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A message from Professor Wendy Graham, The Soapbox Collaborative’s Chief Scientific Adviser

There are an estimated 135 million babies delivered each year in the world, with just over three-quarters of these occurring with trained care providers in healthcare institutions. In the 21st century it would be reasonable to expect that the majority of births occurring in health facilities receive safe and respectful care from the providers and the environment. This is sadly not the case, with too many women and babies facing risks owing to care, the environment, or to what we call iatrogenic factors. Occasions where unintended and avoidable harm arises from healthcare delivery occur all over the world, irrespective of income, education, culture, or health system capacity. However, the greatest burden of unsafe care is borne in low-income countries and amongst the most marginalised populations. These women and babies have been the main target group for the work of The Soapbox Collaborative over the last seven years. We have focused on one important dimension of unintended harm at the time of birth – infection-related risks owing to poor hygiene in terms of practices and the care environment. Awareness of these risks is not new – indeed, some of the earliest work on the consequences of unhygienic birth practises can be traced back to 1795 and the City of Aberdeen in North East Scotland with Dr Alexander Gordon – ironically also the UK base of Soapbox. Whether this is mere coincidence or not is unimportant, but it is clearly a stark reminder of the long lag-time between discovery of risks and the practise of prevention to reduce harm. Two centuries after Gordon’s work, women and babies are still being delivered where infection risks are unacceptably high. And this insult is all the more problematic given that the solutions are well established and known. 

The Soapbox Collaborative has focused on finding fundamental root-causes and interventions – and has demonstrated the value of important, evidence based hand hygiene and cleaning activities, combined with working collaboratively with those able to put these benefits into action – at both provider, manager and policy-maker levels. This 2019 report is our final one and tells a story of partnership, discovery and opportunity.  And as we close Soapbox just a few weeks after the new World Health Resolution to prioritise water, sanitation and hygiene (WASH), infection prevention and patient safety in healthcare facilities, and having been one of the actors pushing for this, we are ending on a high note. We hope you will enjoy this story of a small Non-Governmental Organisation with a big collaborative mission.

Read the full story of the Soapbox Collaborative’s achievements here.

A special seminar celebrating Soapbox’s achievements and highlighting the unfinished agenda was held on the 18th June at London School of Hygiene and Tropical Medicine; the recording of the event is available here.