Improving child birth with safe water and sanitation facilities
For every child, a clean environment
When Aziriyen Alobinuruum delivered her first child in March 2015, the experience of childbirth was an unpleasant one, not because of the labour pain but rather the difficulty in accessing water at the Sumbrungu Health Centre in Bolgatanga, where she gave birth.
It was dreadful to watch her mother-in-law trek two miles from the Sumbrungu Health Centre to a distant stand pipe to join a long queue in order to get water for her use.
“After I gave birth to my first child, I was relieved for a few moments but the constant struggle of my mother-in law to find water to wash soiled clothes and for my bath took some excitement away,” the 22-year-old peasant farmer and basket weaver said.
Fast forward to October 2018, Aziriyen’s second childbirth experience at the same health centre was totally different. “This time, there was water everywhere for me to wash my hands, bathe and wash my baby’s clothes,” she said with a smile as she looked at her five-month son’s face nestled in her arms.
In order to improve the quality of health care and sanitation for mothers and newborns, UNICEF constructed mechanized boreholes linked directly to maternity wards, toilets, bath and handwashing facilities at six health centres in Ghana’s Upper East Region.
Improved access to water and sanitation in health facilities has been made possible through UNICEF’s Mother Baby-Friendly Health Facility Initiative (MBFHI) with funding from the Bill & Melinda Gates Foundation and Ghana Health Service as the main Government implementing partner since 2016.
For the Municipal Director of Health Services at Bolgatanga, Edmund Nyanwura, the impact of the WASH facilities is apparent and cannot be underestimated.
“WASH improvement in our health facilities is a dream come true. It has reduced health infections and marternal mortality drastically in the municipality,” said Edmund, a trained pharmacist with over 16 years experience. According to the health directorate, mortality associated with childbirth reduced from 19 deaths in 2017 to 8 in 2018, representing a 58% reduction. For the first quarter of 2019, only one death has been recorded.
Community Health Nurse at Sumbrungu Health Centre, Mauricia Ababu, 30, said life of healthcare workers has changed since the WASH facilities were constructed. “Previously, nurses had to queue for several hours at the community pipes in order to get water to bath and report to work. Community members competed with us for water and it was stressful and led to late reporting to work by staff.”
"After I gave birth to my first child, I was happy for a few moments but the constant struggle of my mother-in law to find water to wash clothes and for my bath took some of the excitement away."
For some expectant and newborn mothers who had no help from family during the absence of the WASH facilities, it behoved on health workers to walk in search of water which greatly impacted their commitment and quality of healthcare delivery, Mauricia explained.
Another aspect of UNICEF’s MBFHI is the education of pregnant and newborn mothers on quality hygiene and childbirth preparation from antenatal to postnatal periods. Through mother-to-mother support groups and focused group discussions spearheaded by NGOs such as PARDA and Community Health Nurses, the women are educated extensively on the impact of quality maternal care for their babies.
“The WASH facilities and education have led to a reduction in diarrhoea cases as well as infections normally experienced by mothers. Also, transporting water from sources several metres away led to contamination,” said Raymond Adoganga, Physician Assistant and Sub Municipal Health Leader at Sumbrungu. “Now, mothers and newborns have decent sanitation facilities in the ward as opposed to the previous situation where urinals served as bathrooms.”
Improving the quality of healthcare requires complete, reliable and accurate data collection and analysis. With support from UNICEF the Ghana Health Service has developed national indicators for WASH in healthcare facilities and incorporated them into the national health information system for routine reporting through the District Health Information Management System.
Health Specialist at UNICEF, Peter Baffoe, believes that with this effective reporting system, “it will help track areas of deficits that need investment and give stakeholders a true snapshot of the the status of WASH in healthcare facilities.”
For many mothers like Azuriyen, the WASH facilities and education has changed their lives positively. “Now, I know the best ways to breastfeed my son exclusively to ensure he grows up healthier and happier,” she adds.