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A Price Too High to Bear: The Costs of Maternal Mortality to Families and Communities

A Price Too High to Bear, a research study conducted in Kenya by Family Care International in partnership with the International Center for Research on Women (ICRW), and the KEMRI-CDC Research and Public Health Collaboration, documents the financial and social costs of maternal death to families in a poor, remote community and the ways that these costs affect newborn survival, child health and education, and family well-being.

A technical brief summarizing the study's findings is available for download, along with two advocacy briefs that highlight the key messages.

A Systematic Review of the Interconnections between Maternal & Newborn Health

Poor maternal and newborn health is a significant contributor to the burden of disease in developing countries, with most maternal and newborn deaths caused by the poor health of the mother before or during pregnancy, or by poor quality care during and immediately after childbirth. In close collaboration with Aga Khan University, Family Care International undertook work highlighting the interconnections between maternal and newborn health and identifying common advocacy messages to promote investment in and implementation of evidence-based interventions found to be beneficial to both women and newborns.

Built on findings emerging from a systematic review of recent and on-going research of the impact of potential interventions on maternal and newborn outcomes,this set of advocacy materials for dissemination at key meeting and events includes:

  • An executive summary of the full research paper, for research/academic/medical audiences
  • A pocket card, for advocates and policymakers, incorporating the review findings and key messages
Advocacy, Approval, Access: Misoprostol for Postpartum Hemorrhage A Guide for Effective Advocacy

This publication, available in English and French, provides guidance to national advocates and civil society organizations in conducting effective advocacy for the successful uptake of misoprostol for prevention and treatment of postpartum hemorrhage (PPH). Through case studies and an Advocacy for Access Framework, this publication provides concrete examples to support misoprostol’s availability and use at the national level.

Advocating for Maternal Health: A Checklist for Private Sector Health Providers

This checklist presents a set of tips and relevant resources and tools to help private sector health providers improve their knowledge, skills, and capacity to conduct advocacy in support of maternal health.


Advocating Together: The Power of Alliances for Maternal Health

This toolkit provides guidance for national civil society organizations (CSOs) interested in establishing or strengthening an alliance in support of maternal health advocacy. The toolkit provides a step-by-step approach to working with partners in a national-level alliance to advocate for maternal health policy change. Divided into three major sections, each provides steps CSOs can take in order to:

  1. Analyze the maternal health environment in order to decide if working with an alliance is advantageous;
  2. Work with an alliance by either joining an established alliance or creating a new one; and
  3. Plan advocacy activities taking into account the political context and ways an alliance can effectively reach decision makers.
Apuntes para la incidencia en las políticas públicas sobre maternidad segura y salud sexual y reproductiva para mujeres indígenas

This educational manual (“Notes on the impact that public policies have on safe motherhood and the sexual and reproductive health of indigenous women”) explains the implications of public policies; the role of civil society in shaping public policies; what they consist of; and how they are designed, decided, implemented and monitored. It helps to foster the role of community health agents in ensuring that the demands of indigenous organizations translate into culturally pertinent public health policies.

Este manual didáctico explica qué son y en qué consisten las políticas públicas, cómo se diseñan, deciden, implementan y mantienen a lo largo del tiempo, y la importancia de incidir sobre las mismas a través de la demanda político-social que se genera desde el desarrollo de las capacidades colectivas. Así, explica el rol de los agentes de salud comunitarios para favorecer que las exigencias de las organizaciones indígenas se traduzcan en políticas públicas de salud efectivas.

Buenas prácticas en prevención del embarazo adolescente: Herramienta para la sistematización de experiencias desde una perspectiva de buenas prácticas [Best Practices for Preventing Teen Pregnancy: A Tool for Systematizing Experiences]

El objetivo de este documento es guiar la sistematización de experiencias de prevención del embarazo adolescente tanto de los ministerios como de organizaciones de la sociedad civil bajo la óptica de “buenas prácticas”. La herramienta se construyó participativamente a partir de los procesos de sistematización de iniciativas que emprendieron los Ministerios de Salud de los seis países del Plan Andino para la Prevención del Embarazo en Adolescentes — Chile, Perú, Bolivia, Ecuador, Colombia y Venezuela — entre 2008 y 2009, describe sus lecciones aprendidas y presenta una guía para la comunicación de aprendizajes.

This document is a guide for systematizing best practices in prevention of adolescent pregnancy, based on government and civil society experience. It describes a process conducted in 2008 and 2009 by Ministries of Health from the six member countries of the Andean Plan to Reduce Unwanted Teenage and Adolescent Pregnancy (Chile, Peru, Bolivia, Ecuador, Colombia, and Venezuela) to analyze their teen pregnancy initiatives using a best-practices lens, and outlines lessons learned.

Cartillas: "Maternidad Segura" y "Salud Sexual y Reproductiva"

Los presentes módulos de capacitación, adaptado de ¡Cuídate!: Una guía de salud y bienestar, fueron desarrollados para prestadores/as de servicios de consejería médica a mujeres en edad reproductiva, mujeres embarazadas y madres de niños/as menores de dos años. Los mismos abordan de forma integral y con un enfoque de derechos temas relevantes a la salud sexual y reproductiva y salud materna.

These training modules, adapted from ¡Cuídate!: Una guía de salud y bienestar, were developed for use by Bolivian health care providers for counseling women of childbearing age, pregnant women, and mothers of children under two. They contain comprehensive information on sexual and reproductive health and maternal health, including the rights to health and services of this population.

Case Studies on Maternal Death Surveillance and Response

In Latin America and the Caribbean (LAC), the estimated maternal mortality ratio is 59 deaths per 100,000 live births. Overall, the LAC region has seen a reduction of its MMR by 39% between 1990 and 2015.Efforts to strengthen data and accountability, especially in recent years, have helped fuel this improvement. In 2015, the Regional Task Force for Maternal Mortality Reduction (GTR) released an updated version of the Guidelines for Maternal Death Surveillance and Response in the Americas to assist national efforts to identify and timely notify all maternal deaths, followed by review of their causes (maternal death reviews) and the implementation of actions to prevent future deaths. These case studies, which complement the guidelines, were conducted in five countries that have made the greatest strides in improving their maternal mortality surveillance and response systems: Brazil, Colombia, El Salvador, Jamaica and Mexico. They are targeted to maternal mortality surveillance systems managers, and are meant to foster greater national proficiency in maternal morbidity and mortality monitoring and response.

Curriculum de Formation des Parents: Communication avec les Enfants, Adolescent(e)s et Jeunes en matière de Santé Sexuelle et Reproductive

Ces publications, développées par FCI-Mali en collaboration avec le Ministère de la Santé de la République du Mali, fournissent aux facilitateurs un curriculum pour aider les parents maliens, à travers des petits groupes de travail, à apprendre à parler avec leurs enfants, adolescent(e)s et jeunes de la contraception et d’autres sujets de santé sexuelle et reproductive. Les documents sont disponibles en français, en arabe et en bambara (bamanankan), les trois langues principales du Mali.

This set of publications (Curriculum for Training Parents: Communicating with Children, Adolescents, and Young People about Sexual and Reproductive Health), developed by FCI-Mali in collaboration with the Ministry of Health of the Republic of Mali, provides facilitators with a curriculum for helping Malian parents, through small group workshops, to learn to talk with their children and adolescents about contraception and other reproductive health issues. It is available in French, Arabic, and Bambara (Bamanankan), Mali’s three most common languages.

Essential Medicines for Maternal Health: Ensuring Equitable Access for All

A set of seven briefs, available in English, French, and Spanish, that outline challenges and solutions for increasing the availability and use of three essential maternal health medicines (oxytocin, misoprostol and magnesium sulfate), drawing on lessons and experience from reproductive health supplies.

Estudios de caso de la vigilancia de la mortalidad materna

En en América Latina y el Caribe (ALC), la razón de mortalidad materna registrada es de 59 defunciones por 100 mil n.v.  A pesar de las desigualdades, se estima que la RMM en ALC, se ha reducido en un 39% entre 1990 y 2015. Los esfuerzos desplegados para fortalecer la recolección de datos y la rendición de cuentas en los últimos años han favorecido esta mejoría. En 2015, el Grupo de trabajo regional para la reducción de la mortalidad materna (GTR) lanzó una versión adaptada de las Guías para la vigilancia epidemiológica y respuesta a la mortalidad materna en las Américas para la identificación y notificación oportuna de todas las muertes maternas, seguida del análisis de sus causas y de las mejores intervenciones para su prevención. Los casos de estudio que presentamos aquí son parte de esta serie que acompaña las guías. Serán utilizados–junto con las guías–para el fortalecimiento de las capacidades de las personas responsables de la vigilancia epidemiológica y respuesta a la mortalidad materna en la región.

Harmonizing Health Services: Saving Lives through Integration of Reproductive, Maternal, Newborn & Child Health and HIV/AIDS, Tuberculosis & Malaria Programs

These briefing cards, published in 2012 by FCI and Population Action International as part of The Integration Partnership, provide information on integrating AIDS, TB, and malaria services across the reproductive, maternal, newborn, and child health continuum of care. Available in both English and French, they highlight how integration can strengthen health and community systems, save money, and empower women to access the services they need and deserve.

Investing in Midwifery: Improving Health, Saving Lives (infographic)

This infographic highlights the critical role that midwives play in improving maternal and newborn health around the world. Midwives have a powerful voice in changing policies and practices that support the availability, accessibility, acceptability, and quality of health services.


Jóvenes y derechos: mensajes para incidir en la esfera pública

“Jóvenes y derechos: mensajes para incidir en la esfera pública” está dirigida a organizaciones o personas que quieran abogar por el ejercicio de los derechos sexuales y reproductivos, y en particular para la prevención del embarazo en adolescentes. La misma servirá de respaldo a estrategias de incidencia política y de comunicación que no solamente influyan en la política pública o la participación ciudadana, sino que además contribuyan a fortalecer la ciudadanía, y a ampliar la cultura democrática y de derechos humanos. La publicación fue elaborada en el marco del Plan Andino para la Prevención del Embarazo en Adolescentes (PLANEA).

This publication is a tool for groups, organizations or individuals who want to engage in advocacy to promote the exercise of reproductive rights, in particular the prevention of unwanted teen pregnancies. The tool is intended to support, not only advocacy and communications strategies to influence public policy and participation, but also to foster citizenship, and expand the culture of democracy and human rights. It was prepared under the Andean Plan for the Prevention of Teen Pregnancy (PLANEA).

Kenya's Annual Budget Cycle Calendar

A government budget must be comprehensive and transparent to allow citizens to hold government accountable for managing public funds. This budget cycle calendar shows the key dates for the Kenyan Annual Budget Cycle at both the national and county levels and highlights the opportunities where citizens can be part of formulation and priority setting as well as the accountability processes.


Living Testimony: Obstetric Fistula and Inequities in Maternal Health - - Témoignage Vivant: La Fistule Obstétricale et les Inegalités en Santé Maternelle

This advocacy publication, produced in 2007 by FCI and UNFPA for the Campaign to End Fistula, presents promising practices and strategic recommendations for policy makers, programmers, and researchers seeking strengthen fistula prevention and treatment programmes in affected countries. 
A toolkit with additional advocacy tools (communications/strategic messaging guide, detailed descriptions of promising practices, multimedia resources, and Powerpoint presentation) was published in CD-ROM format in 2010 — most of those tools are also available for download here.


MACS Case Studies: Burkina Faso and Kenya

In 2012, Family Care International (FCI) launched the Mobilizing Advocates from Civil Society (MACS) project in Burkina Faso and Kenya to bring together civil society organizations working in reproductive, maternal, newborn, and child health (RMNCH) and to strengthen their capacity to advocate powerfully and effectively for health policies and programs that meet the needs of women and children. These case studies from Kenya and Burkina Faso detail the experiences and challenges the MACS alliances faced, while sharing lessons learned from the project overall.

Making the Case for Midwifery: A Toolkit for Using Evidence from the State of the World’s Midwifery 2014 Report to Create Policy Change at the Country Level

This toolkit, available in English, French and Spanish, is designed to enhance the knowledge, skills, and capacity of midwives, and of their national midwifery associations, to conduct advocacy for positive policy change. using evidence published in The State of the World's Midwifery (SoWMy) 2014 report.


Mapping Misoprostol for Postpartum Hemorrhage: Regional Reports

In 2010 and 2011, Family Care International conducted mappings in five regions: Francophone West Africa, East Africa, Latin America and the Caribbean (LAC), Middle East and North Africa (MENA), and South Asia. These mappings identified the major policy challenges and opportunities related to introducing and improving access to misoprostol for preventing and/or treating postpartum hemorrhage (PPH). Each document is available in English; when relevant to the region, they are available in French and Spanish as well.

Maternal Health Cards

These seven cards were designed to enable indigenous women in Bolivia to know and understand the new legislation that protects their sexual and reproductive rights and ways to promote its application.

Elaboradas en forma participativa con las mujeres indígenas de Bolivia, estas siete cartillas son una herramienta creada para fortalecer sus conocimientos acerca de las leyes y la normativa relacionada a su salud y sus derechos sexuales y reproductivos y las formas de asegurar su cumplimiento y de acceder a los servicios de salud.

Medicamentos Esenciales para la Salud Materna: Garantizar un Acceso Equitativo para Todos

Un conjunto de siete dossiers que describen los desafíos y las soluciones para aumentar la disponibilidad y el uso de tres medicamentos esenciales para la salud materna (la oxitocina, el misoprostol y el sulfato de magnesio), basándose en las lecciones y en la experiencia de los suministros para la salud reproductiva.

Médicaments essentiels de santé maternelle: garantir un accès équitable pour tous

Un ensemble de sept abrégés décrivant les enjeux et les solutions pour augmenter la disponibilité et l'utilisation de trois médicaments essentiels de santé maternelle (l’ocytocine, le misoprostol et le sulfate de magnésium), en s'appuyant sur les leçons et les expériences des produits de santé reproductive.

Misoprostol for Postpartum Hemorrhage Information Kit

Developed by Family Care International and Gynuity Health Projects, the Misoprostol for Postpartum Hemorrhage Information Kit contains a range of informational publications and briefing cards on the potential role of a widely available drug (misoprostol) in reducing deaths from postpartum hemorrhage, the leading cause of maternal death and disability in developing countries. All publications are available in English, French, and Spanish.

Misoprostol for Postpartum Hemorrhage: Questions and Answers for Policy Makers

Misoprostol for Postpartum Hemorrhage: Questions and Answers for Policy Makers provides information about misoprostol’s critical role in preventing and treating postpartum bleeding or hemorrhage (PPH), one of the leading causes of maternal death worldwide. Misoprostol, a medicine initially developed to prevent stomach ulcers, is often the best available option for preventing and treating PPH in many low-resource countries, and may be a woman’s only chance for surviving PPH.

Misoprostol for Postpartum Hemorrhage: Reaching women wherever they give birth

This publication, available in English and French, presents case studies from three countries — Bangladesh, Nepal, and Zambia — that have introduced and scaled up the use of misoprostol for postpartum hemorrhage (PPH). These country examples highlight the essential role of high-level commitment and support in initiating and implementing national programs, and provide inspiration and guidance for policy makers and partners seeking to expand access to misoprostol for PPH.

Oportunidades y Retos para la Reducción de la Muerte Materna en América Latina y el Caribe

"Opportunities and Challenges for the Reduction of Maternal Mortality in Latin America and the Caribbean" is a call for decision makers in international organisms, governments, and civil society organizations to unite and coordinate efforts to reduce maternal mortality in the region, and constitutes an invitation to join the efforts of the Regional Task Force on Maternal Mortality Reduction (GTR).

El presente documento tiene el propósito de llamar la atención a tomadores de decisiones en organismos internacionales, gobiernos y organizaciones civiles para unir y coordinar esfuerzos, y constituye una invitación a sumarse al Grupo de Trabajo Regional para la Reducción de la Mortalidad Materna (GTR).

Preventing Early Pregnancy and Poor Reproductive Outcomes: A Toolkit

Nearly 16 million girls between 15 and 19 give birth annually, almost all of them in developing countries. After a systematic review of the evidence, WHO has developed guidelines on Preventing early pregnancy and poor reproductive outcomes among adolescents in developing countries, which focus on key actions that aim to reduce the number of adolescent pregnancies in developing countries. In 2012, in collaboration with WHO and UNFPA, FCI developed this advocacy toolkit, available in English, French, and Spanish, to promote the dissemination of the guidelines’ recommendations to policy makers and program planners globally. Designed for advocates, the toolkit encourages and enables evidence-based action among decision-makers, opinion leaders, medical personnel, researchers, and affected communities to prevent early pregnancy and poor reproductive outcomes among adolescent girls.

Reproductive, Maternal, Newborn, and Child Health in a Devolved State: The Kenya Context

In 2013, the Kenya Constitution introduced a devolved system of government that aims to enhance access to health services by all Kenyans, especially those in rural and hard-to-reach areas. Within this new context of devolution, the implementation of health policy commitments will shift: some policy issues will continue to be addressed through national mechanisms while implementation of health policy issues will now be addressed at the county level with the full involvement of local policy makers and health officials.

Family Care International and the African Women’s Development and Communication Network (FEMNET) developed this policy brief to provide guidance to civil society advocates on policy and decision-making structures, and avenues and opportunities for advocacy, in a context where the health system is devolved.

Scaling up Misoprostol for Postpartum Hemorrhage: Moving from Evidence to Action

This policy brief, available in English and French, explores strategies to help governments and partners improve maternal health by expanding access to misoprostol for treatment and prevention of postpartum hemorrhage (PPH), one of the leading causes of maternal death.

Cette note d’information stratégique, disponible en anglais et en français, explore des stratégies pour aider les gouvernements et les partenaires améliorer la santé maternelle en élargissant l'accès au misoprostol pour le traitement et la prévention de l'hémorragie du post-partum (HPP), l'une des principales causes de mortalité maternelle.

Sexual and Reproductive Health and Rights (SRHR) and the Post-2015 Development Agenda (Briefing Cards)

These briefing cards, produced by FCI on behalf of the Universal Access Project and a range of partners, detail the linkages between sexual and reproductive health and rights (SRHR) and other key development issues including environmental sustainability, gender equality, economic growth, educational attainment, and broader health goals. They present key facts about the impact of SRHR on the broader development agenda and make recommendations for inclusion of SRHR in the post-2015 development framework.

You, Your Life, Your Dreams: A Book for Adolescents

Helps young people make informed decisions about their sexual lives by providing comprehensive information for adolescents on changes during puberty, sexuality and sexual health, pregnancy and contraception, STIs including HIV/ AIDS, sexual coercion and violence, substance abuse, building healthy relationships, communicating with parents, and planning for the future. The manual has been developed in fivelanguages and six different versions reflecting the regional contexts and the unique challenges facing adolescents in Sub-Saharan Africa, Latin America, and the Caribbean.

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