Inexpensive but essential items fit into a box the size of a deck of cards.
Clean-delivery supplies help women and newborns avoid infection during home births
At midnight in a rural village in Tanzania, a woman goes into labor earlier than expected. She can’t make the 15-mile journey to the health center, but at least her mother is there to help. With a disposable delivery kit, the two women safely deliver a baby girl. Later, the newborn’s mother tells researchers that the kit protected her baby from infection. She says she will tell her friends to get one before their time comes.
Each year, about 57 million women worldwide give birth without the help of a trained health worker. These births often take place at home, where the risk of infection is high. Some 1,600 women per day die from complications associated with pregnancy or childbirth, and infection is a leading cause. Around 950,000 newborns per year die from infection. The clean-delivery kit is a simple approach to reducing these numbers. It helps women and newborns avoid life-threatening infections.
Small change for safer home births
Over the past decade, PATH has helped develop kits in Bangladesh, Egypt, and Nepal. Most kits contain a small bar of soap for washing hands, a plastic sheet to serve as the delivery surface, clean string for tying the umbilical cord, a new razor blade for cutting the cord, and pictorial instructions that illustrate the sequence of delivery events and hand-washing.
Formative research and field-testing during development ensure the cultural acceptability of the kits and allow us to customize them for local conditions. In Nepal, for example, it is traditional to cut the umbilical cord on a coin, for good luck. Out of respect for this custom, kits produced in Nepal contain a plastic rupee to serve as a clean cord-cutting surface.
Ear to the ground
Once the kits were in use in Nepal, PATH conducted interviews and role-playing to gauge the responses of women who had used them. Mothers and birth attendants generally appreciated the kit and found it affordable.
Recently we quantified the positive impact of another delivery kit on women’s and children’s health in Tanzania. The study, conducted with funding from the United States Agency for International Development through PATH's HealthTech program, involved more than 3,200 participants. Results suggest that women who used the kit were substantially less likely to develop genital tract infections. Their infants were substantially less likely to develop cord infections.
Keeping kits in women’s hands
With each delivery kit project, our goal is to make sure the kits are available to the women who need them. We do so by building the capacity of local organizations and small businesses to produce and distribute or sell kits. In Egypt, we helped community health promoters develop a plan to use kits as an income-generating activity that would contribute to their health programs. In Nepal, we gave a local, woman-owned business a head start: the campaign we funded promoted the kit via wall paintings, advertisements, street dramas, and training for community health volunteers. Within one year, sales increased from 28,800 to 46,800 kits, contributing to the long-term stability of the company. Maternal and Child Health Products, Ltd, continues to make kits available to Nepali women at prices they can afford. Between 1994 and the end of 2005, they sold more than a million kits.
Flexible funding, which comes almost exclusively from individual donors and families, supported our assisting the Nepali business and contributed to the success of several related projects such as creation of a step-by-step manual for other organizations interested in developing kits. PATH will continue to pursue opportunities to implement this simple, high-impact solution—or to assist others in doing so.