CALMED – Collaborative Action in Lowering Maternity Encountered Deaths

A Rotary International Project


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What are the causes and consequences of these preventable deaths? 

Causes of death include malnutrition, poor health and adolescent pregnancies, through to medical issues, such as high blood pressure, severe haemorrhage and infection. Additional problems include delays in recognition of serious and urgent medical problems, access to transport and receiving skilled emergency care at home, or even within a hospital or clinic.

What is being done? 

A comprehensive pilot programme is taking place in India which is the country with the highest number of maternal deaths. A fact-finding Rotary team visited Mumbai and Gangtok in India in Spring 2012, visiting villages, clinics, hospitals and medical colleges, to consider ways of reducing the number of unnecessary deaths.

Following meetings with Medical Professionals, Community Groups, Rotarians, Inner Wheel, Teaching Universities and Government Officials, a comprehensive, collaborative action plan was drawn up.  The planned structure for the project was based on the concept of the CALMED model.

What is the CALMED solution?

Collaborative Action in Lowering Maternity Encountered Deaths

This evidence based programme is a collaboration between Rotary Districts: 3240 and 3250 in India, and District 1120 in England and involves Government Departments of Maternal Health and Family Welfare, Professional Bodies (FIGO and FOGSI), Medical  Institutions, Inner Wheel Groups in India, Universities and local Community Groups.

How is it funded?

Initially through Rotary Foundation Global Grants, with Vocational Training Team (VTT) visits supported by the participating Rotary Districts. Further sources of funding may become available as the programme develops and demonstrates its effectiveness.

How will it work?

Step 1.  A Vocational Training Team (VTT), consisting of  a group of obstetricians, will train medical staff in Sikkim, India, in April 2013 using the “Train the Trainers” skills transfer model, in areas of high maternal mortality.

Training manuals, videos and high fidelity manikins will be used to reinforce up to date training methods and skills transfer, thus ensuring that expert, skilled emergency care is available when it is needed.

Step 2. The newly trained Indian Professionals will then train other basic Medical Staff and Nurses not conversant with obstetric emergencies, cascading and spreading the acquired skills and knowledge. The aim is to extend the skills of basic Healthcare Professionals to provide effective emergency care for pregnant women, throughout the target areas.

Step 3. With respect for the local way of life in the community, ASHAs, in collaboration with local Women’s Groups, will aim to educate all women on the care of the pregnant mother and the new born infant.  Important issues will be covered, such as health and nutrition, age at marriage, family spacing, and child immunisation, with the aim of improving family life and empowering women.

Step 4 Local Rotarians in partnership with Inner Wheel, Government of India, the National Rural Health Mission (NRHM) will establish and empower women’s groups, collect data and through advocacy roles ensure adequate resources such as life saving drugs, transport and access to care in emergency. Regular in-house “fire drills”, or mock emergency exercises, will ensure efficacy and preparedness.

Step 5 The VTT team will revisit after 12 months, and then 24 months, to ensure that the training programmes are being delivered as intended, and that consistent, effective progress is being achieved by the partnership.

What is the role of Maternity Training International?

As one of the main collaborators, we have helped in numerous ways in a completely voluntary capacity.

  • We supplied video training content for the programme
  • We crafted some innovative animated lectures based around GIFs
  • We provided Vocational Training Team members
  • We have created a CALMED documentary based on the pilot project
  • We provided a complimentary photography service for documenting the pilot project
  • We provided advice, data collection and  scientific evaluation for the pilot project

What makes the CALMED Project unique?

It cascades through to remote areas and tries to address urgent medical issues, whether they occur in hospital, clinics or in rural home settings. It involves low cost technology transfer ,suitable for low resourced countries.

It empowers women in their local community to take personal and collective responsibility for the care of mothers and babies – a top down and bottoms up approach.

Components of the project are evidence based and offer long term sustainability and capacity building, through the empowerment of local medical professionals: the Training the Trainers model.

Local Rotarians will be empowered to maintain the momentum of the project, and to ensure that any local issues can be dealt with quickly through collaborative action with the Government, NRHM, Professional groups. NGOs, philanthropists, and Community Leaders.

Positive Outcomes for all!

The mother is at the heart of the family and protecting her health will help to prevent damage to her and to the baby.

Calmed Collaborators