Every year more than a quarter of a million women die from pregnancy-related causes, and nearly 3 million babies die before they reach 1 month of age.

Preventing Maternal and Neonatal Death (PREMAND) project is working in rural Ghana to reverse this trend across four districts in the northern part of the country. Through its Innovate for Health mechanism, USAID-Ghana funded the PREMAND project  to use techniques of social autopsy to determine causes of maternal and neonatal deaths, using community surveys to determine factors associated with maternal and neonatal near-deaths (or “near-misses”), and maps to help visualize the spatial relationships between social and cultural factors influencing maternal and neonatal outcomes. These results are being used inform pilot grants at selected innovation sites to turn project findings into locally-created solutions.

PREMAND is predicated on three simple concepts:

1) Until we can see where mothers and babies are dying and falling ill, we can’t effectively focus prevention efforts.

2) Prevention efforts need to address the social and cultural factors that may affect whether an illness is recognized early, whether care is sought, and what type of care is sought.

3) Communities know best: if given the knowledge and tools, communities have the potential to devise their own, innovative solutions to maternal and neonatal health challenges.

Click on the pages below to learn more about the different phases of the project.

Data Collection

PREMAND utilized field workers, community health volunteers, and health facility personnel to identify deaths and near-misses in the four project districts.

Near-Miss Assessment

Health care facility personnel were trained to screen both mothers and babies to see if they qualified as a “near-miss” by using a checklist of symptoms, treatments initiated, or organ system dysfunction based on World Health Organization criteria.

Social Autopsy

PREMAND uses social autopsies to identify the social and cultural factors that influence illness, illness recognition, and care seeking behaviors; factors that ultimately influence health outcomes.

Geographic Analysis

PREMAND collects GPS data related to maternal and neonatal events to help local communities, government leaders, and members of the donor community better understand where mothers and babies are dying.

Community Interventions

Using the data collected from social autopsies and geographic analysis, five communities were identified to serve as innovation sites for community interventions.

Mapping Portal

Click here to view PREMAND’s interactive mapping portal.

Ultimately, this project aims to redefine the way communities, care providers, policy makers, and the donor community think about maternal and neonatal causes of death, pushing beyond standard clinical causes to highlight those factors that prevent symptom recognition, delay care seeking, steer women away from western providers, and otherwise limit the ability for a mother or baby to get timely, appropriate care when needed.

By redefining ‘cause of death’ to include social and cultural factors, we hope this project will alter future approaches taken to prevent mortality. This project not only provides USAID and local stakeholders with unprecedented access to information on the social and cultural factors associated with mortality, but allows such factors to be geographically placed, fostering the development of locally-driven interventions that bring about the greatest long-term impact on maternal and infant mortality.

The project team is led by Project Co-Director Dr. Cheryl Moyer on behalf of the University of Michigan Medical School, and Project Co-Director Dr. John Williams and Implementation Manager Raymond Aborigo on behalf of the Navrongo Health Research Centre. The project contract was awarded in 2014 and ends in 2018.