Years ago, a woman in labor arrived at a hospital where I was teaching newborn resuscitation. She was in great distress and had already been to two clinics where the staff were unable to help her (with the exception of pulling together funds to send her to the next clinic).
Her complications were the result of gestational diabetes, which sadly resulted in two previous stillborn births. She was terrified and in desperate pain. This was her third pregnancy and many hours had already passed by the time she arrived at the hospital. She knew she was at risk of losing this baby. The team did their best to calm her and provide pain relief while they delivered her baby.
Immediately after delivery the nurse assessed the newborn, but because the baby was not breathing, she pronounced him dead. An anesthesiology colleague—who just happened to be in the labor room—knew I was holding a neonatal resuscitation teaching session in one of the nearby classrooms and called urgently for me. I ran into the labor room (followed by my students) and quickly washed and gowned up. However my heart sank when I found the baby limp, unresponsive, and blue. I then checked for a pulse—something I had just been emphasizing to the midwives and young doctors in my class. To my relief, there was a very weak, slow pulse. We quickly started full resuscitative practices and slowly the baby’s heart rate picked up, he become pink and began to emit a weak cry which gradually strengthened to a full-blown bellow, and then he tried to push away the hands that had just been resuscitating him. The entire process lasted 10 minutes.
Both the mother and the child survived.
Mothers and children are our “North Star”
This story, besides having a happy ending, represents another way of looking at innovation. It’s true that innovation may be a technology, but it may just as easily be a different way of using an existing model or health system to address a need. Innovation may simply be a new way of doing things.
At PATH, we keep our focus on serving women and children because healthy mothers and children lay the foundation for healthy families and communities. This focus is what Steve Davis, our president at PATH, refers to as “our North Star.”
Across the broad arc of our Maternal, Newborn, Child Health, and Nutrition Program work, we firmly believe that innovation is the key to sustainable health impact. At the country and local levels, this work can take on many forms, including new approaches to behavior change and social mobilization as well as new products and services to enable populations to both survive and thrive.
Bringing a lifesaving knowledge package to health care workers
People often talk about knowledge management, but at PATH, one of our innovations is in the way we package knowledge and then bring it to the health care workers where they work. This is a different kind of delivery system. It’s the transfer of knowledge.
For example, in South Africa and Mozambique, we partner with local communities and the government health systems to strengthen care during the first 1,000 days of life. This is the critical period of time from a woman’s pregnancy to her child’s second birthday.
We work to ensure that women get regular prenatal care, and that skilled health care workers can provide optimal, safe care during childbirth and afterwards. Postnatally, we encourage mothers to breast feed and to offer their babies the best nutritional and early childhood practices. We also ensure that communities learn how to be engaged in supporting children and their caregivers, and we partner closely with governments and national and regional health service leaders to develop policies, programs, and practices using cutting edge, best-in-class data to strengthen the health systems.
These programs, while addressing crisis management, are also fundamentally shifting the focus to anticipatory and preventative care. For instance, instead of identifying an existing health or developmental problem years after a child is born, PATH is developing programs that provide health care workers with special training to identify developmental milestones immediately at birth and during subsequent visits. Equally important, when these milestones are not met, early referrals are made for further in-depth care. It is a dramatic shift, one that’s anticipating needs and providing guidance instead of reacting to a health crisis.
The way forward
This year, in Mexico City, PATH’s innovative maternal and newborn work is being featured at the first-ever Global Maternal Newborn Health Conference. The event brings together more than 1,000 partners and colleagues from around the world, with a goal to address the most urgent needs of mothers and newborns.
No matter how we came into this life, no matter where we live, or who we are—we all have our mothers to thank for bringing us into this world. There is incredible power in the life-giving role mothers play. And yet, for many, it remains a time of incredible vulnerability. At PATH we know it shouldn’t be this way and we’ll continue to track our North Star to ensure bright futures for the communities we serve.
- Dr. Cyril Engmann is the director of the Maternal, Newborn, and Child Health and Nutrition Program at PATH.