Working together for a better world
Central America: Fortification of foods with micronutrients
Adequate nutrition, including adequate intake of micronutrients, is essential for good maternal, infant and child health. Fortification of foods with micronutrients is a proven strategy for improving the nutritional status of women and children. The goal of this project is to recommend uniform norms and standards for fortification of foods with micronutrients across the Central American countries. This is a five year project with major funding from the Inter-American Development Bank. Partner organizations include the Pan American Health Organization, the Institute of Nutrition of Central America and Panama (INCAP), the U.S. Centers of Disease Control and Prevention, Ministry of Health of Costa Rica, March of Dimes Foundation and Project Healthy Children. The objectives of this project are to develop recommendations for levels of micronutrients, including iron, folic acid, B-complex vitamins, vitamin A, zinc, iodine; and foods to be fortified, including wheat and corn flours, sugar and salt. In order to ensure quality of the fortified foods, the project will develop recommendations for quality control measures at sites of production and for laboratory monitoring of the food products. The project impact will be measured through a baseline epidemiological surveillance study followed by epidemiological impact evaluation, focused on rates of neural tube defects (a birth defect of the spinal cord that can result from low folic acid intake by the mother), as well as other indicators. Project activities include outreach and advocacy for adoption of recommendations by legislative bodies within each country and by regional commissions.
India: Improving maternal and infant health through community education and care
Providing good prenatal and newborn care to women and infants living in rural or peri-urban areas continues to be a challenge in low-income settings worldwide. The goal of the Global Programs partnership in India is to reduce maternal and infant mortality in a region of central India (Belgaum District, Karnataka State). Our partner, the Jawaharlal Nehru Medical College/KLES Prabhakar Kore Hospital and Medical Research Centre, Belgaum, has developed a track record of success in reaching women and infants who have little access to care. The partnership has developed three initiatives. The first, which began in 2004, focused on training medical officers and auxiliary nurse midwives (ANMs) in rural areas of Belgaum District to improve perinatal health care. This effort has resulted in improved care in the community and at primary health centers, as well as increased rates of hospital deliveries among women from rural areas. Additionally, the project initiated an emergency transport system. Beginning in 2008, the partnership developed two new initiatives. One aims to improve prenatal health and infant care within the peri-urban areas of the city of Belgaum. A combination of health promotion and clinical care, the initiative has been successful in gaining the support of the community and has resulted in referrals of women with high-risk pregnancies, as well as sick newborns and infants to local hospitals for care. The second initiative focuses on provision of health education and basic care to adolescent girls in rural areas of Belgaum District. In the two years since its inception, approximately 2,000 girls have participated in the program.
Kosovo: Strengthening capacity in perinatal surveillance to improve birth outcomes
The goal of this mission alliance is to improve the quality of maternal and newborn care in Kosovo by strengthening local capacity in hospital-based perinatal health surveillance. With over 90 percent of deliveries occurring in hospitals, a robust hospital-based surveillance network can be a cost-effective and efficient means of assessing pregnancy outcomes. Access to these data will facilitate the identification of needed improvements in clinical care and health education of medical providers and women. As a first step, a pilot study of late stillbirths and early neonatal deaths is being carried out. Implementing partners include the Foundation for Healthy Mothers and Babies and the University Clinical Center of Kosovo (UCCK), both located in the capital city of Prishtina. The data from the six-month pilot study will help to identify quality of care improvement measures that can be implemented to reduce late stillbirth and early neonatal death rates. It is anticipated that additional hospital sites will participate in the study and that recommendations for quality of care improvements will be made to the Ministry of Health and to participating hospitals.