Credit: MamaYe!/Malawi
MamaYe activists, Malawi 2015

Evidence for Action | MamaYe

Evidence for Action (E4A) works to improve maternal and newborn survival by using evidence and advocacy to drive accountability at national and sub-national levels in Ethiopia, Ghana, Malawi, Nigeria, Sierra Leone, Tanzania and across Africa.

E4A acts as a catalyst for action. By ensuring decision-makers and advocates have access to data at the right time and in the right format, our teams across Africa work to influence how resources are used to improve quality of care for mothers and babies.

Transparency is fundamental for accountability. Easy access to data is fundamental for transparency. Our teams package data in ways that help decision-makers to allocate resources effectively. The data also empower advocates with evidence to influence policy, practice and resource allocation. And the evidence and advocacy are used to build platforms for accountability.

MamaYe is the public face of E4A’s regional and national advocacy campaign for maternal and newborn health (MNH). MamaYe reframes the issue away from fatalism towards stories of survival and positive change. MamaYe’s regional and country websites host evidence, tools, news and success stories to encourage action by MamaYe champions and others to improve maternal and newborn survival across Africa.

Evidence driving accountability:

By strengthening maternal death reviews (MDRs), E4A generates evidence that saves mothers’ lives. For example, MDRs in Jigawa, Nigeria, revealed that 66% of maternal deaths occurred at night due to fewer qualified staff working night duties. This led to changes to ensure that more staff cover the critical night period, thereby increasing maternal survival. Impacts of this sort are expected to multiply in Ethiopia, where we have supported the roll-out of a Maternal Death Surveillance and Response (MDSR) system, which, having trained over 2,000 health workers, has been introduced in over 30 zones.

Our E4A teams designed QuIC - the Quality of Institutional Care tool. This quickly collects, analyses and presents data to show whether facilities are ready to provide Emergency Obstetric and Newborn Care (EmONC). In all countries where QuIC is used, its data are influencing improvements in resource allocation and, subsequently, quality of care. In Malawi, as soon as quality of care gaps were raised, District Health Officials provided missing autoclaves, kits and soap, replenished drug supplies and also prioritised funds for ambulance fuel in their annual budget.

District dashboards are promoted in all countries so management teams can make decisions based on the latest district-level data. In Malawi and Tanzania, the dashboards are now generated by the district health teams themselves.

In Mara Region, Tanzania, we facilitated a new MNH strategy adopting a participative and evidence-based approach. The willingness to hold districts to account has been transformative. Soon after its launch, 11 health centres were upgraded to comprehensive emergency obstetric centres, and 183 new health providers were deployed.

Our work with the African Union (AU)’s Campaign on Accelerated Reduction of Maternal, Newborn and Child Mortality (CARMMA) enables comparison of every African country using scorecards showing data on maternal, newborn and child health. This much-used resource has sparked the development of the African Health Stats website, which allows users to track and chart 33 health indicators for all AU member states.

We lead the MDSR Action Network, collaborating with WHO on initiatives that aim to ensure that no maternal death goes unaccounted for.

The Africa Health Budget Network was established through E4A to support African activists to hold their governments to account for health financing commitments. It provided inputs into the Global Financing Facility's business plan and is collaborating with the World Bank, the Reproductive Health Supplies Coalition and others to ensure that civil society can play an accountability role within this important financing instrument.

Advocacy driving accountability:

MamaYe activities drive advocacy with communities, activists and civil society organisations using highly visible events, such as blood drives or youth projects, to raise the profile of MNH and engage communities directly. These bring a public voice and build momentum for action.

The Give Blood to Save a Mama and Baby campaign in Malawi demonstrates that the public are willing to give blood, a concept not previously accepted. Blood collection days were so well attended that the Malawi Blood Transfusion Service changed its policy to include community blood collection for the first time. Not only do these events express huge public support for making it safe for a woman to give birth, they also result in the saving of women’s lives from increased availability of blood.

In Nigeria, we have strengthened accountability through the creation of ‘SLAMs’ – State-Level Accountability Mechanisms – in six states. These comprise government, media, health professional associations and civil society networks, and use packaged evidence, such as scorecards, to monitor progress of plans and budgets and advocate where action is needed.

E4A is managed by Options, in partnership with the University of Southampton, London School of Hygiene and Tropical Medicine, Immpact at the University of Aberdeen, University College London and Advocacy International.

Programme:

Quick facts

More than 2,000 health workers have been trained on the MDSR system in Ethiopia

We have had more than 45,000 unique visitors and nearly 70,000 hits to our parent website MamaYe Africa since its launch in 2012 

The MDSR Action Network has over 400 members from more than 70 countries since it was launched in 2013

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