,i #aaith ,,congress #ast ,session ,h4 ,r4 #fgfe ,,in ,,the ,,house ,,of ,,representatives ,december #af1 #bjbe,mr4 ,smith of ,new ,jersey 7for himself and ,ms4 ,salazar7 introduced the following bill2 which was referred to the ,committee on ,foreign ,affairs ,a ,,bill ,to prioritize and fund life-affirming maternal and child health initiatives globally by equipping local health providers and community health workers to reduce the leading causes of maternal and child mortality1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,safe ,passages ,act of #bjbe4 #b4 ,findings ,congress finds the following3 7#a7 ,around the world1 over #bhg1jjj women die each year from pregnancy-related complications--most of which are preventable4 7#b7 ,in sub-,saharan ,africa1 the maternal mortality rate in #bjbc was #ddb per #ajj1jjj live births1 compared to #ad per #ajj1jjj in developed countries4 7#c7 ,sub-,saharan ,africa accounts for approximately #gj percent of all global maternal deaths4 7#d7 ,these deaths are nearly all caused by treatable conditions including postpartum hemorrhage1 severe preeclampsia1 infection1 and obstructed labor1 reflecting a lack of access to skilled birth attendants with the training1 tools1 and infrastructure needed to provide life-affirming obstetrical care4 7#e7 ,short of death and in the absence of skilled pregnancy care and birth attendance1 women may also suffer severe complications during and after childbirth including stillbirths1 obstetric fistula1 severe anemia1 infection1 and cardiovascular damage1 all of which can cause lifelong complications4 7#f7 ,maternal death1 which is also associated with a decline in the standard of living for children in the bereaved family1 is one of the leading causes of fetal and newborn death4 7#g7 ,infants whose mothers die during childbirth face dramatically elevated risk with a least #bj-;fold times risk of mortality in the first month of life4 7#h7 ,even beyond the neonatal period1 maternal death is associated with #d-f times greater mortality risk for young children4 7#i7 ,these statistics reflect not merely public health trends but the personal tragedies of women1 children1 and families whose futures are forever altered4 7#aj7 ,the first #a1jjj days of life--from conception to age #b--represent a critical window in which appropriate maternal and infant health care can dramatically reduce risk of child malnutrition1 stunting1 developmental delays1 and early childhood illness and help prevent and treat complications of pregnancy that can have short- and long-term impacts on the health of mothers4 7#aa7 ,strengthening maternal and child health preserves both mother and child1 strengthens family units1 enhances a myriad of human development goals1 and upholds the dignity and worth of every human life4 7#ab7 ,the engagement and support of fathers through financial1 material1 relational and emotional support of the mother and child1 is key to strengthening maternal and child health and promoting a safe passage1 and has been correlated with increased prenatal care1 enhanced skilled birth attendance1 improved maternal mental health and higher neonatal survival4 7#ac7 ,programs such as ,maternal ,life ,international's ,safe ,passages model have proven successful in training frontline providers1 reducing mortality1 and delivering sustainable1 culturally respectful1 life-affirming care in low-resource settings4 #c4 ,purpose ,the purpose of this ,act is to advance and fund life-affirming maternal and child health interventions that-- 7#a7 equip local providers1 including midwives1 physicians1 physician assistants1 nurse practitioners1 and community health workers1 with life-affirming training in how to prevent1 recognize1 and manage the leading causes of maternal and perinatal death and their complications2 7#b7 provide medical resources1 training1 and emergency obstetric equipment to carry out the above skilled life-affirming management of obstetrical and perinatal complications2 7#c7 provide education and support for health care and nutrition during the first #a1jjj days of life2 7#d7 provide education and support for fathers in their support and responsibility for the well-being of the mother and child2 7#e7 support a continuum of life-affirming care for women and men inclusive of pre-conception health1 fertility health1 fertility awareness1 healthy child spacing1 natural family planning1 safe birth and postpartum mental health2 and 7#f7 operate in full alignment with respect for life at all stages from conception to natural death and strengthening the family4 #d4 ,safe passages maternal and child health program 7a7 ,establishment ,there is established a global initiative to be known as the ,safe ,passages ,maternal and ,child ,health ,program to help reduce maternal and child mortality in low- and lower-middle-income countries with high maternal and child mortality rates through fiscal year #bjcj1 through faith-based health partnerships1 community-based care1 collaboration with national health systems1 and life-affirming health interventions4 7b7 ,elements ,interventions supported by the program established by subsection 7a7 are for life-affirming training and resource assistance for the following3 7#a7 ,prevention1 recognition1 diagnosis and treatment of obstetrical hemorrhage1 and its complications1 including postpartum anemia4 7#b7 ,prevention1 recognition1 diagnosis and management of preeclampsia and other hypertensive1 metabolic and cardiovascular disorders of pregnancy1 and their complications1 up to #a-year postpartum4 7#c7 ,prevention1 recognition1 diagnosis and treatment of infections and their complications associated with ectopic pregnancy1 miscarriage1 stillbirth1 normal pregnancy1 childbirth and the postpartum period4 7#d7 ,prevention1 recognition1 diagnosis and management of obstructed labor and its complications1 including uterine rupture1 obstetric fistulas1 and additional related complications4 7#e7 ,reduction of fetal1 perinatal1 neonatal and infant mortality1 including stillbirth1 by preventing1 recognizing1 diagnosing and treating fetal distress1 newborn asphyxia1 birth trauma1 intrauterine growth restriction1 premature birth1 small size for gestational age1 and neonatal infections and sepsis4 7#f7 ,nutritional and health education for the mother and provision of nutritional resources for the mother and child during the first #a1jjj days of life1 from conception to #b years of age provided through coordination with the office leading on global food security4 7#g7 ,training and dissemination of natural fertility awareness based methods in accordance with evidence-based non-abortive practices4 7#h7 ,promote increasing fathers' support and involvement for mothers and children4 7c7 ,implementation ,the ,secretary of ,state shall prioritize the implementation of the program established by subsection 7a7 in collaboration with new and existing global health partnerships deemed to be efficient and reliable in the expenditure of taxpayer dollars1 prioritizing local faith-based providers and faith-based organizations with strong local partnerships and which have experience and expertise in maternal and child health delivery in resource-limited settings4 #e4 ,amendment to existing law and availability of funds 7a7 ,amendment ,section #ajd7;c7 of the ,foreign ,assistance ,act of #aifa 7#bb ,u4,s4,c4 #baea;b7c77 is amended to read as follows3 7c7 ,maternal and child health and nutrition ,assistance under this section shall prioritize maternal and child health interventions consistent with the ,safe ,passages ,maternal and ,child ,health ,program established by section #d of the ,safe ,passages ,act of #bjbe1 including prevention and treatment of obstetric complications1 such as hemorrhage1 hypertensive disorders1 sepsis1 obstructed labor1 and neonatal resuscitation2 support for maternal nutrition2 health care for the child throughout the first #a1jjj days of life from conception to approximately #b years of age2 and support for fathers to care for mothers and their children4 ,such assistance shall promote natural methods of fertility awareness and shall not be used for abortion or abortion-related services4 4 7b7 ,availability ,notwithstanding any other provision of law1 the ,president1 acting through the ,secretary of ,state1 shall1 from funds made available under the ,global ,health ,programs account1 make available not less than #djj1jjj1jjj annually to carry out section #d of this ,act and subsection 7c7 of section #ajd of the ,foreign ,assistance ,act of #aifa1 as amended by subsection 7a71 including for life-affirming maternal and child health programs that-- 7#a7 focus on the prevention of maternal1 fetal1 and neonatal deaths2 7#b7 promote natural methods of fertility awareness and couple-centered care2 7#c7 provide training and emergency response to the #e leading causes of maternal mortality3 hemorrhage1 hypertensive disorders1 sepsis and infections1 obstructed labor and uterine rupture1 and miscarriage1 to include surgical management of obstetrical emergencies and pregnancy complications 7not to include elective abortions72 7#d7 provide training and response for the leading causes of maternal late postpartum complications3 severe anemia1 neurological and cardiovascular injury following hypertensive disorders1 fistula1 hemorrhage1 infections1 and postpartum mental health conditions2 7#e7 provide training and emergency response to the leading causes of infant mortality3 premature birth1 birth complications 7birth asphyxia_/trauma71 intrauterine growth restriction1 and neonatal sepsis and infections2 7#f7 uphold life-affirming care for both mother and child2 and 7#g7 engage fathers in these life-affirming maternal and child health programs as well as in the care of the mothers and their children4 #f4 ,reporting and oversight ,not later than #b years after the date of the enactment of this ,act1 and biennially thereafter1 the ,secretary of ,state shall submit to ,congress a report detailing-- 7#a7 the number of trainings offered1 providers and cadres trained1 including midwives1 physicians1 community health workers1 nurses1 physician assistants1 nurse practitioners1 pharmacists1 laboratory technicians1 and other birth attendants1 and the content of the training curricula2 7#b7 the effectiveness of such trainings1 measured rigorously and objectively1 to determine improvements in knowledge and skills through pre- and post-training assessments2 7#c7 initial and annual co-investments made by private industry and foreign governments2 7#d7 sustainability plans and timelines for organizations and governments receiving assistance2 7#e7 the number of facilities receiving support for facility upgrades 7such as basic lab tests1 blood transfusion services1 second-line uterotonics for postpartum hemorrhage1 broad spectrum antibiotics1 referral and transport systems for rural health-care facilities1 and ultrasound services for recognition and management of high-risk pregnancies71 and the nature of the upgrades2 7#f7 any support provided for establishment of revolving capital funds2 7#g7 community- and hospital-level data on maternal1 fetal1 neonatal and infant morbidity and mortality1 presented as a comparison between areas served and not served2 7#h7 regions and facilities served2 7#i7 estimated maternal and child lives saved2 and 7#aj7 compliance with ,united ,states foreign assistance restrictions and goals of this ,act4