1. HOPE FOUNDATION FOR WOMEN AND CHILDREN OF BANGLADESH From Home to Hospital: a Project to Drive Down Maternal Mortality

2. Project Deliverables Provide antenatal care services to 500 expectant mothers. Increase hospital birth to at least 20%. Increase utilization of skilled birth attendants by 30% for home births. Increase immunization rate. Increase number of ANC visits per mother.

3. Project Deliverables Reduce maternal mortality for the women in this group by 50%. Educate all 500 women on family planning. Educate the 500 women on maternal nutrition. Decrease the occurrence of obstetric fistula among the 500 women.

4. Registering New Expectant Women Daily!

5. Reporting Number of expectant mothers who received antenatal care services, immunizations and education about family planning and proper maternal nutrition: 500 At each ANC visit, expectant women received: Folic Acid and Calcium supplements, counseling on postnatal Dos and Don'ts, exclusive breast feeding education, family planning, immunizations and nutrition counseling.

6. Reporting Number of hospital births: 44 A total of 245 women still need to deliver. 32 deliveries took place at HOPE, 2 at Cox’s Bazar District Hospital and 10 at other clinics. (Important to note, 113 women were unreachable by phone)

7. Reporting Utilization of skilled birth attendants: 39 out of 98 home births – 40%. Number of antenatal care check-ups total for the group performed- 826 visits. (Visits will continue for women still pregnant) Impact on maternal mortality and obstetric fistula- No maternal mortality and no obstetric fistula occurrences.

8. Additional Information No neonatal sepsis recorded. No neonatal death recorded. The youngest woman receiving care in the project was 15 years old and the oldest 40. A total of 54 post-natal care visits have been done thus far.

9. Project Short-Term Impact The seeking of antenatal care services by expectant community women has significantly increased. An additional 154 women have enrolled in the project after 500. Women are being accompanied by their husbands and mother-in-laws- this is very rare! Hospital delivery increased from 10% to 30%. Skilled birth attendance for home births increased from 7% to 40%. Our community health communicators delivered critical messages to their communities on maternal and child health. Our midwifery students were involved in data collection, conducting the ANC visits and finding LMP dates.

10. Project Long-Term Impact Women in the community are vastly aware of our services and delivery capabilities. The hospital has provided care to 500 women, increasing the likelihood that these women will bring their families to HOPE for care. A database has been created which collects local maternal health data and racks the health of the mothers and their children. HOPE is considering using this database of 500 women to deliver information via SMS-messages regarding the importance of vaccination for their children and racking the improvement of health and survival rates of these children up to age 1 and then again at age 5.

11. HOPE Provisions As One Sky funded more than the initial request, HOPE discounted hospital delivery costs: Normal Delivery- $13 down from $20 Cesarean Section- $65 down from $90

12. HOPE Provisions HOPE has set-up a Maternity Care Corner that is open 24/7 to provide uninterrupted, one stop services. Two employees staff this, providing: pregnant women enrollment, counseling on dos and don'ts of pregnancy and postpartum period, providing supplementation, ANC visit scheduling and calling patients for follow-up and visit reminders.

13. HOPE Maternity Care Corner

14. Challenges While the majority of women have a mobile phone or access to one, not all do. Some may lose their phones or not be able to afford service at any given time. HOPE was unable to contact 113 women regarding their delivery status after their received their ANC care.

15. Please Remember… This project is not finished! The last estimated delivery date for our most recent registered pregnant woman is May 14, 2015.

16. Baby Akter, Age 20 Baby Akter is 20 years old while her husband, an automobile mechanic, is 27 years old. It was Baby Akter’s first pregnancy and naturally she was worried. After learning from her neighbors about the necessary services offered from HOPE Hospital and registering, Baby Akter received her ANC care at HOPE. During ANC the examining doctor informed the couple that Baby would have to undergo a caesarean operation and advised her to take all the necessary precautions. As it was their first baby to be delivered the couple did not take any risk. As per instruction Baby had a C-section at HOPE Hospital. Baby is exclusively breast feeding her baby and says she is relieved she was involved in this project to prevent complications.

17. Johura Begum, Age 27 Johura Begum is 27 years old and has finished schooling up to class 8. This was Johura’s second pregnancy. In her first pregnancy she suffered uterine complications and to avert the recurrence this time she enrolled to ensure a safe delivery. During ANC, she came to know about the Dos and Don’ts during pregnancy and benefitted tremendously. While attending an interactive counseling session during ANC, Johura shared her experience about her first which was a home-based birth without skilled a skilled birth attendant. After giving birth to her second child at HOPE she found that HOPE provided her the necessary care and support. The baby is doing well and being exclusively breast-fed as recommended.

18. Thank you for YOUR Support!