Five Inspiring Stories from COVID-19 Changemakers

How USAID is supporting maternal and child survival during the COVID-19 pandemic

A health care worker walks past a mural at the Polana Caniço hospital in Maputo, Mozambique.
A health care worker walks past a mural at the Polana Caniço hospital in Maputo, Mozambique. USAID and partners have been working to support the national pandemic response alongside the country’s Ministry of Health, providing technical assistance to improve treatment of critical cases of COVID-19. / Karel Prinsloo, Jhpiego

Since the start of the pandemic, USAID has worked tirelessly with our partners to rapidly deploy support and assistance to countries in need, both to fight COVID-19 and to deliver essential health and nutrition services.

Our response has focused on protecting the continuity of care for women, newborns, and children; strengthening health systems to prepare and respond to future shocks and stresses; sharing emerging data, evidence, and best practices within the COVID-19 context; and building new partnerships to expand the availability of COVID-19 vaccines globally.

The five stories below highlight the resilient individuals and innovative approaches to safeguard the delivery of safe, high quality maternal, newborn, and child health and nutrition services as well as voluntary family planning and reproductive health care during the ongoing crisis.

“We’re used to these changes and we feel more at ease. We have learned and strived so much this year. I’ve grown stronger than I ever thought I could be.” Quote from Midwife Kussudiati in Indonesia.
Oscar Siagian, USAID Jalin Project

Protecting Women, Newborns, and Midwives in Indonesia

Early in the pandemic, roughly 10% of private midwifery clinics in Indonesia were forced to shut down due to public safety measures aimed at stopping the spread of COVID-19, leaving thousands of pregnant women with limited options for prenatal care and delivery services.

“Being pregnant during the pandemic was worrisome,” mom Indah explained. “I had to think about taking care of myself and my baby. I just needed to make sure we stayed safe.”

In the Banten province, long-time midwife Kussudiati joined a USAID-supported webinar series to get the most up-to-date information on how to respond to COVID-19 and to provide safer maternal and newborn health services during a pandemic. Adopting the guidelines and practices from the webinars, her clinic added a handwashing facility right outside, exhaust fans for air circulation, and stocks of personal protective equipment. She now safely serves dozens of mothers each week with prenatal care, contraceptive, and vaccination services.

“When I looked at the facility data, the numbers of children getting immunized against measles was dropping. In a typical month, we had an average of 119 children, but after COVID-19, the numbers had dropped to 60. I was worried that they could drop to zero.” Quote from Assistant Nursing Officer of Midwifery Susan Akwang in Uganda.
Kate Holt, USAID Maternal and Child Survival Program

Ensuring Essential Childhood Vaccines in Uganda

Movement restrictions and fears of infection during the pandemic have exacerbated challenges around the delivery of lifesaving childhood immunizations in Uganda, particularly in remote communities near Paraa National Park. Early on, facility data showed that the numbers of children receiving immunizations against measles was dropping rapidly. USAID responded by using this data to identify 13 hard-to-reach communities and partner with the local COVID-19 taskforce and community groups to visit isolated homes and gain approval for mothers to travel on motorcycles and bicycles without the required permits. Within two weeks, 546 children received their much-needed vaccinations and health center data reports showed a notable rebound in service utilization.

“But once I knew that mothers also needed special emotional support and skills to breastfeed the child, I looked after the two other children and performed household chores so that [my wife] has the time and emotional strength to breastfeed the newborn.” Quote from Father Ram Lama in Nepal.
USAID Suaahara II Project

Digitizing Breastfeeding Counseling in Nepal

In Nepal, USAID works to promote, protect, and support breastfeeding through intensive social and behavior change (SBC) interventions with families and communities. Throughout the pandemic, breastfeeding counselors and health care workers have been grappling with restrictions to mobility and lockdowns as COVID-19 case numbers change. In response, USAID helped health workers shift to a hybrid model for breastfeeding SBC activities, supporting counseling for over 87,500 mothers and caregivers in-person and over 230,000 mothers and caregivers virtually. Regular radio announcements, a “Mother Says” radio program, and social media campaigns helped reinforce messages learned during counseling sessions so that mothers and their young children in Nepal stayed well-nourished and healthy.

“Rasazy Mino, the midwife at Mananjary’s primary health center, introduced me to family planning methods. I have never changed providers because she inspires me with confidence and knows how to put me at ease while remaining very professional.” Quote from new mom Meva in Madagascar.
Samy Rakotoniaina, Management Sciences for Health

Mobilizing Family Planning Care in Madagascar

In Madagascar, the spread of COVID-19, resulting lockdowns, and restrictions on mobility have made access to care difficult for many, including women and couples in need of family planning services.

But Malagasy midwives, who are often the ones providing modern contraception in primary health centers and district hospitals across the country, have stayed on the frontlines to provide family planning services that support the healthy timing and spacing of pregnancies.

To maintain health care services during the pandemic, these midwives have incorporated infection prevention and control measures, such as mask wearing and increased handwashing, into their work to protect themselves and their clients. They have also literally gone the extra mile — using mobile outreach clinics to serve those unable to reach the health centers or living in the most isolated communities.

“We take all the precautions handling every patient so that at least they feel safe and comfortable with our continued services. There is so much work to be done here, there is no time to pause now; life does not take a pause. Every birth matters, every life matters.” Quote from Midwife Kazul Rani Paul in Bangladesh.
USAID Maternal and Newborn Care Strengthening Project

Building Trust in Health Systems in Bangladesh

From the community to the facility, the health system in Bangladesh has been strained during the pandemic, working overtime to save the lives of COVID-19 patients while continuing to provide emergency medical services. Lacking clear guidance and equipment, many service providers were also unprepared to continue essential services — like maternal and newborn care — early on in the pandemic. Fears of COVID-19 infection also reduced the number of mothers seeking care from facilities, with a nearly 50% drop in visits by April 2020.

In response, USAID supported midwives, paramedics, nurses, and doctors from public facilities around the country to creatively adapt and encourage care. Some midwives started making one-on-one telephone calls for follow-up check-ups, and others even worked with their local governments to raise awareness for the COVID-19 safety measures implemented by local service centers.

As the global community adapts to operating in an ongoing pandemic, it becomes more and more apparent that COVID-19 will not be the last pandemic — nor global crisis — that we will collectively face. Despite the challenges that lie ahead, USAID recognizes that the pandemic has also created new opportunities for innovation and partnership to better support families over the long-term for the yet unknown crises the world may face.

Thank you to all the changemakers who are delivering essential care to women, children, and families facing infectious disease, natural disasters, conflict, and other emergencies. We commend your bravery, tenacity, and resilience.

Explore our 2021 Acting on the Call Report to learn more about USAID’s efforts to advance maternal and child survival in our partner countries. This year’s report focuses on sustaining lifesaving health services amidst the pandemic for women and children globally, and analyzing how far we have come towards reaching our collective global goals.

About the Author

Jennifer Adams is the Acting Assistant Administrator for the Bureau for Global Health.

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Stories of USAID’s Work from Around the World

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