THE Maternal, Neonatal and Infant Health (MNIH) Project is where women's rights and fundamental human rights come to meet. The three-year project, funded by the European Union, was launched in 2018 to combat the higher-than-acceptable rates of maternal, neonatal and infant deaths in Jamaica. The programme has since been making strides by mobilising civil society organisations (CSOs), and increasing awareness of patients' rights as users of the health care system.
“This is part of the bread and butter of the Women's Resource and Outreach Centre (WROC),” Nikeisha Sewell Lewis, WROC executive director, told All Woman of the project.
“WROC was really founded to deal with women's issues, and we continue to do that, so this project fits right into our strategic plan to ensure that women's health and human rights are critical parts of the national conversation.”
WROC partners with The University of the West Indies Community Health and Psychiatry clinic on the project, under the leadership of Dr Wendel Abel.
The leading causes of maternal, neonatal, and infant deaths are high blood pressure in pregnancy (16 per cent), haemorrhage (15 per cent), abortion and tubal pregnancy (13 per cent), clots in the lungs (13 per cent), and heart disease and stroke (11 per cent). Complications due to cancer, sickle cell disease, HIV/AIDS, other pregnancy-related causes, and other medical problems account for smaller fractions of deaths.
Linnette Vassell, advocacy specialist in the MNIH project, explained the need for intervention.
“We have 79 deaths per 100,000 live births, and it really should be lower. It is a really critical issue, and infant health issues are being addressed as well. When mothers die, it has a lot of ripple effect on the family. Moreover, those deaths are preventable.”
Ruth Howard, communications officer of the programme, added that social determinants also impact the quality of care that women receive during pregnancy and childbirth, and ultimately, affects the number of maternal and infant deaths.
“For example, women who live in rural areas, women who experience poverty, and women who have a low level of education tend to have a lower level of awareness when it comes to maternal health care. Someone in the rural area might not be able to go to the clinic as often as she would like, simply because of the distance between her and the clinic. It could be as simple as the condition of the roads to get to the clinic, or the availability of transportation that causes her to miss her appointment. Subsequently, if she develops a complication she wouldn't know about it until it gets serious,” she said.
Vassell highlighted that another preventable cause of maternal, neonatal and infant deaths is inefficiencies in human personnel.
“That is why this important programme by the European Union is seeking to address some of those deficiencies, such as training doctors to give better neonatal health care, providing ambulances and special centres for high-risk people,” she noted.
“We try to work from a human rights approach,” Howard said.
“Looking at the maternal health rights of mothers, and the fact that there are some demographics who have it harder than others — for example, a woman living with HIV who gets pregnant, she might be dealing with discrimination from people around her, and when she gets to the [health care] facility she might have a harder time because of that.”
Howard lamented that there are cultural beliefs that hinder such patients from receiving the best possible care, such as beliefs that people in some situations should not have children.
“Another group that faces serious challenges in accessing maternal care is women living with disabilities,” she pointed out. “But they, too, have the right to be loved, to be cared for, and to have families if they so desire.”
MNIH is a part of the larger Programme for the Reduction of Maternal and Child Mortality (PROMAC) project, Howard explained.
“Our section focuses on civil society organisations, and engaging them in advocacy around maternal, neonatal, and infant health. We focus on health care being provided the 'rights' way. We're working with about 20 CSOs to bring the message of maternal rights and neonatal rights across Jamaica. We have launched the Society Collaborative Forum which provides small grant funding for the 20 CSOs,” she said.