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Namibia, 26 April 2018: Making every pregnancy safe for mothers

© UNICEF Namibia/2018/Mutseyekwa
Sister Paulina Fillemon, together with student nurse Martha Aron, giving health lessons to mothers at an ANC class

By Tapuwa Mutseyekwa

Ongwediva, Namibia – On a typical Tuesday morning, Ongwediva Health Centre, which is in Namibia’s Northern Region of Oshana, is abuzz with pregnant women coming for their routine Ante Natal Classes. On average, 30 women walk through the gates of the health centre, each one of them at a different stage in their pregnancy, and each with great expectation for a safe delivery.

Sister Paulina Fillemon attends to each woman with great compassion and gives even closer attention to 32 year Maura Amagola. Since she was 20 years old, Maura has fallen pregnant 10 times, but unfortunately none of these pregnancies has gone beyond three months. Sister Paulina’s desire to see a change in this situation.

“There are many factors why a woman like Maura might have difficulty in carrying a pregnancy through and it always breaks my heart when I am unable to give support to a woman with a high risk pregnancy,” says Sister Paulina, as she explains how a miscarried pregnancy can be both scary and overwhelming for the mother and also for the nurses.

According to the Namibia Demographic and Health Survey (2013), lower levels of the health care delivery system, such as health centres and clinics, are not adequately equipped with personnel to provide emergency obstetric and new born care (EmONC). Women who require specialized care and treatment, which is beyond the scope of basic care, are referred to the nearest referral hospital.

High risk pregnancies from Ongwediva Health centre are referred to Oshakati Referral hospital, however, not all mothers who travel this 30 kilometres stretch to access specialized care are lucky. Cases of losing a mother, the baby or both have been recorded, while some mothers are unable to meet the costs of traveling for scheduled specialized follow up sessions.

Today, Maura is seven months pregnant, thanks to the consistent mentoring, emotional and medical support that Sister Paulina is now able to give to her clients at the health centre.

The turning point for Sister Paulina has been the intense and specialized training she has received as part of the Every New-born Action Plan (ENAP) which is being modelled in the Oshana Region with support from Teck Resources and UNICEF.

© UNICEF Namibia/2018/Mutseyekwa
Continued specialized care is given to mothers with high risk pregnancies, to ensure that mother and baby are saved.

Trainings in Focused Antenatal Care (FANC), Emergency Obstetric and Newborn Care, essential newborn care, which are critical components of the ENAP, has now built the capacity of 117 nurses from 18 facilities in the region, to identify, navigate and manage some of the high risk pregnancy factors.

With this training facility level nurses are now authorized to attend to high risk pregnancy conditions such pre-eclampsia and also to administer pre-referral treatment. Before the training, they did not have this skill nor the mandate.

“Namibia has the potential to substantially reduce maternal and new born deaths if specialized services are brought closer to the women and the communities,” says UNICEF Representative, Rachel Odede. “These basic trainings in Focused Antenatal Care and Emergency Obstetric Care is therefore a major milestone as facility based nurses are now strengthened to save the lives of women and children.”

Apart from closely monitoring and attending to the medical side of saving high risk pregnancies, Sister Paulina has learnt the value of being a pillar for emotional and psychological support to women who face the pain and distress of losing a pregnancy.

“When I first met with Maura, I could notice the trauma and discomfort when she told me that this was her tenth pregnancy and that none of her previous pregnancies had come to term.”

Four months since this first encounter, Maura is now positive and optimistic about carrying this pregnancy to full term. At each consultation, she informs Sister Paulina of the preparations she is making to receive the baby. Today, Maura ecstatically tells Sister Paulina that the baby will be named Ndahambelela, which means “Testimony of praise” in the local Oshiwambo language.



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