Potential roles for professional associations in South Africa – making a difference to maternal he...
Download
1 / 32

Sharon Fonn - PowerPoint PPT Presentation


  • 103 Views
  • Uploaded on

Potential roles for professional associations in South Africa – making a difference to maternal health. Sharon Fonn. Raise the status, maintain the integrity , support and promote the interests of the midwife

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Sharon Fonn' - zeal


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
Sharon fonn

Potential roles for professional associations in South Africa – making a difference to maternal health

Sharon Fonn


Sharon fonn

  • Raise Africa – making a difference to maternal healththe status, maintain the integrity, support and promote the interests of the midwife

  • Develop and promote an adequate, efficient and effective midwifery service in South Africa

  • Consider every matter in connection with or with reference to midwifery and act as an advisory body

  • Bring about liaison and cooperation with other groups and health care providers associated with midwifery

  • Encourage the establishment of local groups in order to promote the aims and goals of the Society

  • Promote research in midwifery

  •  Promote liaison with midwifery groups internationally


National agenda improving maternal and child health
National agenda - improving maternal and child health Africa – making a difference to maternal health

  • MMR is decreasing in some countries

  • WHO - 3 common factors present

  • Policy makers and health service managers prioritize this

  • Skilled providers who operate in a professional manner

  • Access to services and related resources


Professional associations can and should play a role in achieving this
Professional associations can and should play a role in achieving this

  • “Because the country is in need of critical mass of leaders, the days of treating nurses as mere implementers of policy that is already exists are long gone, and it’s time for nurses to take up a leading role in solving the country’s health problems in support of existent programmes.”

  • ThembekaGwagwa, General Secretary of Democratic Nursing Organisation of South Africa (DENOSA),




Human rights framework
Human Rights framework achieving this

  • Failure to reduce preventable maternal deaths violates women’s right to

    • Life

    • Health

    • Non discrimination

    • Equality


Under what auspices do professional associations do this1
Under what auspices do professional associations do this? achieving this

  • Human Rights instruments (CEDAW) provide mechanisms (and responsibilities) for the public to

    • Monitor

    • Scrutinize

    • Document progress

    • Report (nationally and internationally)



Pressure from coalitions
Pressure from coalitions achieving this

  • Women’s organizations,

  • Health and legal professionals

  • Parliamentarians

  • Church groups


Sharon fonn

  • In achieving this South Africa and internationally saw abortion law reform

  • In UK quality of care and patient satisfaction indicators are now standard audit tools used by health professionals



Sharon fonn

Reprod achieving this Health. 2011; 8: 39.

Published online 2011 December 22. doi: 10.1186/1742-4755-8-39


Did it make a difference to maternal mortality
Did it make a difference to maternal mortality? achieving this

  • Choice on Termination of Pregnancy Act in 1996

  • Maternal mortality due to unsafe abortion down by 91%

  • Maternal morbidity due to unsafe down by 50%,

  • Safe TOPs increased by 67%. 26 401 to 81 900 in 1 year


Other examples
Other examples? achieving this

  • HIV services – a coalition of lawyers, health professionals, clinician associations, community members, NGO’s worked together to ensure that women got access to prevention of transmission to their children and then treatment for themselves and others

  • Community – provider links (treatment literacy campaigns)


Other mechanisms
Other mechanisms? achieving this

  • UK confidential enquiry published every three years since 1952

  • Target medical and midwifery professions who responded by improved training and M&E

  • Consistent and sustained decrease in MMR


Confidential enquiry into maternal deaths in south africa
Confidential enquiry into maternal deaths achieving this in South Africa


Recommendations
Recommendations achieving this

  • Protocols available and used

  • Training (anaesthesia)

  • Screening and Rx for non pregnancy related disease

  • Referral

  • Staffing and equipment norms

  • Blood

  • Contraception

  • Abortion deaths

  • Community involvement


Sharon fonn
YET achieving this

2005-2007

recommendations almost

identical to

2002-2004


Enquiry necessary but not sufficient
Enquiry necessary but not sufficient achieving this

  • In South Africa and Botswana we have the reports but as yet not the required response

  • Some don’t want to change

  • Many are prevented from doing so – conditions prevent providing quality of care



Does anyone do it
Does anyone do it? achieving this

Uganda May 2011

  • Hundreds of health professionals and concerned citizens went to the constitutional court in Kampala to support a lawsuit which is trying to hold government responsible for the death of 2 women who bled to death

  • By not providing essential medical commodities and health services to pregnant women their constitutional rights are being violated


Professional associations role
Professional associations’ role achieving this

  • Commitment to professional competence

  • Providing quality care

  • Who holds them accountable?

  • Governments have a duty to create conducive environments to allow for providers to act in a professional way

  • Health professionals should be accountable for the standard of care they provide

  • Speak out about abuse


Why do it
Why do it? achieving this

  • Raise the status, maintain the integrity, support and promote the interests of the midwife


Changing policy and practice
Changing policy and achieving this practice

  • Who are the allies who can be relied on to support professionals?

  • Learning from HIV

  • Bring about liaison and cooperation with other groups and health care providers associated with midwifery


Anyone done it
Anyone done it? achieving this

  • SA Human Rights report

  • Kenya a similar report –

    • Removal of user fees

    • Midwives association invited Federation of Women’s Lawyers to do training on a rights based approach

    • Public enquiry on sexual and reproductive health in June 2011

    • Coalitions formed and partnerships developed – indication of improved quality of care


Challenge protectionism
Challenge protectionism achieving this

  • Nepal 1996: 3-month training for anaesthetic assistants

  • Provided anaethesia for thousands each year including caesarean sections

  • Physicians opposed this

  • Nepal’s safe motherhood initiative, alliance of health professionals and NGOs ensured they were reinstated and accredited


If we are serious about our profession
If we are serious about our profession achieving this

  • Incumbent on us to act in defense of what we do and how we do it


Lastly dealing with indirect causes of maternal mortality
Lastly – dealing with indirect causes of Maternal Mortality

  • Comprehensive care

    • Contraception

    • HIV

    • TB

    • Chronic diseases

    • Our patients are people


Sharon fonn
How Mortality

  • It starts with me ….


Sharon fonn

Role model Mortality

  • Explain the reasons for the baby-friendly initiative

  • A new style of engagement: “customers”, “service”

    If I behave the right way and you keep on seeing me behave the right way towards the patients: being customer friendly, the patients talking to me, being happy, greeting me, I greeting them. Then you’ll also think, is this not nice?’ It won’t be everybody changing but most of the nurses will think, ‘hey, this is good’ and they’ll also change.

B Harris Centre for Health Policy


Thank you

Thank you Mortality