Mentorship restores women’s smiles
Improving health systems
It’s a typical sunny day in Chikwawa, a low-lying district in the Shire Valley in southern Malawi. Like other women in the maternity wing of Ngabu rural hospital, Esnart Frazer is resting in a shade with her second baby born six hours earlier.
When labour kicked in, the 19-year-old mother of two, from Miseufolo area, looked no further than her nearest facility for safe delivery.
“I chose to give birth here because health workers assist us better now,” she says. “When I had my firstborn aged three years ago, many women were losing their lives. If you started bleeding while giving birth, you were gone.”
The teen mother says she wished to deliver her first child at Chikwawa district hospital, which had more staff and better tools than the rural facility.
“I didn’t want to risk my life and first pregnancy. However, I still gave birth here because I had no money to travel to Chikwawa and wait for my first.”
A return trip costs K6000.
Esnart is delighted that she safely delivered her second child at the nearest hospital without financial hardship or a long wait for an ambulance.
Her fears are not unfounded.
Nyson Sekani, Safe Motherhood Coordinator at the Chikwawa district health office (DHO), recalls how a woman succumbed to severe bleeding while giving birth three years ago.
He narrates: “The most touching maternal death in my nursing career occurred three years ago because health workers at Ngabu had no skills and equipment to provide transfusion”.
“We identified the gap through mandatory audits of maternal death and mentored our colleagues to operationalise transfusion.”
Women in labour now receive blood when they need it most.
Chikwawa DHO also mentored a nurse at Ngabu rural hospital to operate a mobile scanner, which detects possible life-threatening complications in time for treatment or referrals.
Nyson Sekani, Safe Motherhood Coordinator at the Chikwawa district health office (DHO), recalls how a woman succumbed to severe bleeding while giving birth three years ago.
He narrates: “The most touching maternal death in my nursing career occurred three years ago because health workers at Ngabu had no skills and equipment to provide transfusion”.
“We identified the gap through mandatory audits of maternal death and mentored our colleagues to operationalise transfusion.”
Women in labour now receive blood when they need it most.
Chikwawa DHO also mentored a nurse at Ngabu rural hospital to operate a mobile scanner, which detects possible life-threatening complications in time for treatment or referrals.
Nursing officer Joseph Namwanda has spent three years of his five-year career at the rural hospital’s five-bed labour ward where up to 15 babies are born every day.
He attended the mentorship under the United Nations Joint Program for Health Systems Strengthening (UNJP-HSS) commonly known as the Umoyo Wathu project, funded by the UK’s Foreign, Commonwealth and Development Office through UNICEF, UNFPA and WHO The six-year programme, now in year four, seeks to halve maternal and newborn deaths as well as stillbirths in health facilities.
Namwanda says peer-to-peer learning has tremendously cut the risk of mothers and babies dying from manageable birth-related complications.
“Previously, we were referring all pregnant women to the district hospital if they had possible complications. After the mentorship, there has been a drastic reduction in referrals because basic ultrasound scans are done right here,” he says.
Using the scanner, Namwanda figures out the weeks a pregnancy has taken, the expected date of delivery, a foetus’ weight, its position in the womb, the amount of protective fluid cushioning it and possible dangers.
“I didn’t have this know-how until I underwent a weeklong training, including three days of theoretical knowledge and two for practical work,” he explains.
Master sits on the district maternal and newborn health committee that investigates every maternal death for accountability and continuous learning.
He recounts: “The committee was alarmed when Ngabu had reported six maternal deaths in three months.
“We transferred the mobile scanner that we used to screen women in our maternity ward after our inquiries revealed that most of them were delivering on the way and without skilled caregivers since they had to come here to know the baby’s status.”
Master’s team now partly uses the time saved to plan and conduct more coaching sessions.
“I thank UNICEF and its partners for their support. The skills should further be decentralized to more facilities so that women can portable ultrasound scanning at the point of care.
