Giving birth, caring for newborns and raising children can be difficult in developing countries with few resources for maternal, newborn and child health services. Deaths from obstetrical and newborn complications such as postpartum hemorrhage and birth asphyxia, as well as diarrhea and pneumonia in young children, are all too common in such places.
Maryanne Crockett and Lisa Avery have seen first-hand such problems, as well as the impact that effective interventions in health care, family planning and nutrition – throughout the life cycle and indeed right up to adolescence – can have.
Dr. Crockett, an associate professor, and Dr. Avery, an assistant professor, both in the Rady Faculty of Health Sciences and the Centre for Global Public Health at the University of Manitoba, are involved in research and public health programs in Pakistan, India and Kenya to help governments improve the quality of and access to such services.
Their studies have led to strategies that range from a nurse-mentoring program in India that is improving training and skills for nurses and community workers to a project in Kenya that encourages the use of a commonly available labour and delivery-monitoring tool.
"These are areas where we can have a huge impact on mortality rates," says Dr. Crockett, a pediatric infectious disease physician, noting that a program in rural Kenya to have community health volunteers encourage breastfeeding brought rates to 73 per cent from the previous 25 per cent. "Even simple things can make a difference."
Dr. Avery, an obstetrician and gynecologist, says there has been "a lot of cross-learning and uptake of approaches" between the different areas and countries involved in their studies. "But you have to understand the underlying context. There's no one-size-fits-all approach."
It's critical to do research directly in the field "and speak with the women and families and front-line workers" about their challenges and perceptions, she cautions. "It gives you an entirely different perspective than if you're dealing with data sets…It's easy to come up with a program that looks good on paper but doesn't work on the ground."
Dr. Crockett says it's "an incredible privilege" to find solutions that are relevant, acceptable and "can have an impact on the future of a population," as well as individuals. "Any time you know that one woman or newborn or child has survived, you feel it's a huge success. That's what keeps us going."
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