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Accelerating Women-centered Local Action and Increasing Impact to Stop Preventable Maternal & Newborn Deaths in Low- and Middle -Income Countries: Case-study in Senegal

Received: 8 October 2021    Accepted: 8 November 2021    Published: 17 November 2021
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Abstract

There is an urgent need for improvements in maternal and newborn health despite the efforts of numerous stakeholders and the adoption of specific targets as in the Sustainable Development Goals. In 2018, using an evidence-based and design-thinking approach involving communities, three stakeholders (a foundation, an NGO, and a startup) decided to combine their expertise to better understand and potentially revisit the drivers for improving maternal and newborn health. The AIM – Accelerated Impact Model - has been designed as a systemic, needs-led innovation framework for improving maternal and newborn health in low and middle-income countries. The AIM is currently being tested to assess its real-world impact in the Saint-Louis region of Senegal. This paper aims to explain the rationale and methodology for designing this innovative model, as well as presenting hypotheses concerning its impact. This novel, integrated approach is associated with community empowerment and accompanied by “glocal” experts and organizations. It represents the backbone of the AIM method. The first step of the AIM application was the pre-pilot phase, as the population itself identified the health and medical-social barriers contributing to maternal and newborn mortality together with the corresponding corrective measures. The second step integrated co-created projects into a three-pillar program centered on awareness of community engagement, optimizing the attractiveness of the health pyramid base, and the empowerment of women. To test the sustainability of the model, the third step of the AIM approach resulted in the creation of a local pilot team to accelerate the implementation of new co-created projects and optimize existing initiatives supported by local and global sponsors. Over the course of one month, the newly formed “Rawal ak Diam” platform transformed the COVID-19 epidemic into an opportunity to mobilize the community and connect with the authorities. This step was crucial for gaining legitimation for the platform and helped design and implement a three-pillar program. The community program focus here is on the two first deadlines (the decision to request help and access care) in maternal health while remaining aligned with the Sustainable Development Goal of reducing maternal and neonatal mortality in low- and middle-income countries.

Published in World Journal of Public Health (Volume 6, Issue 4)
DOI 10.11648/j.wjph.20210604.14
Page(s) 155-166
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Maternal Health, Design Thinking, Ethnography, Community, Empowerment, Evidence Based, Low- and Middle-Income Countries, Determinants of Health

References
[1] UN Inter-agency Group for Child Mortality. (2020). A Neglected Tragedy The global burden of stillbirths. Retrieved from Report of the UN Inter-agency Group for Child Mortality Estimation: https://childmortality.org/wp-content/uploads/2020/10/UN-IGME-2020-Stillbirth-Report.pdf
[2] UN Maternal Mortality Estimation Inter-Agency Group. (2019). Maternal mortality: Levels and trends 2000 to 2017. Retrieved from WHO: https://www.who.int/publications/i/item/9789241516488
[3] The Lancet Maternal Health Series: Global Research & Evidence. (2016). Lancet maternal health series. Retrieved from Lancet: https://www.thelancet.com/series/maternal-health-2016
[4] Filippi, V., Chou, D., Ronsmans, C., Graham, W., & Say, L. (2016). Levels and Causes of Maternal Mortality and Morbidity (3 ed., Vol. 2). Washington (DC): Black RE, Laxminarayan R, Temmerman M, et al., editors. doi: 10.1596/978-1-4648-0348-2_ch3.
[5] Horton, R. (2019). Offline: The false narrative of “tremendous progress”. Lancet, Vol 394, 1129. doi: https://doi.org/10.1016/S0140-6736(19)32208-1
[6] Yap Boum, Y. M. (2020). Burden of disease in francophone Africa 1990–2017: the triple penalty? The Lancet Global Health, 8 (3), E306-E307. doi: https://doi.org/10.1016/S2214-109X(20)30040-1
[7] OECD Development Centre, P. (2019). 2019_Health_policy_note. Retrieved from https://www.oecd.org/development/networks/2019_Health_policy_note.pdf
[8] OECD. (2018). Private Philanthropy for Development. The development dimension, OECD publishing, 1-132. doi: https://doi.org/10.1787/9789264085190-en
[9] Lancet maternal health] Horton, R. (2019). Offline: The false narrative of “tremendous progress”. Lancet, Vol 394, 1129. doi: https://doi.org/10.1016/S0140-6736(19)32208-1
[10] Sanofi Espoir Foundation. (2021). Brochure 2020-2021 of the Foundation. Retrieved from Sanofi Espoir Foundation: https://www.fondation-sanofi-espoir.com/-/media/Project/One-Sanofi-Web/Websites/Global/Sanofi-Espoir-Foundation/Home/Publication/brochure-of-the-foundation/2020-2021-brochure-fondation-EN.pdf?la=en&hash=2468234F651FB81549F8DB2BD237DB8E
[11] Women and Gender Equity Knowledge Network. (2007). Unequal, Unfair, Ineffective and Inefficient Gender Inequity in Health: Why it exists and how we can change it. Final Report to the WHO Commission on Social Determinants of Health. Retrieved from https://www.who.int/social_determinants/resources/csdh_media/wgekn_final_report_07.pdf
[12] WHO. (2012). Déterminants sociaux de la santé. Retrieved from https://www.who.int/social_determinants/fr/
[13] WHO. (2012). Social determinants approach to maternal deaths. Retrieved from WHO Maternal, newborn, child and adolescent health: https://www.who.int/maternal_child_adolescent/epidemiology/maternal-death-surveillance/case-studies/india-social-determinants/en/
[14] Humanitarian innovation fund. (2016). Linking interventions to cultural ceremonies and practices to reduce intimate partner violence among displaced populations in humanitarian crises. Retrieved from https://www.elrha.org/wp-content/uploads/2019/04/HIF-Final-Report-2019_0201-FINAL.pdf
[15] Brown, T., & Wyatt, J. (2010). Design thinking for Social Innovation. Stanford Social Innovation Review, A préciser. Retrieved from https://ssir.org/articles/entry/design_thinking_for_social_innovation
[16] Roberts, J. P., Fisher, T. R., Trowbridge, M. J., & Bent, C. (2016, March). A design thinking framework for healthcare management and innovation. Healthcare, Elsevier, 4 (11), 11-14. doi: 10.1016/j.hjdsi.2015.12.002.
[17] Brown, T. (2008). Design Thinking. Harvard Business Review, 1-10. Retrieved from https://readings.design/PDF/Tim%20Brown%2C%20Design%20Thinking.pdf
[18] Badara, T. A. (2018). Community-Based Maternal and Neonatal Health Services in Kolda and Sedhiou Districts of Senegal. Global Journal of Health Science, 90. doi: 10.5539/gjhs.v10n3p90.
[19] UN Women Africa, Senegal, https://africa.unwomen.org/en/where-we-are/west-and-central-africa/senegal
[20] Fowler, M., & Highsmith, J. (2001). The agile manifesto. Software Development, 9 (8), 28-35. Retrieved from https://www.researchgate.net/publication/265620641_The_Agile_Manifesto
[21] Eisenmann, T., Ries, E., & Dillard, S. (December 2011 (revised July 2013)). Hypothesis-driven entrepreneurship: The lean startup. harvard Business School Entrepreunrial management Case, 812-095. Retrieved from https://www.hbs.edu/faculty/Pages/item.aspx?num=41302
[22] Stevens, R., & Brownell, S. (2018). IEEE Global Humanitarian Technology Conference (GHTC). Collaborative Social Impact Design Course. San Jose, CA, USA: IEEE. doi: 10.1109/GHTC.2018.8601656.
[23] Easterday, M., Gerber, E., & Rees Lewis, D. (2018). Social innovationn networks: a new approach to social design education and impact. (M. I. Technology, Ed.) Design, 34 (2), 64-76. doi: 10.1162/DESI_a_00486.
[24] Hillgren, P.-A., Seravalli, A., & Emilson, A. (2011). Prototyping and infrastructuring in design for social innovation. CoDesign, 7 (3-4), 169-183. doi: 10.1080/15710882.2011.630474.
[25] Loudon, G. H., Santhosh Kumar, C., SreeKumar, K., Haritha, H., Kuruyachan, H., & George, K. (2019). Conference: 20th Anniversary People’s Palace Projects: Indigeneous Research Methods Workshop. Empowering indigeneous communities in India through the use of design thinking methods. Retrieved from https://www.researchgate.net/publication/335465861_Empowering_indigenous_communities_in_India_through_the_use_of_design_thinking_methods
[26] Thaddeus, S., & Maine, D. (1994, April). Too far to walk: Maternal mortality in context. Social Science and Medecine, 38 (8), 1091-1110. doi: 10.1016/0277-9536(94)90226-7.
[27] Lassi, Z. S., Kumar, R., & Bhutta, Z. (2016). Community-Based Care to Improve Maternal, Newborn, and Child Health. In Disease Control Priorities, Third Edition (Volume 2): Reproductive, Maternal, Newborn, and Child Health (3 ed., Vol. 2, pp. 1-397). Disease control priorities. doi: 10.1596/978-1-4648-0348-2_ch14.
[28] Kruk, M. E., Gage, A. D., Arsenault, C., Jordan, K., Leslie, H. H., & Roder-Dewan, S. (2018). igh-quality health systems in the Sustainable Development Goals era: time for a revolution. The Lancet Global Health, 6 (11), E11986-E1252. https://doi.org/10.1016/S2214-109X(18)30386-3
[29] Mc Laughlin, J. E., Wolcott, M. D., & Rider, T. R. (2019). A qualitative review of the design thinking framework in health professions education. BMC Medical Education, 19 (98), 1-8. doi: https://doi.org/10.1186/s12909-019-1528-8
[30] Design thinking and health communication: learning from failure. (2017, April 25). Retrieved from The Communication Initiative Network: https://www.comminit.com/content/design-thinking-and-health-communication-learning-failure
[31] Chou, C. D. (2018). Applying design thinking method to social entrepreneurship project. Computer Standards & Interfaces, 55, 73-79. doi: https://doi.org/10.1016/j.csi.2017.05.001
[32] Eesley, C., & Miller, W. (2018). Impact: Stanford University's Economic Impact via Innovation and Entrepreneurship. Foundations and Trends® in Entrepreneurship, 14 (2), 130-278. doi: http://dx.doi.org/10.1561/0300000074
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    Stephanie Vougier, Jan Liska, Marouchka Hebben, Cheikh Mbaye, Hadi Issa, et al. (2021). Accelerating Women-centered Local Action and Increasing Impact to Stop Preventable Maternal & Newborn Deaths in Low- and Middle -Income Countries: Case-study in Senegal. World Journal of Public Health, 6(4), 155-166. https://doi.org/10.11648/j.wjph.20210604.14

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    ACS Style

    Stephanie Vougier; Jan Liska; Marouchka Hebben; Cheikh Mbaye; Hadi Issa, et al. Accelerating Women-centered Local Action and Increasing Impact to Stop Preventable Maternal & Newborn Deaths in Low- and Middle -Income Countries: Case-study in Senegal. World J. Public Health 2021, 6(4), 155-166. doi: 10.11648/j.wjph.20210604.14

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    AMA Style

    Stephanie Vougier, Jan Liska, Marouchka Hebben, Cheikh Mbaye, Hadi Issa, et al. Accelerating Women-centered Local Action and Increasing Impact to Stop Preventable Maternal & Newborn Deaths in Low- and Middle -Income Countries: Case-study in Senegal. World J Public Health. 2021;6(4):155-166. doi: 10.11648/j.wjph.20210604.14

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  • @article{10.11648/j.wjph.20210604.14,
      author = {Stephanie Vougier and Jan Liska and Marouchka Hebben and Cheikh Mbaye and Hadi Issa and Amy Fall-Ndao and Isabelle Moreira and Ousmane Thiam and Safiatou Thiam and France Donnay and Valerie Faillat},
      title = {Accelerating Women-centered Local Action and Increasing Impact to Stop Preventable Maternal & Newborn Deaths in Low- and Middle -Income Countries: Case-study in Senegal},
      journal = {World Journal of Public Health},
      volume = {6},
      number = {4},
      pages = {155-166},
      doi = {10.11648/j.wjph.20210604.14},
      url = {https://doi.org/10.11648/j.wjph.20210604.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjph.20210604.14},
      abstract = {There is an urgent need for improvements in maternal and newborn health despite the efforts of numerous stakeholders and the adoption of specific targets as in the Sustainable Development Goals. In 2018, using an evidence-based and design-thinking approach involving communities, three stakeholders (a foundation, an NGO, and a startup) decided to combine their expertise to better understand and potentially revisit the drivers for improving maternal and newborn health. The AIM – Accelerated Impact Model - has been designed as a systemic, needs-led innovation framework for improving maternal and newborn health in low and middle-income countries. The AIM is currently being tested to assess its real-world impact in the Saint-Louis region of Senegal. This paper aims to explain the rationale and methodology for designing this innovative model, as well as presenting hypotheses concerning its impact. This novel, integrated approach is associated with community empowerment and accompanied by “glocal” experts and organizations. It represents the backbone of the AIM method. The first step of the AIM application was the pre-pilot phase, as the population itself identified the health and medical-social barriers contributing to maternal and newborn mortality together with the corresponding corrective measures. The second step integrated co-created projects into a three-pillar program centered on awareness of community engagement, optimizing the attractiveness of the health pyramid base, and the empowerment of women. To test the sustainability of the model, the third step of the AIM approach resulted in the creation of a local pilot team to accelerate the implementation of new co-created projects and optimize existing initiatives supported by local and global sponsors. Over the course of one month, the newly formed “Rawal ak Diam” platform transformed the COVID-19 epidemic into an opportunity to mobilize the community and connect with the authorities. This step was crucial for gaining legitimation for the platform and helped design and implement a three-pillar program. The community program focus here is on the two first deadlines (the decision to request help and access care) in maternal health while remaining aligned with the Sustainable Development Goal of reducing maternal and neonatal mortality in low- and middle-income countries.},
     year = {2021}
    }
    

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    VL  - 6
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Author Information
  • Sanofi Espoir Foundation, Paris, France

  • Sanofi, Paris, France

  • Saegus, Paris, France

  • Artemedis, Paris, France

  • Saegus, Paris, France

  • Sanofi, Global Health Unit, Abidjan, Ivory Coast

  • Senior Maternal Health Advisor, Dakar, Senegal

  • Health Sciences Training and Research Unit, Gaston Berger University, Saint-Louis, Senegal

  • The National Council for the Fight against AIDS (CNLS), Dakar, Senegal

  • King’s College, London, United Kingdom

  • Sanofi Espoir Foundation, Paris, France

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