Asia Regional Meeting

Asia Regional Meeting on

Interventions for Impact in Essential Obstetric and Newborn Care Dates:

4 – 6 May 2012 (Opening Ceremony and Reception on 3 May)

Location:

Dhaka, Bangladesh (Ruposhi Bangla Hotel, Dhaka)

Organizers:

Government of Bangladesh, USAID/MCHIP, Oxytocin Initiative

Description: This meeting will bring together maternal/newborn health leaders, experienced clinicians and program managers to support accelerated implementation and expansion of maternal and newborn health programs in countries in Asia and the Middle East.

The meeting will focus on postpartum hemorrhage (PPH), pre-eclampsia/eclampsia (PE/E) and other aspects of maternal and newborn health. The first day will include an overview of global and regional progress to date in the reduction of maternal mortality and an update on new global guidelines for PPH. It will engage participants in a technical discussion on PPH prevention and treatment, including a review of issues related to quality and availability of uterotonics and maternal health supplies. The second and third days will allow time to deliberate on management of pre-eclampsia and review PE/E program implementation experience, as well as interventions for newborns. The entire afternoon of the second day will be devoted to skill building sessions and opportunities to more deeply explore some technical issues related to service delivery and training. True to the global perspective, the meeting will emphasize PPH, PE/E and newborn initiatives from the platform of Essential Obstetric and Newborn Care and discuss it with respect to the broader Maternal and Newborn Health context in general, exploring themes of innovation, scale up and measurement.

Meeting Objectives:  To present and discuss global scientific and technical information on prevention, early detection and management of PPH and PE/E, and special care for newborns  To review/discuss programmatic experiences and progress in the implementation of newborn care and PPH prevention/management programs in Asia / the Middle East  To review and consider an appropriate programmatic platform for the scale up of PPH reduction and newborn care programs and the initiation or expansion of PE/E reduction programs that can be implemented at multiple levels of the health system  To develop knowledge and greater understanding of selected interventions in maternal and newborn health.

Audience:  Ministries of Health from Governments throughout Asia and the Middle East, predominantly from the Maternal Newborn Health Unit  Professional societies of Midwifery, Obstetrics and Pediatrics; Universities and Preservice Education Institutions  Leading Asian Institutions working in maternal and newborn health  Global Health Agencies: WHO; Unicef; UNFPA, World Bank 1|Page

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Donors and USAID Missions from throughout Asia and the Middle East Implementing partners, Bilateral programs in MNH, MCHIP Implementing partners

Collaborating Organizations: • • • • • •

USAID and the USAID/Asia Near East Bureau The Government of Bangladesh MCHIP The Gates Foundation-funded Oxytocin Initiative WHO/EMRO, WHO/SEARO and WHO/WPRO, Unicef, UNFPA FIGO, ICM, FCI, Women Deliver

Participants from: 1. Bangladesh 2. Afghanistan 3. Pakistan 4. India 5. Nepal 6. Myanmar 7. Lao PDR 8. Cambodia 9. Vietnam 10. Indonesia 11. East Timor

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Philippines Papua New Guinea West Bank/Gaza Yemen Jordan Iraq Egypt All interested participants from the Middle East and Asia/Pacific Regions

Tentative agenda: Day Before Conference All Day (9:00 – 5:00) Special Pre-Conference Meeting on Nutritional Issues in Maternal and Newborn Afternoon (3:30-6:00) Health: Pre-Conference Orientation on Calcium for Prevention of Pre-Eclampsia Programming the Helping Babies Breathe and Initiative for Newborn Resuscitation Iron for Treatment / Prevention of Anemia Evening (7:00) Opening Ceremony Technical Presentation: Maternal Health in Context Welcome: Prime Minister of Bangladesh (tentative) Welcome Dinner

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Day 1 Morning Improvements in Maternal Health: The Changing Situation of MNH  Maternal Mortality 1990 – 2011: Dr. Monir Islam, WHO/SEARO  Recent documented reductions in Maternal Mortality in Asia: Four Stories o Bangladesh: o Afghanistan: Honorable Dr. Suraya Dalil, Minister of Health o Nepal: Dr. Pradhan, Director General, Ministry of Health o Cambodia: His Excellency Deputy Prime Minister Yin Chhay Ly Global Evidence and Guidance for PPH Prevention and Treatment  WHO PPH and Task Shifting Guidance: João Paulo de Souza, WHO  AMTSL Trial: Pisake Limpiganon, Khon Kaen University, Thailand  The evidence for use of misoprostol for prevention and treatment of PPH: Gynuity  Prevention & Management Strategies at levels of health system: Farhana Dewan, OGSB Lunch and Prayers Afternoon Overcoming barriers and measuring success - implementing PPH prevention and management programs  Global overview of PPH Scale up: A Multi-country Analysis: Jeffrey Smith, MCHIP  Maternal Health Indicators and Use of a Uterotonic in 3rd stage: Steve Hodgins, MCHIP  Experience with community level use of misoprostol in Asia: Ndola Prata, VSI  Implementation experience: Bangladesh (highlight operational issues) Bangladesh Rep  Implementation experience: Nepal (highlight national scale up process) Naresh Pratap KC, FHD, Government of Nepal Drugs and Commodities  Quality of Oxytocin & Ergometrine, India Scoping Exercise: Cindy Stanton, OI and JHU  Quality of misoprostol: Peter Hall, Concept Foundation  Improving the quality of uterotonics: Patrick Lukulay, USP  The horizons of oxytocin – TTIs, Heat Stable Oxytocin: Hans Hogerzeil, ex-WHO GROUP EXERCISE: Uterotonic Selection Tool Optional Evening Satellites 1.

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Story of Bangladesh Maternal Mortality Reduction – MOH/Bangladesh Uterotonic use in India: Oxytocin Initiative Training on PPH Prevention – “Bleeding After Birth”: Peter Johnson, Cherrie Evans Improving newborn survival: role of chlorhexidine application to the umbilical stump: Joseph de Graft Johnson & Steve Hodgins

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Day 2 Morning Opening of the Day and Daily Keynote: Quality of Care / Access to Care: Lynn Freedman, AMDD Evidence for Prevention and Detection of PE/E  New WHO Guidelines on PE/E (2011): João Paulo de Souza, WHO  Use of calcium and Vitamin D for prevention: Zulfi Bhutta, Aga Khan  Detection of PE during ANC – data from QoC studies: Barbara Rawlins, MCHIP  Screening and early detection of PE/E at community: Harshad Sanghvi, Jhpiego Evidence for Decisions in PE/E Management  Choice of Anticonvulsants in treatment of PE/E: João Paulo de Souza, WHO  Choice of Antihypertensives in treatment of PE/E: Tabassum Firoz, Pre-EMPT  Induction of Labor/Delivery Management in PE/E: Pisake Limpiganon, Khon Kaen Univ  Management strategies at different levels of health system: Dwirani Amelia Jhpiego/Indonesia Lunch Afternoon – Need most of afternoon for these sessions.

Programs for PE/E  MgSO4 in Bangladesh: OGSB  Calcium supplementation Nepal: Kusum Thapa/Nepal  Experience Implementing PE/E Management Program in Nigeria: Pop Council, Nigeria  Does literature support perception that MgSO4 is a dangerous drug? MCHIP/VSI Skills sessions on: (Total 8 offerings, participant chooses 4) 1. BP measurement/Urine testing 2. Induction of Labor 3. MgSO4 teaching tool 4. New PPH Technologies (tamponade, condom catheter, anti-shock garment, non-invasive anemia testing) 5. NeoNatalie and HBB 6. Kangaroo Mother Care 7. MamaNatalie 8. Oxytocin in Uniject Poster Session: Status of PPH and PE/E Programs in Participating Countries Optional Evening Satellites (include a room for toolkits) 5.

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mHealth and the MAMA Initiative: James Bon Tempo PPH, PE/E, PPFP and PSE toolkits: Catherine Carr, Stephanie Suhowatsky Improving newborn resuscitation using HBB materials in interested countries: Joseph de GJ MNH Financing strategies Integration of FP and MNH – Health Approach: Cat McKaig

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Day 3 Morning Opening of the Day and Opening Plenary: Sue Bree, ICM  SoWMy Report / Midwifery In Asia: Prakassama, Indian Midwifery Association  Midwifery model in Afghanistan: Pashtoon Azfar, ICM  Scaling Up HRH for MNH through the HBCI, Petra ten Hoope-Bender, Integrare Newborn Panel/ Improving Neonatal Resuscitation: (Newborn team to look at this session)  Technical update on newborn resuscitation and home visits for newborn survival: WHO  Improving newborn resuscitation in Bangladesh: HBB Bangladesh  Ensuring newborns with infections get prompt treatment: Nepal experience: MOH/Nepal  Scaling-up Kangaroo Mother Care in Vietnam: MOH/Vietnam Addressing Other Areas of Maternal Health  Maternal Sepsis  Complications of Unsafe Abortion  Integration of FP and MNH Programs: Abdullah Baqui, JHU Lunch Afternoon GROUP EXERCISE: Interventions for Prevention and Management of PPH Interventions for Prevention and Management of Pre-Eclampsia / Eclampsia Country Posters (meeting by country group) Implementation MNH Programs  Financial Incentives for use of MNH services – a USAID Evidence Summit; and New Universal Rights of Childbearing Women – remarks from Mary Ellen Stanton  Respectful Care at Birth: Baharuddin, Budi Kemuliaan Hospital, Jakarta  MNH Financing I: Equity Fund-Cambodia: Cambodia  MNH Financing II: JSY- India: Pop Council / India Environment for MNH  Health System for MNH: Ana Langer, MHTF  Advocacy for MNH: Ann Starrs, FCI  The role of Maternal Health Professionals in Reducing MMR: Andre Lalonde, FIGO  Going beyond MDGs and 2015: Jill Sheffield, Women Deliver Panel Discussion: The way forward: Integrating new ideas and approaches with current situations in countries Summary and Closing

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