Safe Motherhood Alliance

Safe Motherhood Alliance is a social enterprise that designs, develops and distributes affordable healthcare products to pregnant women in low income communities so that they can have a safe childbirth. Our products, which include the ‘baby delivery kit’ which contains all the items needed for a safe childbirth such as cord clamps, surgical blades etc. which provide a positive social and economic impact and this is because our products are affordable, sterilized and convenient for usage with the total number of births in Zambia being approx. 750,000 end of 2019.

Our organization works with a network of agents who are Traditional Birth Attendants (TBA’s) who are local community leaders who act as midwives carrying out childbirths. We upskilled our TBA’s so that they can have a greater positive influence on the business and in the community as it increased awareness of safe birthing in their communities.

In Zambia, only 63% of births are attended by a skilled health worker at health institutions. Home delivery is high (37%) as at end of 2017. Communities in rural areas have limited access to health care. It is currently, estimated that in urban areas approximately 99 percent of households are within 5 kilometres of a health facility, compared to 50 percent in rural areas. 

A big part of the problem is the lack of access to sterile supplies in rural communities who have a broken healthcare chain thus forcing more home births with traditional birth attendants (TBA) who practice unsafe birthing practices such as severing umbilical cords with rusty blades infecting babies with tetanus, women giving birth on cold floors dirty, wiping themselves with dirty pieces of cloths. 

In addition, a challenge we’ve seen is that sanitary pads are increasingly difficult to access for girls and women in rural low-income communities and that sanitary napkins are becoming increasingly expensive. This has has resulted in girls sitting in sand so as to contain the bleeding which could cause infection to the girls as well as the new and prospective mother.

Our solution is to design, develop and distribute affordable healthcare products to pregnant women in low income communities with our flagship product being the ‘Baby delivery kit’ which contains all the items needed for a safe childbirth such umbilical cord clamps, surgical blades, maternal pads etc. so that they can have a safe childbirth.

We have also developed reusable sanitary pads made from banana fiber so as to girls and women can have clean sanitary pads during their menstrual cycles. The pads are ‘biodegradable’ meaning that it can be turned into waste and efficiently decomposed as our sanitary napkins can be used in creating a combust thus acting as a form of fertilizer when disposed.

We distribute our products through our Traditional Birth Attendants who we upskilled to become Community Health Workers who sensitize the community on issues that affect women and children. The also act as our sales agents on the ground who distribute our affordable healthcare items be it the clean birthing kits or sanitary pads while getting a commission off each product sold effectively empowering our agents and their families.

At Safe Motherhood Alliance we are elevating women's health to be a core topic globally. We aim to raise a $250,000 investment to impact half a million (500,000) lives with an integrated-solutions to develop & design innovative healthcare products for women and girls living in low-income communities and rural areas by using low-cost appropriate technology & local materials designed to meet the unique needs of women in resource poor settings to create intergenerational wellbeing across the continuum of Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH+A). Integrated solutions are the need of the hour - as a woman journeys from girlhood onward we must eliminate preventable causes of death that cost the lives of millions of women and children each year and remove all the obstacles to good health so that she can reach her full potential. As a pioneer in the sustainable business and women's health we are a market-led research organization which has pioneered an innovative process for product development. We combine leading-edge bio-technology insights, systems thinking in the selection and development of our products. The results are safe, effective, market-ready solutions for businesses in the consumer health sector. 

In Zambia, only 63% of births are attended by a skilled health worker at health institutions as communities in rural areas have limited access to health care. It is currently, estimated that in urban areas approximately 99 percent of households are within 5 kilometres of a health facility, compared to 50 percent in rural areas. Further, socio-cultural factors compound families’ health care seeking behavior such that many children are taken late to health facilities and pregnancy is not given special care. Knowledge about post-natal care is low. Knowledge and practice on infant and young child feeding practices are low. 

Organizations have worked with different versions of clean births projects but these efforts remain largely ineffective, expensive, and unsustainable because they depend on grants, wrong target market, and lack efficient access to resource-poor markets. We have unique understanding of and access to the Zambian health and regional market, and a sustainable source of revenue scaled via repeat sales to health institutions. Our organization also leverage existing channels/systems, involve local communities in supply chains, and train women from poor communities to function as frontline health workers, who diagnose basic illnesses, distribute essential medicines and other health products such as locally manufactured sanitary napkins in their catchment geographies. These models help decentralize healthcare, improve referral linkages, leverage local resources, and above all, generate employment and build capacities. Safe Motherhood Alliance leverages existing networks of local health workers in their target geographies to distribute their baby delivery kits. The technical knowledge and skills of these health workers, supplemented with our product training courses, equip them adequately to market and use the safe-birthing kits. The kit has reduced complaints of abdominal pain previously caused by unclean materials such as the  dirty rags used for padding. It is a US$7 million market and we are projecting that we will capture 5% of the market by the third year and 10% by the fifth year.  

SafePay which is part of Safe Motherhood Alliance is a health financing platform, helping new and expectant mothers reach their goal of delivering universal healthcare coverage. It revolutionizes the management of large-scale health schemes through its payments integrator and health system management tools. It allows patients, payers and healthcare providers to send, receive and pay healthcare funds to each other quickly and at minimal cost. Individuals save money or pay their insurance premium to help cover their future healthcare needs. Healthcare providers, like clinics and hospitals; and payers, like private insurers, public health schemes and donors, are also linked in to the system. When someone needs treatment, this person dials in to the Safe Pay platform with a mobile phone, selects the appropriate health scheme and location and thereby initiates the process. The healthcare provider then proceeds with diagnosis and treatment and finally submits the claim. If the patient is covered by insurance or via a donor, the clinic digitally sends the information to the funder, who reviews the information and authorizes payment - again, all through Safe Pay. If the claim is approved promptly, payment can be made under 24 hours, with total transparency at every stage of the process.

The product is currently designed for pregnant women in rural low-income communities so as to give them access to affordable healthcare needed to have a safe childbirth. We are conducted a pre-pilot programme in Lusaka as we work with 10 health facilities. We realized that one of the reasons pregnant women did not have safe childbirths was lack of access to healthcare financing as pregnant women often have to borrow money from friends, deplete their savings or that they would be forced to borrow money from a local money lender who often charge high interest rates and collateral on products. It has been proven that financial protection is at the core of universal health coverage and is one of the final coverage goals of the SDGs and it is achieved when direct payments made to obtain health services do not expose people to financial hardship and do not threaten living standards. Yet, out-of-pocket payments for healthcare can cause households to incur catastrophic expenditures.

Through the work of our TBA’s we’ve embarked on a program that aims to make sure that all stakeholders involved are knowledgeable on clean birthing practices and how they can help improve the odds of survival of the mother and child at birth.  These are mainly done through the 1 hr daily health talks in clinics before selling the kit. Initially we faced skepticism concerning our mission as many felt that the kit should be given out for free or did not trust the information provided by the TBA’s that otherwise would have called for a shift in mindset from the norm of the social, cultural and religious beliefs they were otherwise accustomed to. With time, there has been a general improvement in community awareness in issues that affect pregnant women and we are constantly gaining support in relation to our cause.

A meeting with community’s has been organized once a month since July 2018. These are often informal gatherings which are mainly advertised at the nearest health facility and we invite as many people as possible so that all stakeholders involved are more knowledgeable and the overall goal has been to change perceptions of how people view these source materials. Changing male perception was particularly important because often times men where the heads of the household and needed to know why the items purchased are essential as well as the basics of post and pre-natal care.

During our pilot project which started in 2017, Safe Motherhood Alliance distributed over 1,000 baby delivery kits in 6 health clinics and health institutions in Zambia, trained 10 caregivers TBA’s directly impacting 1,000 new mothers and newborns; and we have received queries from Malawi, Zimbabwe, Mozambique and South Africa thus, validating our products are not only relevant in Zambia, but also in other developing world markets. Of these 1000, 200 where distributed at Kanyama clinic in Lusaka province through our TBA’s and that established the basis for a microcosm of our project. We have seen high growth as we distributed up-to 1,000 clean birthing kits as at end of 2018 during our pilot program and went on to distribute up-to 5,000 kits end of 2019 distributed at $10 which gave us a turnover of $50,000. Over the next 5 years, we plan on capturing 40% of the market. Zambia had 750,000 births end of 2019 and this can be translated into 192,000 pregnant women.

Our short-term objectives and strategy is to advance and improve safe births by developing a simple, low-cost, disposable delivery kits for pregnant women in sub-Saharan Africa that will be used during childbirth. Our overall goal includes working with the Ministry of Health in Zambia to reduce maternal and neonatal morbidity and mortality. We have validated demand for our product and market viability of our model and are ready to bring our innovation to scale. This involves expanding our following key activities: production, sales and distribution; product training for health workers; developing “kit extension” products; and monitoring and evaluation of kit impact in heath institution settings (via a cost-consequence analysis in collaboration with the Ministry of Health). During our six (6) month pilot project we generated US$10,000 in revenue during our pilot with a US$10 product since beginning sales in our first year while maintaining a 20-30% profit margin.

We are working towards projected sales of 25,000 kits and 500 TBAs as our sales agents by the end of 2022. One delivery kit ensures a safe delivery, creates behavioral change and offers economic empowerment to a birth attendant. We intend to continue creating “extension products” to seamlessly target the reproductive, maternal, child, newborn and adolescent health (RMNCAH) continuum. Extension products include kits targeting newborn health and hygiene around newborn care, post-partum care etc Through our brand and products, we aim to build demand for health and hygiene from the onset of a woman’s first period all the way through childbirth.

One of the problems that were faced upon carrying out our sensitization activities is the need to change social, cultural and religious of people in the communities we targeted. informing them that something they have otherwise practiced for generations. This too was difficult for the TBA’s to acknowledge upon undergoing the Safe Motherhood training workshop as we also had to change their perceptions of safe birthing practices so that they could sensitize others as somewhere still using unsafe practices such as using a rusty blade to sever the umbilical which could potentially cause tetanus.

In addition, our TBA’s have also been approached with problems beyond there scope. This is causing their training is mainly restricted to maternal, neonatal and infant health and in such instances, we use a referral system that will enable the TBA’s to escalate the problem to the appropriate medical personnel.

Also, people expected the kit to be given out for free which was an issue. TBA’s where met with skepticism more so when they presented the community with a potential solution that was outside the norm and so sensitizing the community on safe birthing practices first proved to be a challenge but with time, we were able to overcome much of the mistrust we initially encountered.

Our organization targets pregnant women in rural-low income communities We sell the affordable healthcare products directly to the pregnant women using TBA’s as our agents who then get a 10% commission off each product sold in a B2C model. Organizations will be able to purchase our healthcare products from us in bulk so that we can redistribute them to pregnant women at a subsidized cost in a B2B model, which we are yet to start, with subsidies of up-to 50% which will enable us to grow more rapidly. Safe Motherhood Alliance has trained 50 Traditional Birth Attendants (TBAs) in Safe Birthing practices and they act as our community health workers and agents selling our products directly to pregnant women so that they can have a safe childbirth.

This model will apply to our other alternative product lines such as the faces masks and hand sanitizers as our TBA’s will be equipped with these items and an economic incentive will be given via commission to make sure that we boost sales and ensure that as many products as in the hand of the community members while simultaneously educating them on issues that affect women and children.

Our organisation currently has 5 full time staff and 30 part time staff who are the Traditional Birth Attendants (TBA's) who are traditional midwives who we on-boarded onto our organisation.

From a managerial perspective, we have a cross sectional team with a great skill set. I am Mhlangeni Chiiko and I’m the co-founder of Safe Motherhood Alliance as I am an economist by training and was recently selected as a Mandela Washington Fellow 2020 as well as the First Runner Up Winner of the most recent MTN MoMo Hackathon 2020. In addition, we have Muzalema Mwanza who is our co-founder and co-CEO and a Mandela Washington Fellow 2017 with skills in community development and an expert in growing and scaling social enterprises.

Our overall goal includes working hand in hand with the Ministry of Health (MoH*) and Government of the Republic of Zambia to reduce maternal, neonatal and infant morbidity and mortality with our mission to help significantly improve maternal and child health in Zambia through the provision of safe, affordable, sterilized healthcare products, training of traditional birth attendants and the delivery of simple lifesaving solutions as well as by providing sensitization through TBA’s who we train on safe birthing techniques via our curriculum. We are currently based in 3 districts and 10 health facilities in Zambia with plans in place to scale to all of Zambia’s 10 provinces as part of our 5-year plan.

Our organization targets pregnant women in rural-low income communities We sell the affordable healthcare products directly to the pregnant women using TBA’s as our agents who then get a 10% commission off each product sold in a B2C model. Organizations will be able to purchase our healthcare products from us in bulk so that we can redistribute them to pregnant women at a subsidized cost in a B2B model, which we are yet to start, with subsidies of upto 50% which will enable us to grow more rapidly. Safe Motherhood Alliance has trained 50 Traditional Birth Attendants (TBAs) in Safe Birthing practices and they act as our community health workers and agents selling our products directly to pregnant women so that they can have a safe childbirth.

This model will apply to our other alternative product lines such as the faces masks and hand sanitizers as our TBA’s will be equipped with these items and an economic incentive will be given via commission to make sure that we boost sales and ensure that as many products as in the hand of the community members while simultaneously educating them on issues that affect women and children.

Our first of its kind solution is a product suite and delivery model that addresses gaps along the RMNCH+A continuum to improve the survival, health and well-being of the world's most vulnerable women (adolescents, pregnant women, mothers and children). Signature to the Safe Motherhood Alliance brand is a suite of simple, affordable kit style products that make essential tools and commodities available at the right place, right time, right price. Our products (Baby delivery Kits, Postpartum Health Kits, and Biodegradable Menstrual Hygiene Kits made from Banana Husks) are sold and distributed to health institutions in Zambia, with queries coming in from around the region thereby increasing our access in regions with high rates of mortality.

The project has been self-funded during the ideation stage through to the pilot project. After a successful pilot we are actively seeking transition to scale investment that will help us take the leap from being a one product company to delivering across the RMNCH+A Continuum and reducing the cost of the delivery kit from $10 to $5 in order to reach more pregnant women in the BoP index. 

We are solving a major obstacle in public health – recruiting and supporting local health workers – through a system that provides quality care and performance incentives for health workers. We are looking to develop a feature phone app to help the traditional birth attendants in the field, send vaccination reminders to the pregnant women and through to post pregnancy and track key metrics.