Post-natal home visits improve newborn survival in Gaza
By Catherine Weibel
GAZA, Occupied Palestinian Territory, 1 June 2012 – Every year, an estimated 1,600 babies die in the first four weeks of life in the Occupied Palestinian Territory. Most of these newborns deaths could be prevented if mothers and newborns’s health was systematically evaluated, and if young mothers received advice on how to best care for their children.
To improve newborn survival, UNICEF has revitalized a post-natal home-visit programme for new mothers and infants in the Gaza Strip. Last year, nearly 5,000 home visits were supported, reaching more than 3,000 high-risk pregnant women in Gaza with technical and financial support from UNICEF.
Problems facing young mothers
“The idea is to visit mothers during the first crucial days of their babies’ lives, to provide a safety net for mothers and newborns at risk,” said Sawsan Hamad, the Director of the Mother's Health Department at the Gaza Ministry of Health.
Post-natal home visits are conducted by nurses and midwives who visit each mother three times, with the first visit taking place immediately after birth. During the visits, they promote and support exclusive breastfeeding, detect any health problems in either the mother and newborn, give advice about safe infant care, increase awareness about the benefits of spacing pregnancies, and promote immunization of the newborns.
In Gaza, many women marry at a young age and bear children shortly thereafter, despite the harmful health effects of teenage pregnancies. Following home visits, more than a third of the Gaza mothers were found to be anemic. Ten per cent of mothers, and 2 per cent of newborns, were referred to a health center for further follow up.
Another problem is short birth spacing; according to the 2006 Palestinian Family Health Survey, more than a quarter of Palestinian women give birth at intervals shorter than 18 months, and among women between ages 15 and 19, this number was more than a third. During home visits, half of the women said their pregnancies were unwanted and resulted from a missed opportunity for birth spacing. The nurses and midwives visiting the mothers at home provided counseling about appropriate birth spacing methodologies.
Eager for advice
Icelandic nurse Margret Hafsteinsdottir, a UNICEF technical advisor, participated in many post-natal home visits to see how the programme could be strengthened. All the mothers she met were eager for advice, no matter how many children they already had.
“I remember a 38-year-old mother who had just given birth to her 14th child. She and her 15-year-old daughter were pregnant simultaneously, and consulted together at the clinic,” Hafsteinsdottir said. “The mother told me she wanted all her children to marry young, to move out of the family house and start having children immediately because this is what she did, and because it is a practical way of making room for the younger children in her crowded house.” During the visit, the mother told Hafsteinsdottir that 14 children were more than enough, and that she would get sterilized.
Post-natal visits are especially crucial for teenage and first-time mothers. “I remember a very unsecure teenager who was discharged from the hospital only one hour after the delivery, because the maternity ward was too crowded, and who did not receive any education on breastfeeding,” Hafsteinsdottir said. The girl, who did not know how to breastfeed, ended up bottlefeeding her newborn formula.
But the post-natal home visit programme also showed that three-quarter of the mothers exclusively breastfed their baby. The programme is helping to encourage this practice.
“One mother, who was giving up on breastfeeding her twins because she didn’t realize she could breastfeed them both at the same time, changed her mind after our visit,” Hafsteinsdottir recalled. “Just a little support makes all the difference.”