Model and Strategy
The purpose of this project is to advance progress towards maternal health as a human right. GAIN project will accomplish this by equipping nurses with the training and skills to offer women in the poorest country in the world safe and respectful deliveries. In many developed countries, dying in childbirth is rarely considered. However, in sub-Saharan Africa, childbirth is a risky endeavor. In Malawi, where the GAIN project will launch, a woman’s lifetime risk of dying in childbirth is 1 in 29 compared to 1 in 3800 in the US; and 45% of women do not access skilled birth attendants. Without access to comprehensive maternal care, a woman’s agency is hampered as she cannot make effective choices to ensure her safety and the future of her baby. The GAIN project focuses on a KNOWN solution for addressing this critical issue: skilled nurses. Nurses deliver 9 out of 10 babies in Malawi. Saving mothers stabilizes families and communities, both emotionally and economically.
Impact
Recognizing that Malawian women cannot always control their reproductive health, and that nurses cannot always access training and resources, GAIN offers an evidence-based solution. The GAIN theory of change is based on a model developed by Ariadne Labs and the WHO. There are three components:
1. Engage: “Engage” strategies increase nurses’ knowledge and establish a team of leaders to support implementation of the WHO Safe Childbirth Checklist.
2. Launch: “Launch” strategies adapt the checklist to specific gaps at each facility.
3. Support: “Support” strategies use ongoing mentorship to reinforce new behaviors and embed competencies into practice. Why the interventions will make a durable impact and supporting evidence:
(1) Engagement- involves participation in a short course covering the WHO Safe Childbirth Checklist to guide practice. The checklist consists of 28 essential practices for safe childbirth beginning with arrival of the mother at the facility to discharge. The checklist has been validated in over 100 facilities.
(2) Launch- involves mentoring by advanced practice nurses in-country for one year rotations. Research shows that access to mentoring is linked to sustainability and success of health care programs.
(3) Support- involves monitoring and evaluation. Mentors will work closely with the evaluation team to collect data on maternal and infant outcomes. These outcomes will include complications during delivery, incidence of low birth weight infants, and maternal or infant deaths.
1. Engage: “Engage” strategies increase nurses’ knowledge and establish a team of leaders to support implementation of the WHO Safe Childbirth Checklist.
2. Launch: “Launch” strategies adapt the checklist to specific gaps at each facility.
3. Support: “Support” strategies use ongoing mentorship to reinforce new behaviors and embed competencies into practice. Why the interventions will make a durable impact and supporting evidence:
(1) Engagement- involves participation in a short course covering the WHO Safe Childbirth Checklist to guide practice. The checklist consists of 28 essential practices for safe childbirth beginning with arrival of the mother at the facility to discharge. The checklist has been validated in over 100 facilities.
(2) Launch- involves mentoring by advanced practice nurses in-country for one year rotations. Research shows that access to mentoring is linked to sustainability and success of health care programs.
(3) Support- involves monitoring and evaluation. Mentors will work closely with the evaluation team to collect data on maternal and infant outcomes. These outcomes will include complications during delivery, incidence of low birth weight infants, and maternal or infant deaths.
Leadership
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Kim Baltzell
Executive Director