A mother and her baby wait for an appointment at an Afya Jijini clinic in Nairobi, Kenya. (Craig Thompson/IMA World Health)
A mother and her baby wait for an appointment at an Afya Jijini clinic in Nairobi, Kenya. (Craig Thompson/IMA World Health)

Achieving results in some of the toughest environments in Africa

Background

Pregnancy and childbirth are the most dangerous times in a woman’s life in Sub-Saharan Africa. Nearly 303,000 women die during childbirth each year, primarily from postpartum hemorrhage, pre-eclampsia/eclampsia and obstructed labor. Their newborn and young children are vulnerable as well, at risk of dying from infections. More than 1.5 million children die each year from vaccine-preventable diseases.

Despite these challenges, much progress has been made in recent years in ending preventable maternal mortality, thanks in part to advocacy and funding around the Sustainable Development Goals and greater country ownership. IMA contributes to these efforts by helping health systems provide effective facility- and community-based care to mothers and newborns.

In South Sudan and the Democratic Republic of Congo, IMA works with communities to encourage antenatal care and deliveries at health facilities, where IMA-trained health care workers provide skilled attendance at birth. Health care workers provide basic Emergency Neonatal and Obstetric Care, providing women Active Management of the Third Stage of Labor, Pre-Eclampsia/Eclampsia Treatment, and treatment for post-partum hemorrhage.

For infants and children, IMA assists facilities in providing screening and treatment of newborn and childhood infections. IMA also helps Ministries of Health forecast, administer and manage essential vaccines for childhood illness in DRC and South Sudan. At the community level, IMA encourages countries to roll out Integrated Management of Childhood Illness at both the facility and community levels, where appropriate.

More on our programs

Access to Primary Health Care Project (ASSP) (2012-Present): IMA prioritizes delivering essential health packages that improve maternal, newborn, and child health for ASSP. Using a comprehensive approach, the project helps train healthcare workers in safe delivery, including delivery of emergency obstetric and neonatal care services. Some key achievements include:

  • 779,022 births during the year were attended by skilled health personnel
  • Reached 834,782 children under one year of age with vaccinations against measles
  • 675,287 pregnant women were provided with two doses of intermittent preventative treatment as prophylaxis for malaria
  • More than $16 million in medicines were procured for distribution and use at health facilities within ASSP’s 52 health zones
  • By the end of year three, 21 new health centers were built and 93 health facilities were rehabilitated.

Provision of Reproductive Health Services Project (2014-present): The UNFPA-funded project provides new services through mobile clinics and outreach as well as through strengthening local capacity to implement the Minimum Initial Service Package for reproductive health, including interventions to address gender-based violence, sexually transmitted infections and HIV services. It also supports sexual and reproductive health outreach activities in partnership with community-based organizations or support groups. Internally displaced people, who would have otherwise had no access to reproductive health services, are seeking services at an average of 200 patients per month at the temporary clinic in Mingkaman, where thousands of IDPs from Jonglei are still encamped. The program includes procurement of supplies, which is no small feat; the remoteness of the area makes it difficult to obtain quotes, especially given the rapid inflation of the South Sudan pound, and materials usually must be transported by small boats that can carry only a few cartons at a time as they cross the Nile from the city of Bor.

Rapid Results for Health Project (2013-present): IMA ensured that health care worker training and critical commodities for EPMM services reached some of the most rural health facilities in this 24 County primary health care improvement project. More than 53,000 women received at least one antenatal care visit last year, despite ongoing conflict that makes access and treatment difficult.

Afya Jijini (2015-2018): Afya Jijini, which translates to “health in the city,” is a three-year USAID contract (with two option years) with the strategic goal of improving Nairobi City County’s institutional and management capacity to deliver health services. The program will improve access to and use of maternal, neonatal and child health services; family planning and reproductive health services; water, sanitation and hygiene; and nutrition services. In its first year, the USAID-funded Afya Jijini project supported Nairobi City County to scale up and make maternal and child health services available not just five but seven days a week at 35 of the county’s busiest sites. More than 3,000 mothers were reached with focused antenatal care and other maternal, neonatal and child health services as a result of the availability of weekend services. An additional 7,000 children benefited from weekend child health interventions.