Mrs. Nzengeza smiles warmly as she gently sprays water over young plants in a freshly dug garden bed. She is neither an avid nor experienced gardener, but as District Environmental Health Officer, she ardently wants this garden to thrive. “In my own research in this very district I’ve found that one of the top three reasons women refuse to deliver their babies at health centers is the absence of food provided for them there. That is why what [help2kids] is doing with this garden is so important: fewer women will give birth [at home] in the village.” The garden is part of a larger safe motherhood initiative designed to attract more women to deliver their children at the health center.
A safe birth at a health center is one of the most important ways to reduce infant mortality and improve the lives of children and families in Lifuwu and its surrounding areas. Unfortunately there are many logistical and cultural obstacles to birthing at a health center, and almost half of all children in Malawi are born at home1.
Maternal mortality in Malawi is one of the highest in the world (574 deaths per 100,000 live births) and is accompanied by an equally high neonatal mortality rate (29 deaths per 1,000 live births)2. Many of these deaths are preventable through interventions available at rural health centers, which raises the question: how can we make delivery at the health center an attractive choice?
Medical Assistant Mr. Zakeyu, help2kids Field Manager Nicole, and Health Advisory Committee Chairman Harrison Yona worked together to come up with a few possible answers in response to two of the major obstacles to delivery at the health center.
The first obstacle is the burden of carrying food from home and preparing, cooking, and cleaning up after meals while waiting for birth as well as immediately afterwards. Unlike hospitals in Europe and the United States, meals are not provided at the health center, so if one must stay for several days, it is up to them or their family to provide food and care.
The second obstacle (which directly relates to the first) is the lack of a family support structure which would be available at a home birth. At a woman’s home in the village, she has family and friends available to help her cook, clean, and bathe before and after birth as well as to encourage her during labor.
When women deliver their babies at the health center, they customarily bring two attendants from her family to help care for her to replicate this support, however this only adds to the burden of supplies that must be carried and food that must be purchased. In addition, these attendants historically had not been provided even a reed mat to sleep on at the clinic, so it could be difficult to persuade someone to serve as an attendant (sometimes for several days).
In response to the lack of food, help2kids partnered with the health center, and with funding from a generous donation, started a clinic garden to provide fresh nutritious vegetables for women and their attendants at the health center.
The vegetables are grown using sustainable, conservation agriculture techniques (organically when possible). The donation also funds a dedicated gardener and a supply of maize flour to prepare the staple food, nsima. The garden program has provided healthy meals for thirty five mothers-to-be and their health attendants in its first two weeks.
|The women are extremely enthusiastic about the new program, and we have already seen women coming from further than typical distances to deliver their children at Lifuwu Health Center because of the garden. One woman in particular chose Lifuwu Health Center over a closer facility in order to benefit from the garden. Owing to the garden’s rapid initial success and community support, we hope to expand it with future donations.|
|In order to support the attendants in the culturally essential and practical role of caring for their pregnant relatives, help2kids used another donation to purchase blankets and bedding for the attendants. This donation was matched by the community, who organized 12 reed mats for the attendants to sleep on with the new bedding, greatly enhancing their accommodation at the health center.|
These two small projects work in several ways to make a safe birth at Lifuwu Health Center a more attractive choice. First, they drastically reduce the amount of food and bedding which must be carried long distances while pregnant to the health center. This also lessens the financial strain of purchasing condiments and other food items for the mother and her attendants.
Secondly, it becomes much easier to find willing attendants when they know bedding and meals are available for them at the health center. A third, less tangible way women are encouraged to deliver at the health center is the garden offers a central resource for the women to unite around. Meals are encouraged to be cooked communally in order to reduce waste which frees up other attendants to complete other tasks around the shelter.
This assumed unity produces a more culturally appropriate setting where women help each other and share resources, rather than the former disjointed clinical atmosphere.
A third way the help2kids/Lifuwu Health Center team would like to encourage safe motherhood practices is through offering “healthy baby kits” to mothers who deliver at the health center as an incentive.
The proposed kits would include nutritious foods like beans and soya flour as well as essential baby-care supplies like cloth diapers and wrapping clothes. The kits are designed to support a new mother and child while breastfeeding after they have left the safe setting of the health center and its healthy meals. While we would like to implement this third prong of the safe motherhood initiative as soon as possible, we do not yet have the necessary funding.
However, one of our former volunteers is 74% of the way towards funding the first ten healthy baby kits with his campaign on myhelp2kids, our new crowd-funding platform. He is doing a great job so far promoting his campaign, and only has about USD $100 to go! If you would like to help him complete his campaign and bring this project to life, please consider registering for myhelp2kids and making a quick and simple contribution at https://www.myhelp2kids.org/campaign/medical-treatment-kit-for-newborns-in-malawi/. After funding the initial ten kits, we will need more campaigns to keep this valuable project going!
At help2kids Malawi, we have the unique opportunity to support children from birth with our safe motherhood initiative and clinic outreach programs through their pre-school and primary educations up to secondary school. With the safe motherhood initiative, we are making real progress in addressing actual concerns in child and maternal health in Malawi as evidenced by Mrs. Nzengeza’s comment in the beginning of this blog. Of course none of this would be possible without our excellent community partners, help2kids volunteers, and donors. If you would like to support our projects in Lifuwu, please take a minute to visit our crowd-funding platform, myhelp2kids or our donation page, and remember when it comes to helping kids in Malawi, safety first.
1 UNICEF Malawi. (2006). The Situation of Women and Children. Retrieved 6 November 2015 from http://www.unicef.org/malawi/children.html.
2 USAID. (2015). USAID Malawi Maternal, Neonatal and Child Health Fact Sheet. Retrieved 6 November 2015 from https://www.usaid.gov/malawi/fact-sheets/usaid-malawi-maternal-neonatal-and-child-health-fact-sheet-2012-13.