Donations to a Canberra charity have helped turn Papua New Guinea's shocking maternal death rate around.
A new peer-reviewed medical study shows a simple and cost-effective initiative thought up by Australian doctor Barry Kirby and funded by local charity Send Hope Not Flowers is having "dramatic" impact in stopping mothers dying in childbirth.
The article, published in the June edition of the Australian and New Zealand Journal of Obstetrics and Gynaecology, shows the use of "mother and baby gifts" to encourage village women to access a supervised birth at health centres throughout Milne Bay Province has resulted in an 80 per cent increase in the number of mothers receiving medical assistance during labour.
This has seen the death rate drop by 78 per cent.
Dr Kirby won considerable local and national support for his baby gift idea when he visited Canberra last year to give a National Press Club address on Mother's Day.
A former carpenter working in construction in PNG, Dr Kirby sold everything he owned at age 40 to return to Australia to start a medical degree – such was his despair at health services in PNG.
When he graduated at 52, Dr Kirby based himself around 160 of the most remote islands making up Milne Bay Province where he specialises in obstetrics.
Women in PNG face the second highest maternal mortality rate in the Asia Pacific region after Afghanistan, with the women of Milne Bay facing a one in 20 chance of dying in childbirth.
The journal article shows in 2011, the maternal mortality rate in Milne Bay was 25-30 women per year. But those deaths have subsequently dropped to just five in 12 months.
In 2010 Dr Kirby undertook an in-depth study into why so many women were dying, finding most died of blood loss at their villages without access to the most basic of health care.
Women were reluctant to leave home for a supervised birth at a health centre for a variety of reasons including feeling "shy at presenting in an impoverished state and not having baby's clothes" according to Dr Kirby's original study published in 2011.
Women also lacked the $5 equivalent cost for a health centre birth or money to buy food while they were away from their village. With the assistance of Canberra-based charity Send Hope Not Flowers, Dr Kirby received more than $120,000 to buy and distribute around 3000 mother and baby gifts.
They include funds to cover food and health centre costs as well as a collection of basic supplies for mothers and their newborns such as underwear and a cotton sarong, towel, sheets, soap, sanitary supplies, six cotton nappies and a singlet for babies, and female and male condoms - all packaged in a small plastic baby bath.
The program has been shown to have had a profound effect. At the 10 health centres servicing Milne Bay Province, supervised deliveries have increased from 845 a year in 2012 to 1449 in 2014. The Sehulea health centre has seen a 158 per cent increase in supervised deliveries (to 155 deliveries) while the Wataluma health centre has seen a 188 per cent increase (to 98 deliveries) over that period.
The results have also allowed Milne Bay to exceed the United Nation's Millennium Development Goal to bring down the maternal death rate by 2015.
Dr Kirby said, "We are so happy this is working. We listened to what mothers were saying to us and we responded, although at times it seemed like a crazy idea.
"It is a team effort right from the pockets of generous people in Australia through Send Hope Not Flowers into the hands of these PNG women and they have said 'Yes! Thank you!'.
"Finally, finally our maternal death rate is coming down, at least in our backyard, and we should all feel happy about that."
The report was co-authored by four doctors, including Canberra Obstetrician Professor Steve Robson.
"This study shows how a relatively cheap and simple idea can translate to outstanding survival rates for pregnant women in a country where most families can, at some point, expect to lose a mother, sister, aunt or daughter to childbirth," Professor Robson, who is also vice president of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists said.
- Emma Macdonald is a co-founder of Send Hope Not Flowers