Much of FCI's programmatic work focuses on “building the evidence base” on maternal and reproductive health. FCI works to:

  • develop and communicate powerful advocacy messages that are firmly grounded in the evidence
  • carry out and report about research on effective health interventions
  • produce advocacy materials and publications that summarize and translate scientific data into language that is accessible to non-technical audiences

Here are some examples of FCI's programs:

Misoprostol for post-partum hemorrhage

In partnership with Gynuity Health Projects, FCI is working to evaluate and promote the use of the drug misoprostol as a therapy to prevent Structure of the misoprostol molecule/www.3dchem.comand treat postpartum hemorrhage (PPH).  In this multi-year project, FCI is pursuing an evidence-based policy and advocacy agenda to share the latest research findings with key stakeholders; develop harmonized messages based on solid scientific information; and influence policy change to promote wider understanding, use, and acceptance of misoprostol for PPH in developing country settings.  

A Price Too High to Bear: Research on economic and social costs of maternal death

In arguing for new resources for maternal and newborn health, advocates require solid data on the economic and social costs of maternal mortality and ill health to surviving children, families, communities, and societies. In collaboration with the International Center for Research on Women (ICRW), FCI is undertaking a research study in Kenya that will help quantify the unacceptable social and economic costs of poor maternal health outcomes — data that will highlight the importance of maternal health for the health and well-being of newborns and children, as well as the household, and serve as a catalyst for increased investment in interventions to ensure maternal survival. A report on this research will be produced during 2011.

Building demand for sexual and reproductive health services

Improving health outcomes requires an efficient and sensitive interaction between supply and demand, between the provision of care and the needs of individuals, families, and communities for quality services. In developing programs, governments, donors, and NGOs often emphasize the supply side of this equation — infrastructure development, health worker recruitment and training, equipment and commodity supply, and technology — and pay less attention to whether services, once they are made available, will actually be used. In sexual and reproductive health, where denial, fear, stigma, discrimination, social and cultural barriers, and high costs all have the potential to limit demand, work to increase utilization of services — by such strategies as individual, family, and community mobilization; education; and behavior change communication — is often poorly documented and little known. Working with the United Nations Population Fund (UNFPA), FCI has undertaken a desk review to identify the dominant strategies for improving demand, provide case examples of these program strategies, and outline lessons learned and recommendations by which international organizations can coordinate and advance efforts to increase demand and improve SRH outcomes. In 2011, FCI will share the main findings, identify innovative strategies and lessons learned, and develop a “promising practice” guide and toolkit to support demand-generation efforts.  

Interconnections between maternal and neonatal health

There is widespread recognition that the health of a mother and her newborn are closely linked: most maternal and newborn deaths are caused by the poor health of the mother before or during pregnancy, or by the quality of care she and her newborn receive during and immediately after childbirth. Strategies for improving maternal and newborn health and survival are therefore closely related, and must be provided through a continuum of care approach. When linked together and included as integrated programs, these interventions can lower costs, promote greater efficiencies, and reduce duplication of resources. Although there is a consensus on the strategies that will stop women and newborns from dying during pregnancy, childbirth, and immediately following, existing evidence-based knowledge on the interconnectivity between maternal and newborn health interventions is sparse.

In 2010, FCI collaborated with Dr. Zulfiqar Bhutta and a research team from Aga Khan University in Pakistan to review recent and on-going research on the impact of potential interventions on maternal and newborn outcomes, with a particular emphasis on linkages between the two. After presentations and consultations at the Women Deliver conference and the Global Maternal Health Conference in 2010, FCI is currently drafting an Executive Summary of the full research report for publication during 2011, and is developing advocacy messages to promote investment in and implementation of health interventions beneficial to women and newborns.

Countdown to 2015: Tracking Progress in Maternal, Newborn and Child Survival

The Countdown to 2015 initiative highlights the progress, obstacles, and solutions to achieving MDGs 4 and 5, forging a clear, evidence-based consensus on priority interventions and coverage indicators for maternal, newborn, and child health (MNCH). Countdown collects and analyzes data from the 68 countries that account for 97% of maternal and child deaths, and produces Country Profiles that present coverage data for a range of key health services (contraceptive use, antenatal care, skilled attendance at delivery, postnatal care, and child health), financial investments in MNCH, equity, and health systems and policy. FCI is a member of Countdown’s coordinating committee and co-chair of its Advocacy and Events sub-committee.

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FCI's opportunity

With less than five years remaining until the 2015 deadline for achievement of the Millennium Development Goals, it is absolutely critical that advocates’ recommendations be firmly grounded in the best available evidence. Policy makers are most likely to take concerted action when they have faith that the scale of the problem is clearly understood, that cost estimates are accurate, that new policies will be efficacious, and that recommended health interventions have been proven to actually work. Recent reports that indicate, for the first time in modern memory, that both the number and the rate of maternal deaths is declining globally, makes this particularly clear: this progress is taken as evidence that policy and health care interventions are working, but it is doubly important to determine exactly which interventions are having the most positive impact, where, and why.

FCI holds a unique position in the maternal health community. As a leading voice on the issue, our advocacy is both visible and effective with key audiences, including international organizations, governments, donors, and civil society partners. At the same time, our more than two decades of experience in conceptualizing and implementing field-based capacity building programs has provided us with a strong institutional foundation of practical knowledge about how health care services are delivered and received on the ground. Our years of leadership in these two areas have given FCI a reputation for developing and communicating advocacy messages that are both powerful and firmly grounded in the evidence.

Defining MNCH service packages

In addition to work at important global events and behind the scenes, FCI’s work as co-lead partner for advocacy in the Partnership for Maternal, Newborn & Child Health (PMNCH) includes building consensus around established “service packages” that health systems need to deliver at various stages of the continuum of care. To be published during 2011 as factsheets, these "service packages" will be used, in conjunction with the Global Strategy for Women's and Children's Health and the Consensus for Maternal, Newborn and Child Health  as the foundation for concrete financial, policy, and service delivery commitments to be solicited from donor and developing country governments.

Identifying best practices on teen pregnancy

Working in partnership with UNFPA, Ministries of Health, and other partners, FCI has played a key role in the development of the Andean Plan for the Prevention of Adolescent Pregnancy (Plan Andino). We are also working closely with Ministries of Health in 6 Andean countries to identify, document, scale up, and systematize best programs and practices for preventing teen pregnancy.

FCI was also invited by WHO to participate in a global systematic review of research on reaching pregnant adolescent girls with information and services. FCI has been invited to work with WHO and other research partners to develop a set of key advocacy messages resulting from the review, which will be used to guide Ministry of Health programming and policy making in teen pregnancy prevention globally.

Disseminating Lancet series on reproductive and maternal health

FCI also worked closely with the renowned medical journal The Lancet to compile two special series of articles focusing on critical issues of maternal and reproductive health. These series, published in 2006, distilled the most current information on these topics, and presented clear and focused strategic recommendations. FCI also produced executive summaries for both series, in order to more broadly disseminate their key themes and recommendations.

In 2009, FCI, as part of the Regional Task Force on Maternal Mortality Reduction in Latin America and the Caribbean (GTR), published a Spanish-language compendium of selected articles from The Lancet’s Sexual and Reproductive Health Series, Maternal Survival Series, and Women Deliver special issue for professional audiences in Latin America and the Caribbean. The articles in the compendium address the most pressing issues in the region; reflect the perspectives and solutions proposed by recognized experts in the field; and propose mechanisms to help governments access the technical, financial and human resources necessary to implement effective strategies in these areas.








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