I cannot take my mind off the glint of hope that lit the eyes of the women in Evboroko when they heard about the Birthing Project Nigeria. It was priceless. Their eagerness for a better health system was evident in the manner they told their stories and shared the challenges that they are faced with. They each had a story to tell, with the hope that their journey to accessing better health care had begun. They were eager to take charge of their lives by getting involved in the planning and execution of a process that would help them begin to develop health-seeking behavior, access quality health care, and live healthier lives. The needs assessment meeting served as an entrance point for the women to begin this process.
The objectives of the needs assessment was to determine the health challenges that the women face, the maternal and neonatal death rate and also the health hazards faced by the women delivered by the traditional birth attendant. And, also, to get an input from the women on what maternal health intervention will work for their community.
Findings from the focus group discussion reveal:
Lack of access to orthodox medicine before, during and after delivery.
Women do not have access to prenatal and postnatal care.
No health service delivery points such as pharmacies or patent medicine vendors for community members to buy medicine.
No health centers or health practitioners in the community; the closest health center they can access medical care is two miles away from the community. At times when pregnant women visit this hospital they are referred to Benin City.
Accessibility is very difficult because there are no vehicles to take the women to the hospital; they have to walk two miles or take a motorcycle before they can get medical treatment.
The traditional birth attendant lacks formal training to carry out prenatal care and deliveries. She lacks medical supplies such as iron supplements and delivery kits. There is no electricity or source of power to generate light in case of deliveries at night. No water to use for the women. No beds for the women and their babies to lay in her home. The traditional birth attendant also does not have any means of resuscitating the baby if the need arises.
There is a high rate of unsafe abortion as a result of nonexistence of contraceptives in the community.
In the past three years, though, the traditional birth attendant has lost only one woman and two babies during delivery. But hygiene is a serious issue. The women deliver on the bare floor and also lie on the bare floor with their babies before they are sent back home.
The women suggested that the intervention that would work for them at this point in time would be:
Services of a trained nurse who would work in the community for three months and the traditional birth attendant will assist her during this period so that she can learn how to deliver health services to women in the community.
Rigorous training of three young girls and the traditional birth attendant on providing prenatal care, teaching birth preparedness and also on becoming first responders to emergency obstetric complication.
They need water at the home of the traditional birth attendant for deliveries.
Though there is no electricity in the community, they need a generating set in the home of the traditional birth attendant that will generate light at night during deliveries or emergency situations.
They need iron supplement for pregnant women, delivery kits and beds for pregnant women and their babies.
The women suggested that they would love to sustain the project themselves; hence, they need to acquire a skill that would enable them save money for medical supplies and deliveries
They also need a source of transportation such as the tricycle that would transport pregnant women from the village to the hospital in case of referrals by the traditional birth attendant.
The Birthing Project Nigeria which is housed by Girls' Power Initiative has a lot of planned activities that would ensure that maternal and neonatal health are placed and kept at high priority in the community. We partnered with The Birthing Project USA and got Janma clean birth kits produced by another young champion Zubaida Bai from AYZH Inc. Some of the clean birth kits are been sold to raise funds to carry out planned activities, while the others will be given to the pregnant women in Evboroko community. Though we acknowledge that this will not sustain the project for long but we know that there is need to begin the process while exploring other means of raising funds for sustainability.