Emory Nursing Maternal and Neonatal Health in Ethiopia Partnership

Mother Recognizes Danger Sign of Bleeding During Pregnancy

bahir darWhen the bleeding started without labor, Birhane Simeneh suspected something was wrong. But having been prepared for such a possiblity, Simeneh, a 40-year-old mother of six, knew to seek medical care for the complication right away. Her informed decision likely saved her and her baby’s lives.

Simeneh, who lives in rural Amhara, Ethiopia, learned about the dangers of late pregnancy hemorrhage through the Maternal and Newborn Health in Ethiopia Partnership (MaNHEP), a Bill & Melinda Gates Foundation-funded project at Emory’s Nell Hodgson Woodruff School of Nursing. As part of its effort to demonstrate a community-oriented model for improving maternal and newborn survival in Ethiopia, MaNHEP is working with pregnant women and frontline health workers to build knowledge and skills in the delivery of a basic package of life-saving maternal and newborn health care during the critical period from birth through the first 48 hours of life.

In addition to training, MaNHEP is supporting quality improvement (QI) teams to strengthen those systems needed for maternal and newborn health care. They include systems for identifying pregnant women should complications arise, and notifying health workers of births in order that care can be delivered in time, every time.

When Simeneh recognized the danger sign of bleeding, she contacted her birth attendant, who already knew that Simeneh was approaching her delivery date through the work of her village’s 14-member QI team. The attendant quickly mobilized neighbors and relatives to transport Simeneh to a local health post where a health extension worker determined that her condition warranted emergency treatment at a nearby hospital. Simeneh later delivered a healthy baby by caesarean section.

As the different components of MaNHEP start working together, many more women are expected to have experiences like Simeneh’s. If successful in Amhara and Oromiya Regions, the project will be scaled up throughout Ethiopia beginning in 2013.

“Ethiopia has one of the highest maternal and newborn mortality rates in the world,” said Lynn Sibley, PhD, RN, FACNM,  FAAN, MaNHEP principal investigator and director and associate professor at Emory’s Nell Hodgson Woodruff School of Nursing. “We’re confident that our model can help transform the way that women and newborns receive essential care.”

Photo caption: Knowledge gained through MaNHEP's Community Maternal and Newborn Health Training Program enabled Birhane Simeneh (left) and her birth attendant (right) to recognize the danger sign of bleeding during pregnancy.