It seems unthinkable that hundreds of thousands of women worldwide die every year simply because they can’t get adequate medical treatment for complications during pregnancy. And, it’s completely preventable. In developing countries, extreme poverty is a major cause of this tragedy. But, better access to facilities and education on common childbirth practices can save lives. Read on to learn more about the causes and prevention of maternal death in our partner communities in Tanzania.
The Problem in Sub-Saharan Africa
According to the World Health Organization (WHO), the maternal mortality ratio – the proportion of mothers who don’t survive childbirth compared to those who do – in developing countries is fourteen times higher than in the developed countries. More precisely, Sub-Saharan Africa accounts for two-thirds of maternal deaths worldwide. In Tanzania, maternal deaths represent 18 percent of all deaths of women age 15-49.
This tragic situation has a fairly simple solution: Education and appropriate care before, during and after childbirth. Most of the complications that develop during pregnancy are preventable or treatable, so when women receive quality prenatal and postnatal care and have a safe place to give birth, the number of deaths drops dramatically.
Global Volunteers’ RCP Interventions
In the rural Ukwega Ward of Tanzania, our Reaching Children’s Potential (RCP) Program targets economically impoverished pregnant women and new mothers for intensive education and essential services to fight the causes of maternal mortality. Through the Global Volunteers’ funded Ipalamwa General Clinic (IGC), mothers receive consistent quality prenatal and postnatal care and participate in health, nutrition, and child development workshops. The IGC and on-site pre-natal lodging provides a safe place to give birth and bond with their child pre- and post-delivery. During recent months while volunteers are absent from the program, the guest house lodging they normally occupy has been repurposed to test the model of care and housing for laboring moms.
Accessible and Safe Health Care
It’s still customary for women to deliver at home in rural villages. And, because women care for other family members and work in the fields (regardless of their pregnancy), mothers typically don’t travel to deliver at the clinic until they are in labor. This can be especially risky for women who encounter difficulties near delivery. Transporting women with high risk pregnancies to the local hospital closest to our partner villages is the most critical intervention during emergencies. For routine pregnancies and deliveries, the IGC is a reliable full-service facility. But predicting a mother’s due date is imprecise in rural villages, and travel (especially at night) with a mother in labor is risky. For instance, travelling eight miles from the Mkalanga village to the Ipalamwa hospital may not sound like much, but the rough and rutted roads make the trip a lot more complicated.
To address this issue, the Global Volunteers guest house on the RCP Center campus provides pre-delivery lodging when volunteers aren’t occupying the rooms. Moms are encouraged to stay in the facility up to ten days before their delivery date to mitigate the risks of a home delivery or complications on the way to the clinic. Selemani Salim, IGC Nurse-Midwife, tells us that one of the goals is to “minimize morbidity and mortality of the mother and child since some of the pregnancies may show no signs of complication during antenatal until labor commences, and since chance of home and on-the-way deliveries may be there so the deaths of mother and child may also happen.” She adds that another issue they try to avoid is communication delay: “this is due to fact that not all mothers possess phones, live close to the neighbors with phones, their batteries run out, or they have no credits to call care givers. All these failures to communicate with a health professional may compromise the operation and the outcome may be worse.”
When the mother is at the clinic, the staff can assess the pregnancy to determine if the baby is in the breach position or if the mom is undernourished, dehydrated or weak. Once the baby is born, the mother is again lodged in the guest house, and she and the baby are welcome to stay up to ten days post-delivery. Mothers-in-residence receive nutritious meals and are monitored and supported by the RCP staff, and are attended to by the medical staff at the IGC. It’s not all good news though. Selemani explains some mothers’ hesitance to travel to the clinic ahead of time: “Most women are the main parental figure to feed the family and make sure the kids go to school, so lodging them here for ten days will cost those they left at home (husband do not play this role most of times).” Fortunately, Zahoro Mlekwa Sakala, IGC Midwife, shares that “most mothers are not hesitant to travel to the clinic ahead of time possibly because of the ongoing educations and enabling environments which have been tirelessly set before them. But there are socioeconomic, cultural, and demographic circumstances, and belief variables that might affect their decisions on seeking and utilizing health services.” Thanks to the work of our volunteers and staff in Tanzania Zahoro reports that; “for the past six months, only one home delivery has been reported at IGC.”
Preparing for Long-Term Maternal and Baby Health
Two current goals of the RCP Program are to construct a permanent mothers’ residence at the RCP Health Center to facilitate earlier interventions by IGC medical staff, and to purchase an ambulance to transfer women with higher risk pregnancies to the hospital before emergencies arise. Zahoro tell us that, “relying on the current facility situation, I think we should pondered the need of a special and well equipped vehicle (ambulance) that can facilitate effective childbirth on the way if it happens.”
Your donation now to the RCP Program is an investment in the survival and long-term health of mothers and newborns in our partner villages. These interventions alone can significantly decrease maternal mortality, and serve as a model for expansion of RCP practices to neighboring villages in years to come.
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