2023 Progress Report
Progress Report 2023
We believe in a world where all births are safe.
Where you live should not determine if you live. Yet, 95% of maternal and newborn deaths occur in low- and middle-income countries.
Together with our partners, we’re working to help change that.
Safer Births: Showing remarkable results in Tanzania
Based on 12 years of research including 38 PhD studies and around 140 published papers, Safer Births is an evidence-based program to reduce maternal and newborn mortality. The program includes both training and clinical innovations as well as continuous quality improvement initiatives and supportive mentorship to enable the program to be sustained over time. The first phase of the Safer Births Bundle of Care is concluding at the end of this year after successful implementation in 30 hospitals in Tanzania. Overall mortality rates are trending towards 45% reduction in early newborn mortality and around 70% reduction in maternal mortality during the implementation period. Final results will be published in 2024.
The success of the program and the demonstrated cost-effectiveness per life-year saved has resulted in additional funding from the World Bank’s Global Financing Facility for the second phase of the Safer Births Bundle of Care, making it possible to scale up the Safer Births Bundle of Care program to 150 hospitals in Tanzania.
If results in the best regions so far could be reproduced on national scale, cost could come all the way down to 6 US dollars per life saved, based on preliminary analysis.
We’re also looking forward to expanding the program into other countries.
Shaping the future of midwifery education
The world needs 900,000 more midwives. At current rates, there will be a shortage of 750,000 midwives by 2030. A well-trained midwife can make the difference between life and death. Throughout 2023 we’ve been working with our partners to strengthen midwifery education.
In Nepal, we’ve worked closely with the Ministry of Health and Population and our implementation partners to introduce simulation-based training into the national midwifery curricula, establish simulation labs, and help train faculty in simulation methodology.
The success of simulation-based training for midwives has now been expanded to include nursing and medical students. An exciting pilot test program was launched in 2023 to introduce competency-based assessment into the medical licenture examination. This simulation-based approach and hands-on skills during medical training ensures healthcare professionals are ready for clinical practice. Learn more here.
We know that investing in educators is essential. That’s why we focus on faculty development. In Rwanda, we’ve seen a national expansion of simulation-based training within nursing and midwifery. The implementation of SimBegin, a simulation facilitator course has been completed by 50 midwifery educators from 11 institutions so far. This is just the beginning, with talks of a national rollout underway. Read the story here.
In India, as part of the Midwifery Initiative Strengthening Program funded by the Bill and Melinda Gates Foundation and implemented by Jhpiego, we helped to facilitate a series of midwifery bootcamps, resulting in the training of 40 national midwifery educators who will, in turn, train the future midwifery students using hands-on, competency-based pedagogy. Read more here.
We know that today there are not enough educators, and that peer-to-peer learning between students is key. As part of our longstanding partnership with the International Confederation of Midwives, we co-developed the ICM Midwifery Competencies a digital tool to help students access ICM-verified content and train with their peers.
Saving Little Lives: Scaling up to save more small and vulnerable newborns in Ethiopia
A government-led intervention, the Saving Little Lives program includes training and clinical interventions for essential and small newborn care. Support includes simulation-based training, on-site mentorship, and ongoing quality improvement. It’s currently rolling out to 290 hospitals in Ethiopia through 2024. The goal is to reduce newborn mortality by 35%.
At a recent high-level stakeholder meeting in Ethiopia, continued support and the commitment to invest was reinforced. Saving Little Lives will be integrated with other initiatives as part of the national Sick and Small Newborn Care plans as Ethiopia works towards the ambitious goal to meet SDG 3 by 2030.
Helping establish global standards for newborn care
Together with the World Health Organization and the American Academy of Pediatrics we launched the second edition of the Essential Newborn Care Course (ENCC). This updated training program has adopted the well-known Helping Babies Survive courses.
It’s a competency-based program that provides the foundation for the essential care of every newborn: immediate care at birth, resuscitation when needed, breast milk feeding, thermal care, prevention of infection, recognition, and response to danger signs. This is now a WHO program aimed at standardizing newborn care, globally.
To help support access to digital training tools for program implementation, the Helping Mothers and Babies Survive learning portal provides resources available as global goods.
Improving access to basic emergency care with WHO
More than 50% of deaths in low- and middle-income countries could be addressed by effective emergency care.
In 2023, the World Health Organization launched an initiative to train 25% of all nurses and midwives in 25 low-income countries by 2025 in a new Basic Emergency Care program. Watch the WHO 25x25x25 - Emergency Care Saves Lives video.
But how could they scale it up quickly and effectively? Laerdal accepted the challenge to help. Cross-functional teams on several continents worked tirelessly to fast-track a scalable, impactful, and cost-effective training kit.
Together with the WHO Academy, we developed a condensed, interactive e-learning program as well as an affordable Portable Learning Lab for hands-on skills training. Together with the American Heart Association, the Laerdal Foundation also supported the WHO to establish a new global alliance, the Acute Care Action Network to help strengthen emergency care systems. We believe the initiative will have a tremendous impact on helping save lives.
One life at a time
We’ve been busy this past year. And we look forward to the new year – working towards a world where all births are safe, everywhere.
Together with partners, we never lose sight of the individual lives saved and their stories.
Baby Meskerem weighed only 1.1 kilograms when she was born. Her father, Abebe, didn’t know if his baby would survive. His wife, Mulunesh, had eight previous pregnancies, but only three babies had survived. While Mulunesh recovered from a necessary cesarian section, healthcare workers taught Abebe how to keep the baby in the skin-to-skin position known as Kangaroo Mother Care. He did this for at least six hours every day and throughout the nights. It worked. Today, Meskerem is healthy and thriving.
Baby Tseganesh Senato
Wote Yosef had experienced pre-term pregnancy loss seven times. On her eighth pregnancy, Wote went into premature labor. Their baby girl, Tseganesh, was delivered weighing just 1.3 kilograms. Her husband believed they would lose this baby too.
As part of the Saving Little Lives program, the NICU had adopted Kangaroo Mother Care (KMC), continuous skin-to-skin contact, a proven method of preventing premature deaths. After 20 days of KMC, Tseganesh weighed 1.9kg and she began to breastfeed. At her follow up appointment Tseganesh weighed a healthy 3.5kg.
Veronica's baby was born with the umbilical cord wrapped around his neck. The baby was not breathing. Valentina, a nurse trained through the Safer Births program, took immediate action. She placed the baby on the resuscitation table, applied the NeoBeat heart rate meter, and began ventilation. Thanks to Valentina's skills during the critical first minute – the Golden Minute — the baby began to breathe and when reunited with Veronica, breastfeed.
Post-partum hemorrhage (PPH) is the leading cause of maternal death. When Tabu was brought to the hospital, she was suffering post-partum hemorrhage (PPH). Understaffed with only three on the maternity ward attending other births, the midwife who received Tabu had been trained in the Safer Births program and had practiced how to manage PPH. Tabu survived.
Pramila had a normal delivery, but her baby boy was blue and not crying when he was born. Within the first minute he was rushed to the resucitation corner where he received bag-mask ventilations that midwife Rashmita had practiced regularly as part of the her simultion-based training.
“After that, I felt relieved. I took a long breath. That was a proud moment for me because of my education based on simulation and skills learned in the lab, it made me confident to save a life by tackling an emergency situation quickly and efficiently.”
When baby Aaresh was born, he did not breathe. The hospital was busy and short on staff, so the midwife, Bedika, had to manage the resuscitation alone even though she was a new midwife.
“I took a deep breath and remembered what I had learned. We practiced resuscitation regularly to keep our skills sharp. I had practiced a difficult case where I had to do ventilations for 2 minutes – it’s quite a long time. But I remembered that it worked. So, I didn’t give up. I only stopped once I heard the sound I had been hoping for – the baby cried.”