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By Dynes Chinyama-Kaluba Senior Programme Officer, MAMaZ , Zambia

Responding to Demand side barriers to MNH in Zambia. By Dynes Chinyama-Kaluba Senior Programme Officer, MAMaZ , Zambia. Mobilising Access to Maternal Health Services in Zambia (MAMaZ). What? MAMaZ focuses on tackling demand side barriers to accessing maternal and newborn health care Why?

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By Dynes Chinyama-Kaluba Senior Programme Officer, MAMaZ , Zambia

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  1. Responding to Demand side barriers to MNH in Zambia By Dynes Chinyama-Kaluba Senior Programme Officer, MAMaZ, Zambia

  2. Mobilising Access to Maternal Health Services in Zambia (MAMaZ) What? • MAMaZ focuses on tackling demand side barriers to accessing maternal and newborn health care Why? • High MMR and newborn mortality rates • Limited evidence of what works in addressing demand side barriers How? • Support districts to implement community activities to increase knowledge and resources • Compile evidence of change and “impact” Where? • 6 districts: Choma, Serenje, Mongu, Chama, Kaoma, Mkushi

  3. BEOC Intervention Sites

  4. Intervention Communities

  5. Objective To improve access to routine and emergency maternal and newborn care through community-based interventions

  6. Barriers to receiving MNH care Three Delays model: • The delay in the decision to seek care • The delay in getting to a facility • The delay in receiving medical attention Key demand-side barriers: • Knowledge and attitudes – limited awareness of danger signs; some conflicting beliefs and practices • Physical – long distances to facilities; challenging terrain; lack of transport • Financial – lack of savings for emergency and routine costs

  7. MAMaZ PROGRAMME STRUCTURE Quality Assurance Group (QUAG) Country Director Abdul Badru HPI office UK: Programme and finance management support District Medical Offices Senior Programme Officer Dynes Kaluba Finance & Admin Officer Drivers District Programme Officer, Mongu District Programme Officer, Choma District Programme Officer, Serenje District Programme Officer, Kaoma District Programme Officer, Chama District Programme Officer, Mkushi Community Facilitators Community Facilitators Community Facilitators Community Facilitators Community Facilitators Community Facilitators Safe Motherhood Action Groups (SMAGs)

  8. 4. Community Monitoring Access to Maternal and Newborn Care 1. Community Mobilization 2. Community Systems 3. Facility Based Emergency Transport Scheme 5. Mentoring and Support Intervention components

  9. Community Mobilization: Participatory Methods Whole Body Communication: Severe Headache

  10. Community Mobilization: Danger Signs Whole body communication: “Hand or foot comes first”

  11. Community Mobilization: Follow-up Support Volunteers and other community members follow-up on discussion group issues and visit pregnant women and newly delivered mothers

  12. 6. ‘Food Bank’ 5. Child Minding Scheme Community Systems 1. Emergency Transport Scheme 4. Mothers’ Helpers 3. Safe Pregnancy Plan 2. Community Savings scheme Component 2: Community Systems

  13. Community Emergency Transport Scheme Aim: To provide a reliable means of transport for patients from community to health facility Several options, depending on terrain: • Oxcarts and donkey-driven carts • Suitable for Mongu, Kaoma and Choma where bicycle ambulances cannot work

  14. Bicycle Ambulance and Ox Cart

  15. Safe Pregnancy Plans Once other community systems are in place, pregnant women are supported to develop safe delivery plans

  16. Targeting mothers’ shelters

  17. Component 3: Facility based ETS: Motorcycle Ambulance

  18. Component 4: Community Monitoring System • To generate information on community activities • The system is participatory • Strengthening communities’ capacity to document and reflect on changes • Evidence from other contexts shows that community monitoring helps promote sustainability

  19. Thank You

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