2. President’s December 10 Appeal 2011

3. Overview Educate – rolling out 4 levels of education for birth attendants in Papua New Guinea Empower – giving skills and confidence to birth attendants and new mothers Enable – improving facilities to ensure the highest attainable standard of maternal care available

4. Maternal mortality: The Facts Complications in pregnancy are generally not preventable, but they are treatable. But without access to skilled birth attendants to recognise problems or facilities with the equipment needed to provide treatment, nearly half a million women die every year – just because they were pregnant.

5. Maternal Mortality – The Facts Every year, approximately 350,000 girls and women die from pregnancy-related causes. Almost all of these deaths (99%) occur in the developing world. Ten million women are lost in every generation. Four million newborn babies die every year, also from causes that are mainly preventable and typically linked to the mother's health. Huge disparities exist between rich and poor countries, and between the rich and poor in all countries. Source: Women Deliver

6. Maternal Mortality – The Facts

7. Cost-effective and proven solutions: 1. Access to family planning – counselling, services, and supplies 2. Access to quality care for pregnancy and childbirth - antenatal care - skilled attendance at birth, including emergency obstetric and neonatal care - immediate postnatal care for mothers and newborns Source: see e.g. Women Deliver, AMDD

8. Papua New Guinea 6.3 million people Life expectancy at birth (years): 56.7 Median age of total population (years): 19.5 Human Development Index: 139 out of 177 – the bottom quartile Gender inequality index133 out of 177 – also the worst quartile for women

9. Papua New Guinea 62 out of every 1,000 teenage girls is already a mother Women have on average almost 4 children – that’s twice the ideal number Only 36% of women use ANY form of contraception

10. Papua New Guinea Maternal mortality ratio (per 100,000 births): 733 3 women die each day More than 1500 each year Mortality rate of children under 5 years old (per 1,000 live births): 73 Source: PNG DOH Report

11. Birthing in the Pacific This project takes international best practice and evidence and applies it to the local situation in PNG – increasing access to both skilled birth attendants and functioning health care services. Working within the community to affect change – and save lives.

12. Project Impact To decrease maternal morbidity and mortality in Papua New Guinea Measured by: Maternal mortality rate Proportion of all births attended by a skilled birth attendant Number of facilities meeting international standards Midwifery density

13. Desired Effect To increase the knowledge and resources for midwives in Papua New Guinea Measured by: Number of trained midwives in targeted areas Case fatalities in targeted areas Percentage of facilities fulfilling checklist for providing basic obstetric care Improvement in the experience of women delivering in targeted facilities

14. Outputs 1.Provide education programmes for birth attendants at four levels of skills 2. Ensure that midwives have access to resources to enable them to practice efficiently in their daily clinical care 3. In association with hospital management, audit facilities for emergency obstetric care 4. Support the PNG Midwives Society to ensure that registered midwives have an avenue to be seen as a professional body of nurses.

16. Outputs Measured by: Variety of project logs Qualitative studies Evaluation tools to assess learning outcomes Audit tools for facilities

17. Activities Work with relevant partners to support the roll-out of four levels of educational programmes for birth attendants – PEmOC courses for trained clinicians – Learning exchange programmes for midwives – Maternal health competency programme for Community Health Workers – Literacy and reproductive health education for Village Birth Attendants

18. Activities Provide Karim work bilum (kit)to skilled attendants Provide buckets and goggles to VBAs Provide SI-branded obstetric wheels Report on facilities to help them to meet international standards Provide support to PNG Midwives Society