A New Perspective on Maternal and Neonatal Care.
In Bla, in the Ségou region, a multi-stakeholder collaboration has reduced maternal deaths by more than 70% between 2021 and 2023, thanks to financial support from the Global Financing Facility (GFF).
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"I have endured the pain of carrying babies only to lose them. It’s a trial of life I have gone through not just once, but twice. Two full-term pregnancies without the chance to see my children grow up. I can tell you that for a young mom, it's one of the most terrible nightmares," shares Sanata, her voice filled with sadness. The 25-year-old woman from Bla, near Ségou, had previously experienced the tragedy of losing two children during unassisted home deliveries. These traumatic experiences had plunged her into deep depression. "I had lost all hope of being a mother," she adds.
In Mali, one out of every ten children dies before reaching his/her fifth birthday, while one in thirty newborns does not survive past their first month of life. In this context, reducing infant and neonatal mortality is a priority for the Government of Mali and its partners.
Sanata's third pregnancy, instead of being a cause for joy, was fraught with anxiety due to her first two experiences. Fortunately, she met Djeinaba, a community health worker who visited her at home during a tour of her village. The health assessment revealed that Sanata had never had prenatal consultations during her pregnancies. Recognizing the urgency of the situation, Djeinaba encouraged Sanata to visit the nearest community health center as soon as possible.
Accompanied by her husband, Sanata arrived, the next day, at the community health, which referred her to the Bla Reference Health Center (CsRef) on the same day. There, she learned that the size of her pelvis would not allow for a vaginal delivery. A cesarean section was the only option to save her unborn child. Sanata realized that another home delivery would result in losing her child for the third time.
She was admitted to the CsRef in Bla on April 5, 2020, and received comprehensive care and close monitoring through prenatal consultations (CPN), allowing her to give birth under better conditions. Minutes after the birth, her baby received neonatal care provided by Tahara Sissoko, a midwife at the CsRef in Bla for eight years.
"On June 8 and September 24, 2022, we received 2 incubators, 1 warming table, 2 ultraviolet light tables, 4 oxygen therapy devices, 40 newborn resuscitation kits, and 1 medical ambulance. This has significantly improved the quality of our care and the transport of mothers in distress and sick newborns. More than 350 premature babies have been saved in our CsRef since we received this equipment, and nearly 1,500 mothers have been evacuated in excellent transport conditions," explains Tahara.
She was admitted to the CsRef in Bla on April 5, 2020, and received comprehensive care and close monitoring through prenatal consultations (CPN), allowing her to give birth under better conditions. Minutes after the birth, her baby received neonatal care provided by Tahara Sissoko, a midwife at the CsRef in Bla for eight years.
"On June 8 and September 24, 2022, we received 2 incubators, 1 warming table, 2 ultraviolet light tables, 4 oxygen therapy devices, 40 newborn resuscitation kits, and 1 medical ambulance. This has significantly improved the quality of our care and the transport of mothers in distress and sick newborns. More than 350 premature babies have been saved in our CsRef since we received this equipment, and nearly 1,500 mothers have been evacuated in excellent transport conditions," explains Tahara.
The CSRef in Bla was equipped thanks to the support of the Global Financing Facility (GFF). This support was combined with collaboration with the Ministry of Health and Social Development and the Malian Association of Pediatrics (AMAPED).
"We were also trained on managing cases of hemorrhage, anemia, malaria, high blood pressure, pre-eclampsia, eclampsia, newborn resuscitation, and abortion care. This training was a great relief for us as health workers, but also a means to improve our communities' trust in health centers. More and more women are now coming to give birth at the centers in Bla," explains Tahara.
Sanata gave birth to Balakissa. Her little girl is 4 years old today and is in excellent health. The family welcomed another, Lalaicha, 13 months old, also in perfect health.
The annual number of maternal deaths fell from 15 to 4 in Bla, a 73% decrease between 2021 and 2023, thanks to an innovation that combines collaboration between UNICEF and AMAPED and the strengthening of local resources. The strategies developed in Bla, their close programmatic oversight and regular monitoring, show that it is possible to save more lives of mothers and babies in a country with some of the highest maternal and infant mortality rates in the world. Replicable strategies include monitoring and auditing maternal and perinatal deaths, responding through the activation of referrals and evacuations, supplying water, sanitation, and hygiene in health centers, promoting community health, social mobilization, and stakeholder accountability.
Sanata's story and the efforts in Bla are a proof that a different approach to maternal and neonatal care is possible despite the daunting context of maternal and infant mortality in Mali and Africa.
"Life has given me a new opportunity, and I am determined to seize it. I am more vigilant than ever about my daughters' health, and I take them to the community health center to ensure they receive their vaccinations and stay healthy. I didn't have the chance to go to school, but God willing, my daughters will attend school, and I will fight for them to succeed in life," concludes Sanata, proudly holding Lalaicha in her arms.
