainably achieved. Our Impacts With very modest resources the BAMA Program has realized dramatic improvements in maternal, reproductive and newborn health. From 2015 to 2021: • 72% decrease in maternal deaths at 48 partnering health centers and hospitals • 44% decrease in perinatal deaths at 48 partnering health centers and hospitals • Case Fatality Rate (the percentage of women dying from major obstetric complications) was reduced from 1.7% to 0.6% • 63% reduction in complicated abortions (spontaneous miscarriages) • 74% reduction in life-threatening hemorrhage both during pregnancy and post-partum • 39% reduction in obstructed labor • Reduction in the Decision to Delivery interval (DDI), which is the time from the decision to perform a cesarean to delivery, from 124 minutes to 59 minutes • Increase in facility deliveries from 9225 to 14,505 • Met need for emergency obstetric care increased from 54.9% to 73.2% In 2021: • 15,603 women screened for cervical cancer • 8,342 out of school adolescent girls and young women vaccinated for HPV, the virus that causes cervical cancer • 18,459 women transported from village to health center and 2009 women receiving emergency referral transport through our Mama Rescue Project. Time for referral reduced from 3 ½ hours to just 35 minutes since June 2021. • As of the end of 2021, 1706 newborns have been admitted to our three recently constructed NICUs, 92.3% were discharged alive. In 2021, the survival rate was 96%. • In partnership with FreO2 Foundation, we have installed their off the grid oxygen delivery system in 18 health centers and hospitals throughout Uganda. Cost Effectiveness of Our Impact Investment BAMA is a cost effective, NGO-Government partnership dramatically improving maternal, reproductive & newborn health in Rakai and Kyotera Districts. The core BAMA Program, focusing on skilled attendance at birth in 48 government facilities providing obstetric and newborn care, cost $1,731,196 from 2016-2020, serving 122,260 beneficiaries. Taking these BAMA costs, dividing by the 62,072 deliveries, we compute our cost per delivery at $27.89. This compares well with cost per delivery of $38 by Saving Mothers Giving Life (SMGL), a major USAID-funded program designed to reduce maternal mortality in 4 districts.1 The cost of our intervention per beneficiary served is $14.16. Since 2016, this investment has resulted in a 72% reduction in institutional maternal mortality, equating to a projected 68 lives saved. Perinatal mortality has decreased by 42.6% since 2016, resulting in 1163 lives saved. Our cost per life saved is $1406. In a study evaluating the cost effectiveness of Saving Mothers Giving Life, the cost per life saved was $10,311.1 Well-accepted interventions such as the promotion of mosquito nets cost $7500 per life saved.2 We are now ready to scale our BAMA Program model. We envision an innovation process within Uganda where the Rakai and Kyotera Districts serve as lead innovation zones, leveraging the capabilities and relationships we have built through the BAMA program to experiment, develop, and prove the potential of new program interventions and to further develop them over time by finding ways to deepen their impact. We believe that we have already built something very special with a high quality, motivated staff capable of ongoing innovation and the monitoring and evaluation capabilities to provide credible evidence for what is working. In sub-Saharan Africa, the quality of health delivery services is almost entirely determined at the district government level. Government-NGO partnerships can be a key to the implementation of innovative evidence-based maternal, reproductive, and newborn health interventions. Instead of traditional NGO programming with their grant-determined 3-5 year cycles and multi-country programs that are directed from centralized and most often foreign headquarter offices, our model is built on committed and long term partnerships with local district government and our beneficiary communities. From the beginning, program design and implementation has been defined and accomplished through the collaborative efforts of both BAMA staff and our district government partners. All of our health interventions are in full alignment with Ministry of Health priorities. In this next stage of the innovation process, our work in Rakai and Kyotera will be leveraged to spread the innovation to a group of early adopting districts, in the Masaka Region, representing a diversity of contexts and demographics. Results in these second-stage districts, together with distillation of the scaling model that enabled their successful adoption and adaptation, would set the stage for a third-phase of Uganda-wide spread of those interventions that have demonstrated sufficiently compelling cost-benefit justification and a robust scaling approach. Our pathway to Transition to Scale is three-fold: I. Expand the BAMA Program to our neighboring districts in the Masaka Region Our initial goal (3-years) is to expand to the two adjoining districts of Masaka and Kulungu, followed by scaling to the entire Masaka Region of nine districts serving a total of 2,218,286 people. Directly overseeing this expanded BAMA Program implementation will allow us to adapt our model to support sustainable integration of our core interventions into the existing government health system, our ultimate goal. II. Identify potential NGO partners in Uganda working in maternal, reproductive, newborn and early childhood health and development. Babies and Mothers Alive has a long history of high impact partnerships with national and international NGOs who are aligned with our mission. The establishment of a network of RMNCAH4 NGOs will support the dissemination our BAMA’s core innovations, and extend and expand the reach of our program. Through such partnerships, and the establishment of an RMNCAH Stakeholder network, we will support NGO-government collaboration, promoting BAMA integration into the government health system. III. Integrate BAMA into the district and national health system In building the BAMA Program in full partnership with district government and the Ministry of Health, we participate in multiple fora at the national level overseeing maternal, newborn, reproductive, and adolescent health. Our senior staff are respected thought leaders. We will work to leverage our success to date, encouraging the adoption of key components of our program model. For example, we have already seen our Maternal and Newborn Obstetrics Complication Survey (MNOCS) integrated into the government health data system. We hold the firm conviction that the ultimate experts in how to build strong and healthy communities in a country like Uganda are not to be found in the carpeted conference rooms of think tanks or the podiums of conferences. The ultimate experts are to be found among the people living in the communities we serve. They are rich in ideas, experience, and local knowledge – what enables them to succeed is the catalytic power of seed capital and resources. Babies and Mothers Alive is not just another program led by “outside experts.” It is built to put power and resources in the hands of those who already hold the solutions.