May 8, 2017

Crafting their first-ever birth plans

Mothers attend a SHARE session
Mothers attend a SHARE session

On 10 March of this year, eleven women enrolled in our Savings for Health and Reproductive Empowerment (SHARE) program in Sikoro gathered together for a workshop with a midwife from the local health center. The SHARE program is designed to help pregnant women save money to pay for their prenatal care expenses. Mali Health contributes a small amount to cover the cost of delivering in a health center in order to make sure that every mother and child start their lives together as safe and healthy as possible. 

The midwife had visited this SHARE group many weeks earlier to discuss hygiene during pregnancy, so she asked the women in the group to review what they had learned last time in order to make sure they recalled the information correctly. After a couple of questions from the newer members who hadn’t attended the previous session, the group collectively repeated what they had learned, and the midwife was satisfied with their responses. 

Today’s session was focused on the importance of creating a birth plan, a concept that many of the women — even those who had given birth before — had never considered. The midwife spoke with the assembled mothers about planning for the finances they would need; the clothing they should gather for themselves and the baby; arranging transportation and identifying someone whose responsibility it would be to bring them to the health center when the time came; writing down and remembering their blood type and having someone available with the same blood type who could donate blood in case of hemorrhage; as well as a number of other topics. 

After the midwife explained each component and why it was important, the mothers spent time discussing, debating, refuting, and asking questions. Some parts of the plan, such as identifying who would bring them to the health center, were not practical in reality, they said, because they could not predict who would be around them on any given day. The midwife patiently and politely answered all of their questions and helped them think of ways to address some of these complications. 

She also reiterated for the women how important it is to give birth in the health center instead of at home. Excessive bleeding and infections are the leading causes of death for women related to pregnancy, so it is critical to deliver in a health center where trained staff have the tools necessary to respond quickly to complications if they arise. The mothers in the group seemed to understand this risk all too well, and all agreed that they would give birth in the Sikoro maternity ward when the time came. 

Sessions like these are one of the reasons why — with your support — we haven’t lost a single mother in our programs for more than three years. Before Mali Health began its work, women’s only hope of receiving qualified maternal health education was to attend a prenatal care session at the health center, a service that most of the women in Sikoro and our other partner communities could not afford. Far too many women went through their entire pregnancy and delivery without ever once coming into contact with a health professional. 

Today, by bringing midwives and other providers out of the health centers and into the communities, we are making this vital information available to far more women than ever before. By reaching them early and in a context where they feel safe and comfortable, we are helping them to recognize the importance of receiving professional care, and we are helping them gather the resources necessary to access it. As a result, 100% of the women enrolled in our SHARE program in the past 16 months have attended all of their prenatal care visits and every single birth has taken place in a health center. You have made that possible with your support of Mali Health. 

Our sincerest thanks,

-The Mali Health team 

The midwife discusses birth plans
The midwife discusses birth plans

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Feb 7, 2017

Meet the "Beautiful Women" of Sabalibougou

Belle Dame de Sabalibougou
Belle Dame de Sabalibougou

For a long time, women living in disadvantaged communities in West Africa have been treated simply as housewives, incapable of participating in the management of family finances. The women in our programs have hope for a different future - hope that they can better themselves and their families. That hope motivates women in one of our groups, named Belle Dame de Sabalibougou (Beautiful Woman of Sabalibougou).

Madame Koura speaks highly of her savings group, and their successes: 

“The program is the best program that we women could ever have. From the beginning of its operations to today, we have seen big changes in our lives. The savings in our two group funds have been an enormous help to us. Thanks to these funds, we know without a doubt that we will have money for our health needs and other small needs.

Even though it’s true that we are a young group, our health fund has already subsidized about ten prescriptions either for children or their mothers. Today, a lot of us have started small economic activities. We cannot be anything but proud of this program.” 

Madame Awa adds:

“Outside of better financial access, this program has really helped pregnant women. The program provides reimbursements for the costs of our prenatal consultations during our pregnancy, which motivates us to frequently visit the health centers. We joined this program not too long ago, but the impact is already perceptible in our group. 

"Outside of our group activities, we have initiated a solidarity tradition to further strengthen our bonds. Each time a mother gives birth, we collect a piece of soap from each member of the group so that the new mother can wash her newborn. We sincerely thank Mali Health. [The old proverb applies:] they’ve taught us to fish, rather than giving us fish. This initiative truly puts women first. We invite all women to join us to take care of ourselves and our children with the support of Mali Health.” 

Belle Dame is a group of 27 women in the community of Sabalibougou who have joined our programs. The members of the Belle Dame group save 100 CFA (~20¢) per week, which is evenly split between their health fund and their general fund for income-generating activities. The group was founded in March 2016 with the help of animateur Bourahima D.

Nov 10, 2016

New Communities, New Families, New Lives Changed

Mah Diarra & Daughter
Mah Diarra & Daughter

By the end of the second quarter in 2016, Mali Health began enrolling children into our Action for Health (APS) program in two new sites—Sibiribougou and Sabalibougou. These sites already benefit from our Savings for Health (EPS) program, and serve as a pilot to test the impact of a continuum of financial and health services: new APS enrollments must already be enrolled in EPS to qualify. In this way, families benefit from a complete package of care and support from Mali Health’s community health workers, facilitators, and trained medical staff in health centers. The continuum of care alleviates financial and geographic access barriers, while providing health education and information from health professionals such as medical staff, mid-wives, and our own health workers.

Enrollment is on-going, and since early-summer 2016, we have added 100 new children into the APS program. Our programs team has already discussed logistics with the new health center staff to describe the program, its benefits, and expectations for beneficiaries. Our Health Communications team, including 8 new health workers, are already conducting door-to-door visits to check in on children’s overall health and nutrition, and to teach parents about disease prevention and healthy behavior change. Our health worker supervisors have already described the benefits these families will receive as a member of the APS program while seeking care in the community health centers. The missing piece that we’re working on right now is the signing of the official legal document between Mali Health and the Community Health Associations (ASACO) that will allow Mali Health to take financial responsibility for the care of their patients in the clinics.

At a glance, the continuum of care looks like this: Mothers and pregnant women are enrolled in Savings for Health. In this program women receive weekly informational and educational sessions, including visits from mid-wives, maternal health experts, and other guest speakers to advocate for facilities-based deliveries, prenatal care, and childhood vaccinations. These women are also saving a self-determined amount of money that goes towards general health or to pay for the cost of prenatal consultations and assisted deliveries. In our new sites, these families are simultaneously enrolled in Action for Health. In this program they benefit from frequent, proactive home care visits by their Mali Health community health worker. During these sessions families discuss health and behavior education, or receive free or subsidized health care at the local clinic, depending on the age of their child.

The idea is that mothers will be saving money in their health fund for the first two years that Mali Health offers free health care. After two years, Mali Health subsidizes health care at an amount that covers the most common illnesses. Anything that exceeds that amount should be easily covered through the accumulated health savings. In the case of pregnant women who deliver, their health savings cover the cost of prenatal consultations and facilities-based deliveries, which APS does not cover. The financial shock is completely absorbed through their health savings. APS continues to follow children closely throughout the first 1,000 days, including nutrition, disease prevention, and disease treatment.

Links:

 
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