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In demand: The ACCESS Program gains global momentum in 2005

20 October 2005

Baltimore, Md. – Last year, ACCESS launched its mission to improve maternal and newborn health through both field-based implementation and global leadership. At that time, ACCESS had three field-supported country programs, and now—one year later—the Program has 12 country programs and ongoing activities in over 20 countries worldwide.

ACCESS Director Koki Agarwal attributes the increase in demand to the fact that "rates of maternal and newborn mortality are still very high, and many countries are recognizing that they are not on track for meeting Millennium Development Goals 4 [to reduce child mortality] and 5 [to improve maternal health]."

For example: In Nepal, the U.S. Agency for International Development (USAID) is seeking to strengthen the country's efforts to reduce newborn mortality due to low birth weight (LBW). In response, ACCESS is creating and testing a community strategy to identify and manage LBW infants. The Program will also assist in developing new health care policies and a multi-cadre training package for skilled birth attendants.

The increase in demand also reflects countries' confidence and interest in ACCESS as USAID's global flagship program for improving maternal and newborn health. And because ACCESS is implemented through such a rich partnership, ACCESS has the technical and programmatic expertise to support the full range of household-to-hospital interventions. Agarwal believes that this focus on bringing life-saving services as "close to home" as possible "resonates deeply in many developing countries."

For example: As a result of the Jhpiego-led workshop Preventing Postpartum Hemorrhage: From Research to Practice, and the enthusiasm of Afghans in attendance, ACCESS is now leading a project in Afghanistan to demonstrate the use of misoprostol in preventing postpartum hemorrhage at home births. Once scaled up, this intervention could have a significant impact on maternal mortality in that country, as more than 95% of births occur at home in Afghanistan, often unattended by a skilled provider (midwife, doctor).

Finally, because there are so many vital areas in reproductive and child health competing for limited funds, programming has to be very creative. "Coming up with innovative ways of integrating new or improved interventions with existing services is absolutely essential," explains Agarwal.

For example: In Tanzania, ACCESS has used antenatal care (ANC) as a platform for other essential maternal and newborn health services, such as counseling to prevent mother-to-child-transmission of HIV/AIDS, prevention of malaria in pregnancy, testing and treatment for syphilis in pregnancy, and infection prevention. ACCESS is training teachers and clinical instructors in nurse-midwifery schools in these strengthened ANC services, as well as reaching out to nurse-midwives already in practice.

As the strengths and capabilities of ACCESS continue to grow over the next few years, the Program looks forward to becoming even more responsive to country needs—and to seeing more women and newborns surviving to live healthy and productive lives.

About ACCESS
The ACCESS Program is the U.S. Agency for International Development’s global program to improve maternal and newborn health. The ACCESS Program works to expand coverage, access and use of key maternal and newborn health services across a continuum of care from the household to the hospital—with the aim of making quality health services accessible for women and newborns.

Jhpiego implements the program in partnership with Save the Children, Constella Futures, the Academy for Educational Development, the American College of Nurse-Midwives and IMA World Health.

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