About

What We Do

Save A Mother, a not for profit organization founded in December 2007 has devised a simple solution for saving women and new born lives: an aggressive health literacy program that trains volunteer village health activists to educate, empower and connect pregnant women to public health systems.

The impact has been astounding: within three years of intervention, maternal mortality rates have decreased by 93% and new born mortality rates by 66% in almost 1000 villages (representing a population of approx. 3 million and approx. 300, 000 households) in the state of Uttar Pradesh, India. Uttar Pradesh is one of the poorest states in India where the number of maternal and child deaths are amongst the highest in the world.

Our program’s impact has been delivered at the cost of $100 per village per year.

The qualitative impact of our program has far greater ramifications. Empowerment of women through access to knowledge has increased demand for public health services leading to an improvement in public health delivery. In addition, empowerment through health appears to be influencing other realms such as attitude towards education of women.

The Problem

With a maternal mortality ratio (MMR) of 212 per 100,000 (2011) live births, India has the highest number of maternal and new born deaths in the world. Uttar Pradesh in particular has the highest MMR (reported at 440 as of 2011) in India. Although ninety percent of deaths are preventable, the cost of private health care, lack of skilled health care workers and inadequate access for women to basic information during pregnancy and childbirth are key issues that are compounded in Uttar Pradesh, one of the poorest states with amongst the lowest literacy rates in the country. We found an MMR of 645 per 100, 000 live births in Sultanpur district in Uttar Pradesh when we started working in the area in 2011.

The Philosophy

Save A Mother approaches health as a responsibility more than a right; viewing health as a personal responsibility thoroughly changes the mindset of villagers, and when coupled with access to information, empowers them to transform the health of their community.

The Approach

Seven Health Practices: Save A Mother runs a program of seven health practices that is communicated repetitively through a variety of low technology media and forums, from master trainers to volunteer village health activists down to women and families.

A summary of the seven health practices is provided below:

1. Regular meetings and discussions in the community to identify needs, build on existing knowledge base, collaborate on finding solutions with the community, and effect behavioral change.

2. Personal hygiene: Illnesses such as diarrhea, dysentery, cholera, worms, typhoid, skin infections ,and dental problems spread due to lack of cleanliness and can be prevented through adopting clean habits.

3. Pregnancy best practices: A health activist takes responsibility for each pregnant woman to ensure they:

• Register with a local clinic.
• Get 3 to 4 check-ups during their span of pregnancy
• Take 100 iron pills
• Get immunized
• Eat a balanced diet
• Have an institution delivery; if not, to have a skilled midwife attend the birth.

4. Infant care: Breast-feeding after birth, exclusive breastfeeding for six months, cord care, hygiene, immunizations, registration with a clinic, follow up with the mother ,and counseling family members.

5. Cooperation with public health workers: Invite public health workers to community meetings, spread awareness regarding public health facilities, clinics and workers in villages, and help public health workers in their work.

6. Child immunization and nutrition: Create awareness in community regarding immunization, nutrition advice after six months of exclusive breastfeeding, and encourage weighing the children in public health centers to monitor growth.

7. Adolescence health education: Create awareness adolescence is a period of rapid physical and emotional development.

Partnering with a Local Organization:

Save A Mother works in tandem with other not for profit organizations. The collaboration provides a platform for intervention and access to resources such as self-help groups and training centers.

Training and Education:

Save A Mother currently employs six master trainers who in turn educate one volunteer health activist per village in the seven health practices in an initial three day training course. All master trainers are from adjoining villages and speak the local language and dialect. Volunteer health activists who form the backbone of our program are also recruited from the community and trained to provide basic knowledge on reproductive health and sanitation. These health activists also link the community with the existing public health services. One day refresher training courses for health activists are held 8 to 9 times a month. Health activists in turn talk to women in their village once a week, and meet in a larger group (cluster level) once a month.

Flip charts that use visuals and graphics drawn by villagers and printed in the village are used for training, along with folk songs and repetitive lectures. Villagers are educated on a one to one basis, through weekly meetings and through self help groups. Training and education is an intense, continuous process that makes our program replicable and scalable.

Our Impact

Geographic spread:

As of March 2011, we have ~1300 health activists working in ~950 villages, representing a population of approximately 3 million and approximately 300, 000 households. We are currently in three states and five districts (Sultanpur, Rae Bareli, and Azamgarh districts in Uttar Pradesh, Jhansi in Madhya Pradesh, and Chikballapur in Karnataka) in India. Our program is currently growing at the rate of thirty villages per month and we aim to add a thousand villages per year to our program.

Quantitative Impact:

As of December 28, 2010, we find that the maternal mortality ratio has decreased by 93 % and new born mortality by 66%. As of March 2011, there has not been a single maternal or new born death reported.

We find that this bottom-up, low technology approach by directly engaging the community has provided a solution to maternal and newborn mortality that is simple, sustainable and scalable with speed.

Events	Before training May to Nov 09 (22 blocks)	After training   Nov 09 to June 11 (37 Blocks)	Decrease
Number of deliveries	1550	7719
Maternal  deaths	10 (MMR 645)	4 (MMR 51.8)	92%
Neonatal  deaths	63 (NMR 40.6)	136 (NMR 17.6)	57%

 

Qualitative Impact:

Empowerment of women through health has encouraged health seeking behavior, in turn inducing demand for public health services and consequently improving health services delivery.

A more nuanced impact has been the opening of womens minds to new knowledge that goes beyond health. An increasing number of women are stepping out of their homes to attend meetings and participate in self help groups, and we find that women are increasingly becoming vocal about a variety of issues, including educating the girl child.

Future Plans

Save A Mother’s mission is to develop health solutions for the poor. We believe that an entire self-sustaining health care ecosystem can be designed with 20-25 “plug and play” modules that include health programs as well as programs in infrastructure and finance.

We started with a maternal and new born mortality reduction program using health literacy in 2008. This module has been implemented and can be replicated and scaled with speed. In 2009, we also initiated programs on eye care, TB and malaria eradication, and adolescence and reproductive health. In 2011, we are launching an under-5 child mortality reduction program. In 2012, we will develope and implement a health IT program to manage rural health clinics and to capture public health data from the villages.

We will launch a maternal mortality reduction program in Gadag district of Karnataka. We are also exploring districts in Rajasthan, Haryana, and Madhya Pradesh.