Empowering Midwives to Save Lives
In Kenya complications related to pregnancy and child birth are among the leading causes of maternal morbidity and mortality. Targeting maternal health interventions to reach those women who have difficulty accessing health care is a high priority in Kenya given the gross disparities in the ability for the majority rural population to reach a health facility.
To reduce postpartum hemorrhage (PPH) cases for women who are unable to reach a facility to deliver, VSI teamed up with a Nairobi based nonprofit, Organization for Health Education Research Service (OHERS), on a project aimed to reduce the number of women dying due to excessive bleeding at home births by distributing misoprostol tablets through community midwives who conduct home deliveries. Misoprostol (or "miso") is an easy-to-use generic tablet that is safe, affordable and practical in a village setting, and it has tremendous lifesaving effects. When a mother takes three tablets immediately after delivery, it can greatly improve her chances of surviving childbirth from hemorrhage.
Focused in the rural communities of the Emuhaya district, objectives of this collaborative project are to (1) ensure community midwives and pharmacists have access to misoprostol, (2) that they are trained on its use and benefits for the management of PPH and (3) are educated on the dangers of PPH in home settings. Since the project commencement in November, we’re delighted to share that community midwives are reporting a monthly increase in number of deliveries which means more women are coming to them for services, perhaps motivated the benefit of misoprostol. Trained by a VSI coordinator, community midwives were educated on the use of misoprostol during home deliveries and in clinics where oxytocin is not available. To date, the project has trained and sensitized over 30 community midwives and 10 local pharmacists who also maintain a stock of misoprostol to create sustainability of the project.
As we approach Mother’s Day, we would like to extend our deepest thanks for support through Global Giving in making childbirth safer for mothers. Please consider continuing your support by joining our “I am a mother” campaign and giving through Global Giving or visiting us online to learn how to get involved – www.vsinnovations.org/mothers.
Empowering Local Midwives to Save Lives
In Sub-Saharan Africa, so many women and girls die from childbirth or unsafe abortion that it is said that everyone knows someone – a sister, aunt, friend, or mother – who has died from these causes. Mozambique is no exception to this with 1 in 37 women risking death in pregnancy and childbirth. One of the leading causes of maternal death is excessive bleeding after childbirth or postpartum hemorrhage (PPH); disparities in women’s ability to access health care and the fact that over 70% of births occur in rural areas exacerbate the risk of dying from this manageable condition. Thus, in efforts to protect women in childbirth from PPH, our project targets pregnant mothers not just where we want them to be, which is delivering in a facility, but wherever they may deliver: at home or on-the-way to that distant clinic.
In partnership with local organizations like AMOG, the Mozambican Society of Obstetricians and Gynecologists, we have piloted a project educating women on birth preparedness and distributing misoprostol for use at home births. Misoprostol (or "miso") is an easy-to-use, heat-stable generic tablet that is practical in developing countries for the management of PPH, and it has tremendous life-saving effects. When a mother takes three tablets immediately after delivery, it can greatly improve her chances of surviving childbirth from excessive bleeding. It can also provide an back-up treatment in clinics that have poor supplies of standard medications that require refrigeration and injection.
The project aims to make miso available through a variety of channels: prenatal care visits and through traditional birth attendants, and a combination of the two in three focused districts areas totaling around one million in population. Traditional birth attendants (TBAs) are trusted community members who receive a cultural education –passed from generation to generation—in the rituals of childbirth. In situations when women cannot reach a health facility, TBAs living in these remote Mozambican communities are often women’s only option for support during childbirth.
Since the project’s commencement, VSI and partners have trained over 175 TBAs to administer misoprostol as part of their care during delivery in the rural communities of Namacurra and Nacala and over 50 ANC providers.
The local women have responded to the program with overwhelming support, testimony to the value of empowering women to save women’s lives in their own communities. One TBA from Nacala Porto excitedly told us that, “Mothers like the tablets! They tell us ‘we want more tablets’!’” Husbands are happy to see their wives feeling stronger after childbirth, and women who attend church are even praying for the tablet to stay in the community. By making miso available both at the facility during an ANC visit and to frontline providers like TBAs, all women can have access to this life-saving tablet regardless of the place of delivery (home or as back-up at a facility).
As we approach Mother’s Day, we would like to extend our deepest thanks for your contributions through Global Giving and your support in making childbirth safer for all mothers. Please consider continuing your support by joining our “I am a mother” campaign and giving through Global Giving or visiting us online to learn how to get involved – www.vsinnovations.org/mothers.
Empowering women to help women
Through the education of young health extension workers, we continue to expand the use of misoprostol for PPH prevention in efforts to save lives throughout Ethiopia’s nine regions. Reaching mothers where they deliver – whether at a facility, home alone or on the way to a distant health clinic – our project is equipping these young frontline providers with the knowledge and skills to use misoprostol for PPH prevention, treatment, and referral on clean and safe delivery.
This year we have expanded our cascade trainings into the SNNPR (Southern Nations Nationalities and Peoples) region which is one of the largest regions in Ethiopia, making up a fifth of the country’s population. With less than ten percent of its population living in urban areas, the region is overwhelmingly rural as well as ethnically diverse (over 80 different ethnic groups; 56% indigenous to the region). Using a cascade or train-the-trainer method to spread messages on PPH management not only is cost effective but allows us to empower local providers to help mothers in their respective communities survive childbirth and pregnancy. More importantly, it increases ownership of the training and the likelihood of success.
Within the SNNPR region, we have conducted cascade trainings in six “kebeles” or neighborhood associations across three districts, reaching 183 frontline providers (health extension workers, nurses, midwives, and health officers). The providers trained on the use of misoprostol for PPH prevention and treatment will assist their fellow health workers develop confidence in managing delivery using misoprostol to help reduce maternal death due to PPH.
As we approach Mother’s Day, we would like to extend our deepest thanks for your support through Global Giving in making childbirth safer for all mothers. Please consider continuing your support by joining our “I am a mother” campaign and giving through Global Giving or visiting us online to learn how to get involved – www.vsinnovations.org/mothers.