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At a glance: Yemen

In Yemen, community midwives save lives

© UNICEF Yemen/2010/al-Ardi
Foreegah Ayeesh works as a community midwife in Yemen, where about three-quarters of children are born outside of a hospital or clinic.

By Zahra Sethna

HODEIDAH, Yemen, 23 November 2010 – Foreegah Ayeesh still remembers the afternoon a few months ago when she was called to check on Amat al-Rahman, who was 17 and pregnant.

Ms. Ayeesh, a UNICEF-supported community midwife, arrived to find Amat pale and breathless. The young mother-to-be had low blood pressure, a high temperature and a quick pulse. She was already in labour.

With Amat’s condition critical, Ms. Ayesh recommended she immediately be taken to hospital for a blood transfusion. Amat’s parents and husband agreed and hours later, surrounded by skilled birth attendants, she gave birth to a healthy baby.

Critical help saves lives

Typically, Ms. Ayeesh would have been tracking a pregnancy like Amat’s from the beginning to ensure the safety of both mother and baby. Amat lived outside the catchment area where the midwife works, but people in the community knew of Ms. Ayeesh’s training and were able to intervene in time.

© UNICEF Yemen/2010/al-Ardi
Community midwife Foreegah Ayeesh measures a newborn as part of an antenatal checkup in Yemen.

Across Yemen, about three-quarters of women deliver children outside of a health facility. A skilled birth attendant is present for only 36 per cent of deliveries nationwide. This figure plummets in rural areas, where the majority of the population lives. Here, trained birth attendants can potentially save thousands of lives each year.

The stakes are high. Midwifery care has a direct and positive effect on child health. By contrast, when a woman dies giving birth, the impact on her family can be enormous. Often, maternal death indirectly leads to other deaths.

Raising awareness

UNICEF has supported the training of community midwives in five targeted governorates across the country. Trainees, who must have a middle school education, are selected from their local communities, where they go to work as soon as they qualify from the two-year certificate course.

© UNICEF Yemen/2010/al-Ardi
Suheila Ibrahim, a community midwife in Hodeidah governorate, Yemen, discusses newborn health with Zainab Abass, who holds her newborn son Muhanad.

UNICEF has partnered with local authorities and religious leaders to make the initiative sustainable and raise awareness of the impact the midwives are having.

In addition, UNICEF has worked to establish small-scale funds in each community that can be used for emergency cases. These are managed by committees consisting of community members, local council representatives, religious leaders and others. When a midwife recommends a patient for referral to a hospital, a driver is dispatched to transfer the mother. Costs are covered by the community fund.

Community acceptance

Another beneficiary of the programme, Zainab Abass, 35, watches intently as her nine-day-old son Muhanad is weighed and measured by Suheila Ibrahim, who has been working as a community midwife for five years.

Ms. Abass lives in the Zaidia district of Hodeidah, a governorate in western Yemen. All four of her children were born at home with the help of a midwife. Having such skill on hand locally makes a big difference, as community midwives are more trusted and accepted than outsiders.

“This is a small village,” says Ms. Abass. “Suheila is my neighbour and I knew she had done this training.”

Rewarding work

Ms. Ibrahim hands Muhanad back to his mother after the newborn’s check-up is complete. She then explains importance of exclusive breastfeeding for the first six months.

For Ms. Ibrahim, working as a community midwife has been extremely rewarding, particularly when she is able to detect and refer a case that needs special attention.

“You cannot measure how happy you feel when you save a mother or child’s life,” she says, before heading off to check on another newborn and mother.



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