Maternal & Infant Health Initiative (MIHI)

The statistics on the health of women and children in Zambia are staggering. The maternal mortality ratio in Zambia is 729 per 100,000; maternal disability is 30 times higher. The country’s infant mortality rate is many times that of the developed world, which is tragic given the preventable nature of many of these deaths. The majority of women give birth with no access to emergency obstetrical or newborn care. There are fewer than 20 practicing obstetricians for a population of over 11 million and less than 50% of hospitals, and none of the rural health centers, have the capacity to provide comprehensive emergency obstetrical and newborn care.

In 2006, the Global Health Innovation Laboratory began working in Zambia through its Maternal and Infant Health Initiative (MIHI). MIHI grew out of an on-going strong collaboration between the First Lady of Zambia, Zambian health agencies, Zambian hospitals and health professional schools, and several Harvard-affiliated teaching hospitals; who all work closely with local Zambian communities.

MIHI's work during its four years focused efforts to lower maternal and infant morbidity and disability rates in Zambia's Central Province - specifically, the 300,000 population Kapiri Mposhi District.

MIHI's major activities included:

1. Development of a training and continuing education infrastructure for Zambian nurse midwives in Kapiri Mposhi;
2. Ongoing in-district, advanced midwife training & mentoring, as well as clinical officers, physicians and other health workers, in emergency obstetric and newborn care, by experienced U.S. health professionals;
3. Direct medical care to mothers and babies at Kapiri Mposhi Hospital and neighboring Kabwe District Hospital;
4. Research on use and effectiveness of medical technologies in resource-poor settings;
5. Upgrades of selected health facilities (i.e., building birthing centers adjacent to existing health clinics, upgrading hospital ORs); and
6. Assisting in development of transportation strategies to increase number of pregnant women and infants to quality care.

MIHI’s Accomplishments

• Multiple health-care trainings of physicians and midwives in Zambia as well as the U.S., on such topics as neonatal resuscitation and ultrasound use;
• Sponsorship of cohort of midwives and other health workers from Kabwe and Kapiri District to complete Zambian government-sponsored training course in emergency obstetric and neonatal care;
• Construction of a modern birthing center in a rural, underserved part of Kapiri Mposhi district;
• Construction of, and opening of, the only hospital operating room in entire 300,000-plus Kapiri Mposhi district; and
• Provision of technical assistance (e.g., assistance with development of a $14 million proposal) and consulting on national maternal health strategy to Zambian Ministry of Health.