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2015 MERCK FOR MOTHERS PROGRAM REPORTMERCK FOR MOTHERS PROGRAM REPORT / OCTOBER 2015 / 3 Merck for...
Transcript of 2015 MERCK FOR MOTHERS PROGRAM REPORTMERCK FOR MOTHERS PROGRAM REPORT / OCTOBER 2015 / 3 Merck for...
2015 MERCK
FOR MOTHERS PROGRAM
REPORT
2 / MERCK FOR MOTHERS PROGRAM REPORT / OCTOBER 2015
MERCK FOR MOTHERSBringing Merck’s scientific and
business expertise to the
challenge of maternal mortality
Designing and testing solutions to save women’s lives during pregnancy and childbirth
Advocating for the change that women deserve
MERCK FOR MOTHERS PROGRAM REPORT / OCTOBER 2015 / 1
Empowering women to make informed choices about contraception and get the quality care they need for a healthy pregnancy and safe childbirth.
*Merck for Mothers is known as MSD for Mothers outside the U.S. and Canada.
DR. NAVEEN RAO
LEAD, MERCK FOR MOTHERS
DR. PRIYA AGRAWAL
EXECUTIVE DIRECTOR, MERCK FOR MOTHERS
A MESSAGE FROM LEADERSHIP
We’re striving to make transformative contributions in three ways:
Now in our fourth year, Merck for Mothers is working alongside 75+ partners on 50+ programs that are helping pave a smoother path to safe motherhood for women in 30 countries around the world.
Together we are investing in two areas we believe will have the greatest impact on ending preventable maternal deaths, especially in countries with the highest maternal mortality burden:
• Improving the quality of care women receive in health facilities at the time of childbirth
• Improving access to high-quality modern contraceptives
Saving women’s lives from pregnancy and childbirth complications is complex, demanding innovation every step of the way. As Merck has learned from tackling other global health challenges like river blindness, HIV/AIDS and cervical cancer, we must take a comprehensive approach that goes beyond any single intervention if we are to achieve substantial and sustainable gains in health.
So we’ve asked ourselves: how can Merck for Mothers apply the company’s business and science expertise to make the greatest contribution?
WE ARE PLEASED TO SHARE THIS UPDATE
ON THE PROGRESS OF MERck FOR MOTHERS *,
MERck’S 10-YEAR INITIATIvE TO REDUcE
MATERNAL MORTALITY.
So where are we now? To date, our partnerships have helped 5+ million women gain reliable access to quality maternal healthcare and modern contraceptives. This number grows every day. And as we generate data on what is succeeding — and as importantly, what is not — we are advocating to bring programs to scale and help improve the lives of millions more women across the globe.
We are grateful for our creative partners and emboldened by our shared vision of a world where no woman dies giving life.
Be well,
Equipping health providers with the skills, tools and technologies they need to deliver high-quality maternity and family planning services wherever women seek care.
Placing lifesaving maternal health products in the hands of women and their providers.
ENABLING HEALTH PROVIDERS
Developing anD Delivering lifesaving proDucts
EmpowEring womEn
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Four years into our 10-year initiative, our partnerships have made impressive
strides to help improve maternal health worldwide:
BY THE NUMBERS
1.5+ MILLIONWOMEn WITH IMPROVED
ACCESS TO qUALITy MATERnAL HEALTHCARE
2,500+FACILITIES
STREnGTHEnED TO PROVIDE qUALITy CARE
5,400+3.5+ MILLIONWOMEn WITH IMPROVED
ACCESS TO MODERn COnTRACEPTIVES
5+ TOTAL nUMBER OF WOMEn
WITH IMPROVED ACCESS
TO qUALITy MATERnAL
HEALTHCARE AnD MODERn
COnTRACEPTIVESMILLION
50+PROGRAMS
75+PARTNERS
30cOUNTRIES
PROVIDERS AnD COMMUnITy
HEALTH WORKERS TRAInED
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Merck for Mothers is proud to be a
founding partner of Saving Mothers,
Giving Life (SMGL), an ambitious
public-private partnership to reduce
maternal and newborn mortality
in sub-Saharan Africa. In less than
three years, SMGL has seen
maternal mortality drop by 45% in
target facilities in Uganda and
53% in target facilities in Zambia.
MATERNAL MORTALITY NEARLY HALvED
IN UGANDA AND ZAMbIA
KEY ACHIEvEMENTS
• U.S.Implemented evidence-based practices to treat the leading causes of maternal death in five states that account for one quarter of the nation’s four million births and inspired government support of quality improvement efforts in eight additional states
• SENEGALDecreased stock outs of contraceptives to less than 2% in all public health facilities (from more than 80% in 2011) and helped increase the contraceptive prevalence rate to 20% nationwide (from 12% in 2011)
• UGANDAExpanded a social franchise network of private providers offering quality-assured maternal health services to 140 health facilities, covering one third of the country
• iNDiAImproved the quality of private maternity care through social franchising, training, quality improvement and government accreditation in three high-burden states with a total population of 300+ million
• ZAMBiADesigned community-managed, entrepreneurial maternity homes, and initiated partnership to develop them and evaluate whether they are an effective solution to help women receive timely, quality care
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OUR GLOBAL PARTNERS & PROGRAMS
IndIa
Hindustan Latex Family Planning Promotion Trust
Jhpiego and the Federation of Obstetric and Gynaecological Societies of India
Pathfinder International and World Health Partners
White Ribbon Alliance for Safe Motherhood and Gram Vaani
Senegal
IntraHealth International
Uganda
Association of Obstetricians and Gynaecologists of Uganda
HealthPartners Uganda
Population Services International and PACE
Save for Health Uganda
Transaid
UnIted StateS
American Congress of Obstetricians and Gynecologists — District II
Association of Maternal and Child Health Programs
Association of Women’s Health, Obstetric and neonatal nurses
California Maternal quality Care Collaborative
Camden Coalition of Healthcare Providers
Fund for Public Health in new york
Maternal Health Task Force
Maternity Care Coalition
northern Manhattan Perinatal Partnership
ZambIa
Africare and the University of Michigan
Boston University and Zambia Center for Applied Health Research and Development
global gIvIng
Al-Hayat Chaînes de Vie (Morocco)
British Pregnancy Advisory Service (U.K.)
Centre de Coopération Internationale en Santé et Développment (Haiti)
Comunità di Sant’Egidio ACAP OnLUS (Mozambique)
Concern Worldwide USA (Malawi)
Doctors with Africa Cuamm (Ethiopia)
Ethno-Medizinisches Zentrum e.V. (Germany)
Health[e] Foundation (Rwanda)
InMED Partnerships for Children (Jamaica)
Jhpiego (Myanmar)
John Snow Inc. (Ukraine)
Lebanon Family Planning Association for Development and Family Empowerment (Lebanon)
Maternity Foundation (Ethiopia)
Medics Without Vacation (Democratic Republic of Congo)
mothers2mothers (Malawi)
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Organización Para Ayuda Entre Los Pueblos (Democratic Republic of Congo)
Pan American Development Foundation (Argentina, Colombia, Mexico)
Pathfinder International (nigeria, Peru)
Project HOPE (Indonesia)
Sinergias (Colombia)
Sociedad Mexicana de Salud Pública (Mexico)
Swiss Tropical Public Health Institute (Tanzania)
Turkish Family Health and Planning Foundation (Turkey)
UMATI (Tanzania)
Universidad Central de Venezuela (Venezuela)
U.S. Fund for UnICEF (South Africa)
Väestöliitto, The Family Federation of Finland (Finland)
World Lung Foundation (Tanzania)
Zuellig Family Foundation (Philippines)
SavIng motherS, gIvIng lIfe
American College of Obstetricians and Gynecologists
Every Mother Counts
Government of norway
Peace Corps
President’s Emergency Plan for AIDS Relief
Project C.U.R.E.
U.S. Agency for International Development
U.S. Centers for Disease Control and Prevention
U.S. Department of Defense
U.S. Department of State
other PartnerS
• Bill & Melinda Gates Foundation
• Columbia University Mailman School of Public Health
• The ELMA Foundation
• Family Care International
• Ferring Pharmaceuticals
• London School of Hygiene & Tropical Medicine
• M4ID
• Population Council
• Vecna Cares
• United Nations Foundation
• Wellframe
• Women Deliver
• World Health Organization
reSearch granteeS
• Gynuity Health Projects
• Maternova
• Rice University
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Health providers are not always equipped with the skills, tools and technologies to deliver high-quality maternal healthcare
ENSURING EVIDENCE- BASED CARE AT U.S. HOSPITALS
After rapid declines in maternal deaths, the rate of maternal mortality in the U.S. has more than doubled in the past 25 years. An estimated 60,000 women nearly die from pregnancy- and childbirth-related causes each year.
We forged a partnership with leading doctors, nurses and quality improvement associations to accelerate the development of nationally-endorsed, evidence-based practices to treat the three leading causes of maternal death in the U.S.: excessive bleeding, high blood pressure and blood clots.
Following the rapid progress in five states, the U.S. government is supporting quality improvement efforts in eight additional states.
CHALLENGE
60,000
PROGRESS IN THE U.S.
THE MATERnAL MORTALITy RATIO HAS MORE THAn DOUBLED SInCE 1990, EVEn AS
DEATHS GLOBALLy HAVE DECLINED By 45%
THE U.S.’ GLOBAL RAnK BASED On
MATERnAL MORTALITy RATIO — BEHInD
nEARLy EVERy OTHER DEVELOPED nATIOn
64th2XTHE APPROXIMATE
nUMBER OF WOMEn WHO nEARLy DIE
DURInG PREGnAnCy OR CHILDBIRTH EVERy
yEAR In THE U.S.
8 STATES that will be participating in government-supported
expansion of quality improvement efforts
300+ HOSPITALS with improved quality of
obstetric care in five states
1 MILLION WOMEN with access to improved quality obstetric care — one quarter of all women who give birth annually
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hospitals and clinics strengthened
health workers trained
deliveries in strengthened health facilities
women with improved access to quality care
750+
4,700+
167,000+
246,500+
• Expandedasuccessfulmaternitysocialfranchise network to Rajasthan
• Helpedprivatematernityprovidersmeetstreamlined quality standards for labor and delivery services and advocated for their inclusion in national accreditation guidelines
• Broughtcareclosertowomeninremoteareas by enlisting private community health workers, introducing telemedicine and leveraging private distribution channels to deliver supplies at the “last mile”
Working in Jharkhand, Rajasthan
and Uttar Pradesh
PROGRESS IN INDIA
In low-and-middle-income countries, about 40% of women receive antenatal care, delivery services and family planning from private health providers.
We are committed to saving more lives by ensuring quality care wherever a woman seeks care.
Strengthening local, private maternal healthcare
We are developing a new
digital tool to guide clinical
decisions in real time, giving
health providers immediate
support to manage labor
and delivery care. The tool
will capture data on the care
health providers offer, allowing
clinicians and managers to
use automated data to inform
quality improvements efforts
at facility, district and
national levels.
data are crItIcal to
ImProvIng QUalItY
44%Private
Antenatal Care
40%Private
Delivery Services
37%Private
Family Planning
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hospitals and clinics strengthened
health workers trained
deliveries in strengthened health facilities
women with improved access to quality care
140+
700+
22,400+
114,000+
• Expandedandintroducedmaternalhealth services into a social franchise network of private providers
• Helpedprivatematernityprovidersoffer quality-assured emergency obstetric care and provided business management training
• Expandedasocialfranchisenetworktourban areas in Kampala to help decongest overcrowded public hospitals
PROGRESS IN UGANDA
Working in 42 districts —
more than a third of the country
bUIldIng PrIvate mIdwIveS’ caPacItY
to Serve more women
In 2009, Jane joined PACE’s ProFam network, a franchise of local clinics, to expand her business and serve more women. At the time, she only had a one-room clinic, but she knew she wanted more.
Before I joined ProFam and the MSD for Ugandan Mothers (MUM) program, I wasn’t as busy as I am now. It’s that simple. They have provided training in how to help me make my services more affordable so they can be available to more women.”
With help from ProFam and the MUM program, she’s doing just that.
Jane has been trained on the management of obstetric emergencies, family planning services, cancer screening and infection prevention as well as business
management, enabling Jane to continue to expand her services to meet the needs of women in her community.
Now, Jane’s clinic serves about 30 women a day and delivers about 25 newborns a month.
Why do so many women attend her clinic? Jane says her clinic provides “a lot of love.”
Photo credit:Julius Caeser Kasujja
“ People call me Mama ProFam. Because of ProFam and the MUM program’s trainings, I’m more confident in everything I do.”
“
Photo credit: IntraHealth International 10 / MERCK FOR MOTHERS PROGRAM REPORT / OCTOBER 2015
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PROGRESS IN SENEGAL
Eliminating stock outs of modern contraceptives
Even the most capable health provider may not be able to save a woman’s life if essential products are not availableCHALLENGE
In July 2015, the first patient enrolled in a clinical trial to evaluate the effectiveness of heat-stable carbetocin, a reformulated medicine to prevent excessive bleeding after childbirth. Unlike the current standard treatment, heat-stable carbetocin is designed to be stable at room temperature, even in hot climates where most maternal deaths occur.
If the results of the study are positive, we will work together with our partners with the aim of making the medicine available in developing countries that have a high burden of maternal mortality at an affordable and sustainable public-sector price.
ADVANCING A LIFESAVING MEDICINE
• Adaptedprinciplesusedinthe commercial sector to develop an innovative supply chain model
• Completedcostinganalysistoidentifyoptions for expanding the model nationally
• ExpandedtheInformedPushModeltopublic health facilities nationwide
Working in all
14 regions of the country
Photo credit: IntraHealth International
“ A few years ago, supplies of contraceptive products were chronically running short,” describes Dr. Bocar Mamadou Daff, Director of the Reproductive Health and Child Survival Unit at the Senegalese Ministry of Health. “Women were being turned away empty handed. I heard that women were rowing canoes across the Doué River to buy contraceptives on the other side because the shelves at their health post were empty.”
The Informed Push Model turns the contraceptive order and delivery process upside down. The project
shifts responsibility for forecasting, ordering and delivering supplies from overworked health providers to skilled private suppliers.
As Mr. Ndiaye, Head Nurse at Tiaba Niassène health post, enthusiastically
described, “We must have everything on the Push. If it weren’t for the Push, I would have to close my post today to go collect medicines. [Now] I stay at the post and the medicines come to me.”
PRIVATE SECTOR MODEL TRANSFORMS
SUPPLY CHAIN FOR FAMILY PLANNING
decline in stock out rate of contraceptives since 2011
increase in contraceptive prevalence rate since 2011
public health facilities benefitting from the model
women with improved access to modern contraception
80% 2%
8% POINTS
1,300+
3.2 MILLION
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USING MOBILE PHONES TO EMPOwER wOMEN TO BE INFORMED HEALTH CONSUMERS
Women are not always armed with the tools and knowledge to be stewards of their own health
CHALLENGE
Photo credit: White Ribbon Alliance India
We’re developing three phone-based tools to help pregnant and postpartum women receive the care they need, when they need it.
Rating care
A voice-based platform will help women learn about the maternal healthcare they deserve and rate the services they receive.
Learning about family planning options
Individuals seeking family planning services will be able to call a free hotline to learn about different options, identify the best ones, receive a referral to a nearby health facility and later rate the quality of care received.
Monitoring health after childbirth
A postpartum app will help women in the U.S. and the U.K. know what to expect during the postpartum period (when 60% of maternal deaths occur), identify warning signs and maintain good health after childbirth.
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In Zambia, many women live miles from the closest health facility with few, if any, affordable and safe transportation options.
We are supporting new, community-managed models of maternity homes — residences near health facilities where pregnant women who live in remote areas can stay until the late stages of their pregnancy and immediately after childbirth. And we’re exploring creative, entrepreneurial ways to make these homes sustainable.
PIONEERING COMMUNITy-BASED PROGRAMS RESPONSIVE TO wOMEN’S NEEDS
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Camden, NJ
Philadelphia, PA
New York, NY
commUnItY health workerS offer a lIfelIne
for Pregnant women In PhIladelPhIa
When Jackie met Sharice, Sharice was pregnant, homeless, jobless and recently diagnosed with diabetes.
Sharice was completely overwhelmed by the fragmented system,” says Jackie Torres, a community health worker at Maternity Care Coalition (MCC) in Philadelphia. “She kept asking me, ‘How am I supposed to take care of my baby, when I can’t meet my own needs?’”
Increasingly, women in the U.S. are entering pregnancy with a more complex set of needs and there are huge disparities in maternal health outcomes across race. Thanks to MCC’s Safe Start MOMobile program, Sharice and many other women are getting the support and care they need.
Jackie became a trusted source and critical link to existing resources, helping Sharice secure a place to live, find healthy food and better communicate with her health providers.
In the U.S., some of the areas hardest hit by maternal mortality are low-income communities where chronic diseases like obesity, high blood pressure and diabetes are on the rise. Our partners are developing new models of care involving community
health workers specially trained to help pregnant women with complex health problems have a healthy pregnancy and safe childbirth — and maintain lifelong good health.
“ Sharice recently said to me, ‘Before I met you, I didn’t have a plan. Now I have goals for my life,’” says Jackie. “To see this woman who faced such extreme challenges making these huge strides is incredible.”
“
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EvERY DAY, MERck EMPLOYEES PROvIDE THEIR bUSINESS AND ScIENTIFIc EXPERTISE TO AMPLIFY OUR IMPAcT
LEvERAGING THE BEST OF MERCK TO SAvE WOMEN’S LIvES
cOLLAbORATING WITH GLObAL cOLLEAGUES TO RESPOND TO LOcAL NEEDS
In countries as diverse as
Ethiopia, Indonesia, Mexico and
Tanzania, we are supporting
programs to train health
providers in maternal care
services, link pregnant women
to care and raise awareness of
safe motherhood.
“ The Merck Fellows brought a business mindset to our challenge of delivering health services — and now we have a better plan to sustain our work for the long term.”
HANNA BALDWIN, CHIEF OF PARTy, MSD for UganDan MotherS
35,000+HOURS COnTRIBUTEDEXPERT ADVISORS PROVIDInG
TECHnICAL SUPPORT TO STREnGTHEn PROGRAMS
50+40GLOBAL HEALTH FELLOWS WORKInG DIRECTLy WITH
PARTnERS On THREE-MOnTH ASSIGnMEnTS In THE FIELD
“ During my fellowship, I worked with the White Ribbon Alliance, a Merck for Mothers-supported nGO in India.
The initiative focused on raising the “voice of the voiceless” and leveraging market efficiency to lower preventable maternal mortality in India. The immersive learning experience over 90 days helped me uncover latent skills, appreciate organizational complexity and energized me to
become an alliance builder and a change catalyst. I have learned to listen, seek first to understand and
collaborate effectively across functions and cultures.”
SIVA MURTHY, DIRECTOR, U.S. PAyER MARKETInG OnCOLOGy
30 PROJECTS
24 COUNTRIES
MERCK FOR MOTHERS PROGRAM REPORT / OCTOBER 2015 / 17
“ Working with Merck for Mothers is one of the most engaging assignments I’ve had at Merck. We are able to implement innovative and disruptive solutions which will make a real difference in the world.”
MICHELLE MOSOLGO, EXECUTIVE DIRECTOR, InFORMATIOn TECHnOLOGy
“ From my years of experience in hepatitis, I’ve seen the valuable role that community health workers can play to improve access to lifesaving care. It’s been a privilege to share my experiences with Merck for Mothers as we explore new ways of helping pregnant women with chronic disease receive the care they need for good long-term health.”
EIRUM CHAUDHRI, EXECUTIVE DIRECTOR, SCIEnTIFIC AFFAIRS
“ I greatly appreciate the opportunity to share the tools we use to evaluate real world evidence. By demonstrating the value of an innovative supply chain model that eliminates stockouts of contraceptives from an economic perspective, our team could provide further insight to the government’s decision to expand access to family planning across Senegal.”
ERIk DASBACH, EXECUTIVE DIRECTOR, OUTCOMES RESEARCH
TOGETHER, WE CAN HELP END PREvENTABLE MATERNAL DEATHS
We are honored to play a role
in global efforts to achieve
the Sustainable Development
Goals. Through our ongoing
commitments to address
important health challenges,
including maternal health,
HIV/AIDS, cervical cancer and
neglected tropical diseases,
we are mobilizing the best of
Merck to help save and improve
lives around the world.
kenneth Frazier, Merck Chairman and CEO
For the latest updates on our programs and progress, visit MerckforMothers.com. You can also join the #EndMaternalMortality conversation by following @MerckforMothers on Twitter and Facebook.