Breakout session presented at at 2012 Rotary International Convention in Bangkok. Wednesday 9 May 2012

1. Reducing Maternal and Newborn
Mortality through collaborative action
(CALMED model) by Future Vision
Global Grant and VTT
Allan O. Jagger
Director Zones 17 and 18a

2. Program
RI Director Allan O Jagger – Moderator 5 mins
RI Past President and Trustee John Kenny
Maternal and Child Health Area of Focus and VTT 10 min.
Rtn. Dr. Niranjan Bhattacharya
Causes of Maternal and New born Mortality 10 min.
PDG Dr. Himansu Basu
A strategic approach with VTT – CALMED model 10 min.
Past RI Director Dr. Bill Cadwallader
Experience in South America 10 min.
Questions and Answers 45 min.

3. The Problem
A pregnant woman dies every minute
6 Children die every minute
Most of these deaths are preventable

4. Maternal Mortality Reduction
Strategies
A realistic solution would have to be
low cost, low technology, and
reproducible in many countries
The strategy should incorporate
sustainability and capacity building

5. Opportunities through Rotary's
Future Vision
Maternal and Child Health is a recognised
Area of Focus
A Vocational Training Team visit , can lead to
capacity development and sustainability for
the programme

6. Future Vision Plan and Vocational
Training Team (VTT)
John Kenny
Trustee, The Rotary Foundation
Past President ,Rotary International

7. Future Vision Plan Areas
Of Focus
1. Peace and Conflict Prevention /
Resolution
2. Disease Prevention and Treatment
3. Water and Sanitation
4. Maternal and Child Health
5. Basic Education and Literacy
6, Economic and Community Development

8. Humanitarian Programme and
Vocational Service
Vocational Service –adds impact
and sustainability to a Global Grant
programme
Vocational Training Team (VTT) has
a bigger impact on the community
than individual hands on vocational
service

9. Vocational Training Team -
VTT
1. At least one Rotarian and 3 non-Rotarian
Professional related to one area of focus
2. Training programme is driven by local needs
and priorities
3. Training the Trainer (TTT) is best for capacity
development in resource poor areas
4. VTT is best supported by a Global Grant

10. Vocational Training Team-VTT
 Training Team of Professionals travel to impart
professional training and skills transfer to local
professionals ,generally in a specified area of Focus
 Leads to sustainability and capacity building in the
area of Focus

11. Why Mothers and Babies Die ?
Rtn. Dr. Niranjan Bhattacharya
Vice Chairman
International Fellowship of Rotarian Doctors

12. Why Mothers and Babies
Die ?
Maternal Mortality Rate is a
Barometer of Women’s
Health and Social Status

13. Why Mothers and Babies Die ?
 Medical Causes –largely preventable
 Delays – 3 delay model in resource poor
countries– mostly preventable
 Women’s status- lack of empowerment

14. Why Mothers and Babies Die ?
Medical Causes are largely preventable in
resource rich countries

15. Why Mothers and Babies Die ?
Delays – 3 delay model specially in
resource poor countries
 delay in recognition by Traditional
Birth Attendant
 delay in transport to an Institution
 delay at the Institution–mostly
avoidable

16. Why Mothers and Babies Die ?
Poor Status of Women in resource
poor countries
Literacy
Income
Access to health information
Nutrition
Culture and tradition

17. Reducing Maternal and Newborn
Mortality through collaborative action
(CALMED model)
PDG Dr. Himansu Basu
Past Chairman
RIBI International Committee
International Fellowship of Rotarian Doctors

18. THE PROBLEM

19. Reducing Maternal Mortality - MDG 5 A
(Problem in Low Resource Countries)
 Life time risk of maternal mortality – U.K
– 1 in 9000 ,Ethiopia – 1 in 40
 The Problem – Three quarter reduction of
MMR ( Maternal Mortality Rate ) by 2015
,will not be achieved in low resource
countries
 But there is a Solution – Rotary’s Future
Vision Plan Vocational Training Team can
assist in low resource countries

20. THE SOLUTION

21. How to stop Mothers and Babies
Dying ?
 Improve skill Standards in Institutional
Delivery
 Encourage Institutional Delivery
 For women outside the Institution (50 to
70 per cent ) - Three Delay model is the
ultimate killer –reduce the delays

22. How to stop Mothers and Babies Dying ?
 In resource poor countries ,a top down
and a bottoms up approach are needed
 Collaboration with Governments,
Communities, Professionals – Rotary
acts as Facilitators for funding,
advocacy, skills transfer

23. THE TOOLS

24. CALMED -
Collaborative Action in Lowering
Maternity Encountered Deaths
A FVP Strategy
of Collaborative
Action – VTT
visit

25. CALMED MODEL
Emergency
Obstetric
Training
Data
Collection Village
Care Women’s
Pathway Groups
Mapping

26. CALMED MODEL
It is important to
have partnership Emergency VTT using the Training
Obstetric
with the Training the Trainer Model –
Government, sustainability and
University and the capacity development
Professions

27. CALMED MODEL
Basic Ambulance,
Cell phone,
Social Obstetrics
,Mapping
Care
Pathway
Mapping

28. CALMED MODEL
Saheli Centres, ASHA,
Anganwadi etc. health
awareness ,family
spacing, empowerment
and social mobilisation
Village
Women’s
Groups

29. CALMED MODEL
Signal functions,
processes and some
outcome indicators
Data
Collection

30. CALMED MODEL
Emergency
Obstetric
Training
Data
Collection Village
Care Women’s
Pathway Groups
Mapping

31. The plan
Sikkim
Mumbai

32. Site Visits

33. Meeting with the Government Health
officials

34. Meeting with the Minister

35. CALMED MODEL – Rotary
shows the way
Global Grant VTT – Training the Trainer
Model – FVP Dist 1120,1130,3140 and 3240
Preliminary visit has confirmed the
feasibility for all components
Partnership with District Inner Wheel
Collaboration with Medical Schools,
Governments and professional
organisations (FIGO,FOGSI),GLOWM,
Drexel University

36. CALMED MODEL
Low cost , low technology method
VTT using the Training the Trainer
model leads to capacity building
Sustainable impact on reducing Three
delays in emergency care
Can be replicated in low resource
countries –empowering women

37. What can you do ?
You can join us

38. What can you do ?
You can join us for
- Funding through cash ,DDF
- Advocacy measures
- Professional Hands on
Assistance

39. Thank You !
drhbasumd@gmail.com