If you can get more pregnant women to come in for prenatal visits and to give birth at a clinic, more women and their babies will survive childbirth and the vulnerable days following a baby’s entry into the world.
HPIC has been supporting the Evangelical Missionary Church of Canada’s work toward these goals over the last year. The EMCC has been managing a project working with traditional birth attendants (TBAs) in northeastern Haiti near the border with the Dominican Republic. Haiti has some of the worst indicators in the Americas on the health of mothers and babies. In 2013, 380 mothers died for every 100,000 births, and in 2012, 76 children for every 1,000 births died before reaching their 5th birthday.
“The concept was to train these TBAs in Gens de Nantes to encourage more women to come in to the local clinic for pregnancy follow-up and to refer women in labour with complications to the clinic,” explained Catherine Sharouty of HPIC.
The EMCC provided the training and the funding support and HPIC provided 30 Mother-Child Health Kits in three shipments over 10 months, including the most recent provision of 10 kits the last week of July. Mother-Child Health Kits (MCH Kits) are designed to equip frontline health workers with the instruments, supplies and medicines they need to care for women and babies during pregnancy, childbirth and the post-partum period. Each kit consists of medicines and supplies that need to be replenished and tools that can help a midwife/clinic for years to come. It is estimated that the consumables in one MCH Kit can serve 15 mothers and 30 children, from newborns to young children up to 5 years old.
“The EMCC provided incentives both for women to go to the clinic and for TBAs to give referrals. In addition, HPIC provided the MCH Kits to help the clinic deal with the boost in patient numbers,” Sharouty said.
The Mother-Child Health Kits “were very useful,” reported Marilyn McIlroy of the EMCC. “We had confidence that the supplies and pharmacy products were available when we needed them.”
In addition to receiving some basic training in managing complications in pregnancy and birth, these 30 TBAs were invited to work alongside the nurses and doctor at the Gens de Nantes clinic. One young mother, who was 19 when she gave birth, encouraged her cousin to go to the clinic for prenatal care. Her cousin, who is 25, had already lost two infants in the first days of life. Marilyn reported that she is now a mother after her baby was successfully delivered at the clinic by TBA Christemene Alcine using supplies from the Mother-Child Health Kits.
Another mother who benefitted from the MCH kits and the TBA training project was Milove St. Ilus. She already had three children when she visited Bertin Bernadin at his home to request his services as a TBA.
Marilyn told the story in a report to HPIC: “Bertin told her he had received training recently and had the materials needed for delivery. He asked Milove how many times she had visited the GDN health clinic for prenatal checkups. Bertin explained the importance of continuing to take the medicines that the nurse had prescribed, and the importance of a healthy diet. Ten days later, Milove’s husband came to get Bertin. She was in labour. He took his TBA kit and went off to her home. Within 45 minutes of his arrival, Milove delivered a big baby boy. He cut the cord; the placenta was delivered. Milove tore upon delivery. She rested until morning and the TBA stayed with her and her husband. In the morning, Bertin encouraged Milove and her husband to go to the clinic. They brought the baby along. At the clinic, the nurse checked out Milove and sutured the tear. She also examined the newborn baby. The nurse complimented Bertin for bringing Milove and her family into the clinic for their first postnatal visit.”
Before the project began, TBAs like Bertin and Christemene, did not have much for training and were not educated about the risks of not referring women in trouble to the clinic. These TBAs have hands-on experience in delivering babies and many would not have much education beyond elementary school. Now they have some basic training and they are motivated to refer their patients to the clinic for professional prenatal care and to manage complications.
“The EMCC is committed to continuing to train TBAs,” reported Catherine Sharouty. “HPIC will need your support to continue providing MCH kits to this project.”