Jamaican survey boosts maternal and child health
Significantly higher survival rates among newborns and their mothers were just the first result of a comprehensive study of pregnant women undertaken in Jamaica in the mid-1980s.
The health-care reforms credited with saving those lives were far from the study’s only success. Conducted by researchers at the University of the West Indies with support from IDRC, the massive national survey propelled a variety of reforms. These included a violence prevention program and changes to national broadcasting policy.
A full generation after the original work, the study now provides the model for a new survey that promises to catalyze another wave of health improvements.
The Jamaica Perinatal Morbidity and Mortality Survey documented the outcomes of 94% of the country’s births over two months in 1986. It also followed maternal and child deaths for a further 10 months. Explains Professor Affette McCaw-Binns: “We wanted to look at the challenges of delivering good care to mothers and their newborns. The point of the research was to change health practice.”
That change wasn’t long in coming. By documenting the leading causes of problems for pregnant women and babies, the researchers made the case for improving their care. Mothers were screened for hypertension, tested (and promptly treated) for syphilis, and encouraged to deliver in hospitals if they had risk factors or lived in remote areas.
Education campaigns used clear language to alert women to dangers that could harm mother or baby. And when the rising popularity of hospital wards with obstetricians and pediatricians on staff led those to become overcrowded, the hospitals themselves were redesigned so staff could care effectively for more patients.
All these measures led to a 20% decline in Jamaica’s maternal mortality and a drop of almost 13% in newborn deaths.
The long-range nature of the research meant that more advances came later. When researchers revisited a sample of the birth cohort in their mid-teens, they documented the impacts of various social factors. Teens who had been enrolled early in school were more successful. Those who watched more television fared worse. Violence was a disturbingly common threat in young people’s lives, the loss of a friend or relative being particularly damaging.
Government, alongside civil society organizations, took on those challenges. They:
- campaigned against excessive television viewing
- embraced the idea of early childhood education
- challenged the old acceptance of corporal punishment; and
- developed a comprehensive strategy against child violence.
Still, problems persist. Since that early, impressive drop in infant and maternal deaths, says McCaw-Binns, the numbers have “gotten stuck.” It’s time for some new ideas based on fresh research. And so, a new study, funded by the Inter-American Development Bank, will follow the progress of all children born in Jamaica between July and September 2011.
“We’re going to build on what we learned in the first study,” says Professor Maureen Samms-Vaughan. “In 25 years, there has been a lot of new knowledge.”
The current cohort will be followed through early childhood and new issues, such as the role of fathers in child development, will be explored. It’s challenging work, says Samms-Vaughan, but one that Jamaica has the capacity to undertake, largely because of the success of the 1986 IDRC-funded study.
Stephen Dale is an Ottawa-based writer.
Photo: Stephane Grandvaux/Pan American Health Organization
Listen to Affette McCaw-Binns talk about the early research
Read the transcript
This story is part of the Lasting Impacts series that highlights how IDRC-funded research has improved lives in the developing world.