The REAL Awards

By: Tara Fisher, Save the Children

Photo Credit: Save the Children

Every year, awards are given to recognize the accomplishments of celebrities, actors, singers, athletes and entertainers.  But what about the REAL people who don’t just play a doctor or nurse on TV?  The ones on the frontlines who are changing and saving lives every day?  This year we will begin to honor the people who rarely receive recognition or accolades – health workers.

The REAL Awards is a first-of-its kind awards platform designed to develop greater respect for and appreciation of the life-saving care provided by health workers around the world.  The REAL Awards was created by Save the Children and the Frontline Health Workers Coalition, with the help of presenting sponsors Medtronic Foundation and The Merck Company Foundation, and supporting partners Masimo Foundation, GlaxoSmithKline, Novartis, and Time Inc.  The Awards is also supported by a number of national health worker organizations including Association of Women’s Health, Obstetrics and Neonatal Nurses (AWOHNN), American College of Nurse Midwives (ACNM), American Congress of Obstetricians and Gynecologists (ACOG), and National Physician’s Alliance (NPA).

Our objective is to demonstrate the universal and urgent need for more trained, caring health workers on the frontlines.  By some estimates, the world is short more than 5 million health workers including one million frontline health workers.  Existing health workers are often overworked and under-appreciated.  We need to remind the public that people everywhere depend on health workers every day.

Starting September 24 at www.theREALawards.com, visitors can read 10 inspirational stories of frontline workers from around the world, nominate a U.S.-based health worker who has made a REAL difference and take an action on behalf of the millions of health workers who often don’t get recognition and support they deserve.

Check out our vision of what an awards show honoring health workers might look like.

Saving Lives Shouldn’t Mean You Risk Your Own

By Sarah Dwyer and Rachel Deussom, IntraHealth International

Health workers shouldn’t have to put themselves at risk in order to do their jobs. But in fact, many frontline health workers face a wide range of occupational safety and health hazards—biological, physical, chemical, and psychosocial, as well as gender-based violence and discrimination.

Let’s take a look at one health worker—the nurse below on the left.

She’s facing a heavy workload and has many patients seeking her attention. The nurse is aware that the facility needs to be cleaned regularly to reduce risk of infection, but the janitor is absent. The lack of running water makes it even more challenging.

Our health worker is a dedicated employee—rather than leave when her shift is over, she takes time after the clinic is closed to do the cleaning. But the absence of her colleagues means more work for her, and she may not be able to do it all while taking measures to protect herself. Some health facilities lack proper disposal equipment, which can be dangerous for both the health workers and their patients.

Now it’s very late, and our health worker has to get herself home after dark. The road may not be safe, especially for a woman traveling alone. And when she gets home, she’ll have to do a lot of housework, meal preparation, and child care.

Then tomorrow she’ll do it all over again.

How can we help this nurse and other health workers like her? A new CapacityPlus technical brief, Ensuring a Positive Practice Environment: Occupational Safety and Health for Health Worker Productivity, outlines ways to make health workers’ safety a higher-level policy issue and shows how to create working environments that prioritize occupational health.

Just a few of the many hazards include:

  • Lack of sterile equipment and proper waste management
  • Exposure to bacteria, parasites, and blood-borne viruses such as HIV and hepatitis as well as communicable diseases such as tuberculosis, avian flu, and swine flu
  • Physical strain and injury
  • Bleach, lead, flammables, solvents, noxious vapors, and radiation
  • Stress, fear caused by violence or verbal abuse, and depression

The good news is that improving safety in the workplace can help address other service delivery issues and result in additional gains, from increased motivation and productivity to a stronger-functioning team.

To learn more, read the technical brief, and please let us know what you think. What are the occupational safety and health hazards faced by you or health workers you know? What is being done to reduce these hazards?

 

Illustrations © CapacityPlus/IntraHealth International

Moms and Mangos: Documenting How Skilled Birth Attendants Are Making a Difference in India

Photo courtesy of IntraHealth International

By: Taylor Marie Snyder, IntraHealth International

After three-plus years of “working in India,” last month I finally had the opportunity to actually work in India. Prior to my UNC-IntraHealth Fellowship, I worked on a program promoting reproductive health in five countries, including India. While I had the opportunity to travel to Ethiopia, Nigeria, the Philippines, and the United Arab Emirates, something always seemed to get in the way of my plans to explore India. Thus, I was thrilled that my fellowship commenced with documenting the USAID-funded Vistaar Project’s interventions improving maternal, newborn and child health, and nutritional status in India.

This documentation process involved collaborating with IntraHealth colleagues in Delhi, Uttar Pradesh, and Jharkhand to capture Vistaar’s impact. It involved capturing hours of video and audio footage, taking thousands of photographs, enjoying several chai breaks, and eating lots of mangos. Through the documentation process, I became passionate about the project’s efforts to reduce the number of maternal and newborn deaths through strengthening the capacity of frontline health workers to conduct safe deliveries.

Background: The Need for Skilled Birth Attendants

For decades many Auxiliary Nurse Midwives (ANMs) stationed at sub-center level healthcare outposts in Jharkhand were present, yet they were not ready. Their lack of readiness to deliver babies meant that in many cases no babies were being delivered in the sub-centers where they were stationed. The absence of education on how to conduct safe deliveries combined with a lack of confidence in their abilities was a major obstacle preventing ANMs from providing lifesaving care. Community members recognized this lack of capacity and chose to deliver elsewhere, often in their homes.

In 2005, the Government of India introduced several major interventions to reduce the frequency of maternal and infant deaths. As part of the National Rural Health Mission, they encouraged delivering babies in medical institutions through an incentive payment system for frontline workers and families called Janani Suraksha Yojana. The Government also released guidelines for Skilled Birth Attendants (SBAs) and launched a large effort to upgrade the skills of existing ANMs so that they could become certified Skilled Birth Attendants (SBAs).

The Vistaar Project is working with the national Government of India and the state Government of Jharkhand to promote evidence-based and sustainable practices in training and providing support for ANMs to become SBAs. These practices include:

  • Improving the quality of SBA training
  • Motivating SBAs with non-financial rewards and recognition
  • Educating SBAs’ supervisors about the concept and use of supportive supervision
  • Ensuring regular access to medical supplies.

My colleagues and I traveled throughout Jharkhand to document the influence of implementing these four practices. We interviewed SBAs, SBAs’ supervisors, beneficiaries of SBAs’ work, and health officials. There weren’t enough hours in the day to speak with all of the individuals who wanted to tell us about the positive changes that are occurring due to the improved SBA training methodologies.

Skilled Birth Attendants in Action

We also saw SBAs in action–they were conducting home visits, giving nutritional advice, administering medications, and delivering babies! That’s right; we actually had the opportunity to witness a live birth at the district level hospital in Hazaribagh. As we were interviewing one doctor, another doctor and a group of SBAs-in-training delivered a baby in the newly improved maternity ward. After the little girl entered the world, we witnessed these SBAs-in-training perform the recommended steps for active management of the third stage of labor outlined in the guidelines for SBAs. It was incredible.

I will always remember our interview with recently trained SBA Kumud Rani, who recalled how the Vistaar supported Government training gave her both the skills and the higher degree of confidence necessary to perform deliveries. Prior to attending the training she lacked this confidence so there were no deliveries at her sub-center. In the six months after her training, she conducted over 50 deliveries. It was powerful to hear Kumud speak about how she always wanted to deliver babies and how this training allowed her to fulfill her dream.

Kumud’s transformation did not go unnoticed by the influential women in her community. It was remarkable to speak with Lakshimi Devi who, as the leader of the local governing council, has the means to access health care and deliver her children where she desires. Lakshimi chose to deliver her most recent baby in Kumud’s care at her local sub-center level healthcare outpost. Over the course of Lakshimi’s pregnancy, Kumud’s consistent home visits and ability to answer questions and supply medical and nutrition information had earned Lakshimi’s trust. Lakshimi’s decision to deliver with Kumud’s assistance strengthened the community’s trust in Kumud. This increased community awareness of Kumud’s abilities and promoted additional deliveries at the local sub-center.

What can be done to further this work? My experience working in India allowed me to witness first-hand the effective programs that Vistaar supported the Government of India to facilitate. It also allowed me to begin to understand the work that remains. It’s my hope that more evidence-based projects will continue to run in ways similar to Vistaar, especially projects that work with government structures in ways that encourage both immediate results and future sustainability.

Taylor Marie Snyder is a UNC-IntraHealth Fellow. Taylor is a master’s in public health (MPH) candidate in UNC’s Maternal and Child Health department with a focus on global health.

Photo courtesy of IntraHealth International