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Community groups saving women’s lives

© UNICEF Bangladesh/2009/Naser Siddique
A healthy mother looks lovingly at her new baby, at Chowgacha sub-district Health Complex, Jessore.
By Fahim Uddin Ahmed*

SIRAJGANJ, May 2010: Sakina Begum’s third pregnancy was difficult from the start. She continually had problems and complications, but due to ignorance, her husband Babar Ali did not take her complaints seriously. Sakina and Babar already had two healthy children, born through normal deliveries, so Babar thought there was no reason to worry.

When Sakina went into labour, she began to develop severe pain, and Babar called a local birth attendant to their home. Like 85 per cent of deliveries in Bangladesh, this birth was taking place outside of a hospital. After some time, the birth attendant asked Babar to urgently find a doctor. “I was at a loss when the birth attendant told me to seek a doctor at the eleventh hour. It was my understanding that my wife would have a normal delivery as before,” he said. At that time, he was not aware of the danger signs of pregnancy, or the importance of antenatal care.

There was no doctor available in the village, so he tried to find transport to the nearest town.  While he was looking, his cousin called out to him and told him to rush home instead. Babar returned home, expecting to meet his new baby. But the situation was very different. He found that his wife and their new baby had left them forever. “I went out to seek a doctor but meanwhile I lost my beloved wife who was my heart, my life,” he says.

A daily tragedy
There are too many men like Babar Ali in Bangladesh, who know the tragedy of losing a wife during childbirth. A woman’s lifetime risk of dying in pregnancy or childbirth is one in 51 in Bangladesh, compared to a rate of one in every 47,600 women in Ireland (the best performer).

While Babar was consumed with grief over his wife’s death, he also had to look after two children and carry on farming his land and working a part-time job. His children were too young to understand what had happened. “It was so painful that a girl of three was looking here and there for her mother, not aware that her mother had left them forever, and that she was deprived of her mother’s love and affection,” says Babar.

Eventually Babar remarried and started his life again, but the death of his first wife remained a source of sorrow and confusion for him. One day he heard that there would be a meeting about maternal health and the role of the community in his local primary school, arranged by the sub-district Family Planning Officer, assisted by the CARE Programme Officer, and supported by UNICEF. For the first time, Babar learnt about the five danger signs of pregnancy, the importance of antenatal care, and the main causes of maternal mortality. He described his own experience and felt relief by sharing his sorrows.

© UNICEF Bangladesh/ 2010/Fahim Uddin Ahmed
Babar Ali (right, in white shirt), holds a community meeting in Sreefaltola village, Rangpur, northern Bangladesh.
Community support
Babar was so inspired by the meeting that he decided to form a Community Support System (ComSS) Group in Sreefaltola Village, Shahjadpur Upazila (sub-district).“I was looking for an opportunity to do something for my community,” he says. These community groups are supported by the Ministry of Health and Family Welfare, the NGO Care and UNICEF.

Babar Ali is president of the Sreefaltola community group, which meets once a month to discuss the needs of pregnant women in the village. The group has 32 members, including local government representatives, religious leaders, community volunteers, community health promoters, teachers, traditional birth attendants and village doctors. The link with local government helps improve the group’s sustainability. Group members receive training from the Upazila Health Complex on all aspects of pregnancy.

There are more than 60 community groups like Babar Ali’s operating in six upazilas in six districts in Bangladesh, plus many more similar groups operating under other UNICEF-supported initiatives, using a slightly different model. The groups raise awareness among the community about maternal and neonatal health, and encourage women to seek health care during pregnancy. Community health volunteers visit homes and collect data about the number of pregnant women in the communities. The groups identify key barriers to safe pregnancy and childbirth in their communities, and come up with local solutions such as establishing transport networks or identifying blood donors.

Since Babar established his group in Sreefaltola in 2008, there have been 17 safe deliveries in the village including 2 caesarean deliveries, and no maternal deaths. Currently 19 pregnant women are being supported by the group. The group has also saved almost 5000 taka (72 USD) to support poor pregnant women in emergencies.

“We are confident to identify pregnancy complications and take measures to save the lives of our mothers. The whole community is now aware of the five danger signs of pregnancy,” said Babar.

Challenges remain
A major challenge is that his sub-district health clinic does not provide 24-hour services. “We have to go to a private clinic which is very costly for us,” he said. In the meantime, Babar Ali and his team are planning to establish a community health centre to provide services to mothers and children. They have rented a building and are looking for a doctor to run the clinic, with fundraising activities planned.

“I strongly feel that community support system groups should be introduced in all villages, and services from the sub-district health clinic should be ensured round the clock. Then only, we would be able to reduce unexpected deaths of our mothers, wives, sisters, etc. I have found the groups the best way to address maternal mortality and morbidity at the grassroots level,” he said.

* UNICEF programme officer, field operations, Rangpur.

 

 

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