Our proposal summary to the MacArthur Foundation 100andchange call

Preventable maternal and perinatal mortality are tragic, unresolved global problems. Two thirds of maternal deaths occur in sub-Saharan Africa (SSA), where health workers and midwives cannot resolve them alone. Sustainability must be embedded in national contexts providing modern obstetric care, which is blatantly absent in many SSA countries. Midwives are essential, yet only in collaboration with obstetricians can complicated emergencies be solved. The Ghana-University of Michigan 25-year partnership led to training and retention of over 140 obstetricians, resulting in improved outcomes and national policy. We will solve the problem of maternal and perinatal morality by activating collaborators from 30 universities…


Our team of faculty, students and international colleagues at Global Initiatives have written a number of papers and books, sharing new knowledge about how to fully address the global crisis of maternal and neonatal mortality. Our research papers aren’t usually accessible to the general public, especially to those who are interested in learning more about the issue and how to get involved. A similar situation was painfully pointed out during the world’s recent crisis encounter with Ebola. Research from the 1970s, acted upon then, could have changed the course of history. (http://www.nytimes.com/2015/04/08/opinion/yes-we-were-warned-about-ebola.html).

In this series of posts, Melani Kekulawala and…


The Ghana postgraduate Obstetrics and Gynecology residency training program started in 1989 in response to the “brain drain” caused by the low return rate of Ghanaian physicians sent abroad to receive specialized training in Obstetrics and Gynecology (OBGYN). A post graduate training program to train young medical school graduates to become fully trained specialists in pregnancy complications and women’s health was established through a partnership between the Ghana Ministry of Health, the University of Ghana, the Kwame Nkrumah University of Science and Technology, the American College of Obstetricians and Gynecologists and the Royal College of Obstetrics and Gynecology (UK), and…


The impact on maternal and infant health from the creation of two obstetrics and gynecology training programs in Ghana has been great. The presence of these programs continues to produce highly trained OBGYNs adding to the more than 141 OBGYN already trained and retained in Ghana. One direct effect and obvious impact is the increase in the number of trained obstetricians and gynecologists who would simply not be available to provide care had these programs not been created. The graduates have saved countless lives and continue to transform the delivery of women’s health care. The impact is even greater as…


Our experience of academic partnerships in Ghana provides a model for a different approach to international development projects. The majority of academic partnerships and collaborations are strained by distance, communication issues, imbalance of resources, and differences in cultural values. To combat these factors, the partners of the Ghana collaboration established the CHARTER Project funded by the Bill and Melinda Gates Foundation. Besides the three technical goals of the project, one overarching goal provided the innovative backbone for the project. This goal led to the creation of a collaboratively created guide called the “charter for collaboration” to establish principles, objectives, and…


In response to the WHO’s call for eliminating preventable maternal mortality, it is strongly suggested that interventions with a capacity building element pave the way to accomplishing this goal. The Ghana training program was founded on academic and professional partnerships that created the context and expertise for training physicians to become specialists. One of the biggest takeaways from the creation of the post-graduate residency program was the potential for international academic and professional partnerships to capacity build — the process of developing and strengthening the skills, abilities, and resources that are necessary for communities to sustainably adapt and prosper. At…


A woman in Sub-Saharan Africa (SSA) is almost 100 times more likely to die from pregnancy or childbirth-related complications than a woman in a developed country; a 1 in 39 lifetime risk compared to 1 in 3,800. These maternal deaths, as well as early neonatal deaths and complications such as obstetric fistula, are almost all preventable with skilled obstetric care. Ending preventable, maternal, perinatal and early neonatal mortality will only be realized when the most severe maternal complications can be addressed with known obstetric interventions. Only professional obstetricians/gynecologists are directly trained to provide solutions at this level, but must work…


Obstetric and Gynecological care in sub Saharan Africa(SSA) is severely limited by the availability of well trained and certified specialists. A large consolidated effort by the Global OBGYN community is urgently needed in SSA to create the ability to respond to the recent WHO call to eliminate preventable maternal mortality. Unless full and expert clinical OBGYN expertise and national leadership is fully developed in all countries of SSA, the most severe obstetric complications, as well as preventable stillbirth and early neonatal mortality will never be fully addressed. This expertise takes years to develop, and must be started now in order…


There are two approaches to solving a large overarching problem. The first is to address the downstream effects, ameliorating the bad effects that result from a bigger problem. The second is to put in the effort to solve the bigger problem so that the downstream effects will disappear- classic prevention-the basis of public health -and the difference between “relief” and “development”.

There are huge health problems in the world to which we must respond to reduce suffering. Trying to solve them is complex because many of the current global health initiatives aimed at maternal and newborn care are actually “relief”…

Frank J Anderson MD MPH

Professor Obstetrics and Gynecology, University of Michigan Department of OBGYN and Director of Global Initiatives - Maternal Mortality Reduction

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