Smart Investments in Maternal Health

Dr. Naveen Rao – Lead, Merck for Mothers 

Impact interviews Dr. Naveen Rao, lead of Merck for Mothers. In 2011, Merck, known as MSD outside the United States and Canada, created Merck for Mothers, a 10-year, $500 million initiative to reduce maternal mortality globally. Rao shares his thoughts on public-private partnerships and the importance of engaging local partners in efforts to improve maternal health.

IMPACT: How do you build an enabling environment in the countries where your initiative has programs?
➤ DR. NAVEEN RAO: We engage a broad range of partners including government officials, iNGOs, and health care providers. Through our engagements and partnerships we have a perspective which allows us to tailor programs to help meet the specific needs of the communities we are serving. Maintaining the community connection is key to establishing programs that can be successful and sustainable.

IMPACT: What is the ideal role of an iNGO and government in a successful public-private partnership?
➤ NR: Through more than 25 years of work on the MECTIZAN® Donation Program, our river blindness initiative, as well as many other multifaceted programs, we have seen that collaboration is a cornerstone for successful public-private partnerships. Every partnership is unique and while there is no secret formula to success, partnerships work best when roles are not rigidly predefined and there is flexibility for each organization to brings its greatest strengths to the table. Making sure that all parties are aligned on objectives and that dialogue is ongoing provides an environment where these partnerships can make a major impact.

IMPACT: A majority of people living in the developing world get their health needs met from the private sector – which is often fragile and inconsistent in terms of quality. How would you improve the system so that it’s more robust and sustainable?
➤ NR: Approximately 50 percent of people in sub-Saharan Africa and 80 percent of people in India seek care from independent doctors, nurses and midwives in the local private health sector. This important part of a country’s health system is an area where more can be done to ensure that quality of care continues to improve. In India and Uganda MSD for Mothers is working to strengthen the ability of private health providers to offer quality, affordable and comprehensive maternal health services. Our partnerships are exploring how private providers and health businesses can most effectively help governments meet their MDG targets for reduc¬ing maternal deaths. We are also looking at ways to enable private providers to build more robust, sustainable practices through loan programs and business trainings.

IMPACT: Results from our survey show lack of funding and political will as top barriers to achieving better health outcomes. Do you agree? Do you think they are related? How can these barriers be overcome?
➤ NR: A recent example of overcoming barriers is the work being done by Saving Mothers, Giving Life (SMGL), a public-private partnership focused on dramatically and quickly reducing maternal mortality. We are a founding partner of SMGL, and in the first annual report we have seen significant progress in the area of improving maternal health. In Uganda, there was a 30 percent decrease in the maternal mortality ratio in SMGL’s target districts, and in Zambia there was a 35 percent decrease in the maternal mortality ratio in target facilities. Strong govern¬ment leadership and leveraging the PEPFAR infrastructure are key features of the effort.

IMPACT: The survey also found that working with local organizations is more important than ever, and it’s going to be a major driver of health outcomes moving forward. Have you found this to be true in your work?
➤ NR: Yes. It is vital for our programs to be reflective of local needs and preferences if we are to have sustained success. Organizations based in the communities they serve are acutely attuned to patient needs – there is no substitute for that knowledge. These groups can be incredibly creative in developing solutions to health challenges, such as convincing families of the importance of giving birth in a health care facil¬ity. For example, one of our partners in Uganda, PACE – a PSI affiliate – is working to ensure that private maternal health care is accessible, affordable and of high quality. PACE’s social franchise network of private providers, ProFam, initially focused solely on family planning, but was expanded to include other areas, namely labor and delivery, through support from MSD for Mothers. PACE knew the expanded focus meant they would need to address the challenge of making sure a woman gets to a facility in time to give birth. So, they began to collaborate with TransAid, a U.K.-based NGO that identifies, champions, implements and shares local transport solutions. These groups now work together to ensure women can reach facilities to deliver.

Merck for Mothers is an initiative of Merck & Co., Inc., Whitehouse Station, New Jersey, U.S. Merck for Mothers is known as MSD for Mothers outside the U.S. and in Canada.
Merck & Co., Inc., Whitehouse Station, New Jersey, U.S.
This publication was supported by a grant from Merck through its Merck for Mothers initiative. The publisher invited Merck for Mothers to par¬ticipate in this interview at its sole discretion and independent request. Merck for Mothers had no other role in its development.