By Kate Ixer; Health Poverty Action is a winner of the Women Deliver 50.
In April 2010, Sierra Leone introduced free health care for pregnant women and breast-feeding mothers to help reduce the maternal mortality and morbidity rate. Almost two years on from this watershed significant improvements have been made and many women have received the health care which they previously would not have been able to afford. Sierra Leone, a country where 70% of the population is living in extreme poverty, illustrates that free health care is crucial to improving women’s health rights.
However, making health care free at a national level does not improve access to healthcare for everyone. 64% of the population live in remote rural areas, significantly reducing access to health facilities for many people. For example, in the Tambaka chiefdom in the North of Sierra Leone 72.9% of people live further than 5 miles away from a health centre and transport is infrequent and unreliable, and sometimes non-existent.
With scattered health facilities and 77% of women giving birth at home with no skilled attendance, Traditional Birth Attendants (TBAs) have played an essential role in maternal health care in rural regions. They would customarily assist women in pregnancy, labour, childbirth and the post-partum period. However, TBAs can lack some more advanced skills and when 15% of deliveries involve complications; they can be too complex for TBAs to handle.
This is why Health Poverty Action has trained traditional birth attendants to become ‘maternal health promoters’ (MHP). The organisation leverages the status of TBAs in the community and builds their capacity to educate women on safe motherhood practices, including the importance of attending antenatal and postnatal clinics, sleeping under mosquito nets, breastfeeding after giving birth, and delivering in a health facility with trained staff. The programme also provides “birth waiting rooms” within people’s homes at no charge, where the maternal health promoters can provide education to mothers travelling from distant locations. These rooms are a major innovation because many women feel more comfortable here than in specially constructed birth waiting homes. Plus they are cheaper to run and can thus be easily replicated within overstretched health systems.
Isha Jalloh, a Maternal Health Promoter trained by Health Poverty Action enjoys what she does and has saved the lives of many women and babies. She is happy when women come to her because she is secure in the knowledge that she is able to support them throughout their pregnancy. Isha is one of many MHPs in the North of Sierra Leone and exemplifies that mobilised and empowered TBAs are giving pregnant women the life-saving information they need for themselves and their babies.
Photo via Health Poverty Action.