Evolution

Overview

It has been 18 years since our founding, and AMDD continues evolving to reduce maternal and newborn death and disability.

What makes AMDD unique is our ability to respond and adapt to new evidence, insights, and changing needs within the field of maternal and newborn health.

We draw upon the expertise found at Columbia University’s Mailman School of Public Health, and United Nations, non-governmental, and government partners, to innovate and advance evidence-based action that saves lives.

Below is a summary of our evolution. 

 

Phase One: 1999 through 2005

In 1999, Dr. Deborah Maine and Dr. Allan Rosenfield founded AMDD in the Department of Population & Family Health in the Mailman School of Public Health at Columbia University with support from the Bill & Melinda Gates Foundation.

AMDD was conceived to work with developing countries to improve emergency obstetric care (EmOC) services for women. The basic premise of AMDD still holds true: Most obstetric complications that lead to maternal death cannot be predicted or prevented, but the vast majority of women can be saved through prompt emergency treatment.

Through advocacy and research, AMDD worked to promote EmOC as a critical solution to saving women’s lives. We sought changes in policy and practical approaches to reducing maternal mortality. Through field projects in 18 developing countries that covered a total population of over 270 million, we helped build evidence to support EmOC as a critical intervention.

In just three to four years, EmOC facilities in project areas doubled the number of obstetric complications treated and cut in half the chances of dying from them.

By 2005, the global and maternal health fields reached consensus that EmOC was essential to reducing maternal mortality, as well as newborn mortality and stillbirths. AMDD’s work evolved to include healthcare for newborns, as we view maternal and newborn care as inextricably linked.

Lynn Freedman, JD, MPH became AMDD's Director in 2005 to lead AMDD into the next phase of its work.

 

Phase Two: 2006 through Today

In 2006, AMDD was among the growing number of voices in the global community calling for a major shift in thinking needed to significantly reduce maternal and newborn mortality and to meet Millennium Development Goals 4 & 5. Recognizing the critical role of health systems to achieve large-scale reduction in mortality, AMDD began to focus more intensively on the health systems barriers to equitable access to emergency obstetric and newborn care (EmONC).

Over the next several years AMDD repositioned to give new attention to the role of health systems and to addressing EmONC as a crucial part of the home-to-hospital continuum of care for women and newborns. We have since focused on researching, advocating, and providing technical support for strengthening the many parts of the health system needed to deliver EmONC equitably and country-wide. We have also continued to develop tools and strategies that countries rely on to improve access to EmONC.

 

Looking to the Future

AMDD’s focus continues to progress as we research health systems and learn more about what it takes to achieve universal access to EmONC.

We are now giving systematic attention to "implementation science," as we examine the process of introducing, institutionalizing, and sustaining policies, programs, and activities in complex settings so that emergency care is accessible to all women and newborns. We continue to work with a variety of longstanding and new partners to better understand how to translate policies and strategies into sound action on the ground.

AMDD is also exploring new themes as we look towards the future. Given global trends in urbanization and increasing recognition that emergency obstetric care is not necessarily delivered in a respectful way, accountabilityrespectful maternity care , and urban healthcare are growing areas of interest for AMDD.

While we explore new themes and new approaches, AMDD’s niche remains the same: ensuring that health systems work at every step of the way to provide seamless, respectful emergency care and respectful care to all women.