Women & Gender

If you grow up in places like Kasungu district in rural Malawi, you learn that when your wife is pregnant, you should not have sex outside marriage---because you will lose the “expected gift” through miscarriage. Male promiscuity during a partner's pregnancy is a taboo that many believe will bring a curse on the family.

Patricia Patrick says that after she miscarried in November 2008 “People talked in the village, and people talked within the household. My relatives asked me suspicious questions.” They wondered whether sexual misbehavior by her husband caused the tragedy. She remembers her husband telling his side of the story to prove his innocence, but nobody believed him.

Mother and children, Salima, Malawi, April 2011

Malawi leads the developing world as the first to propose an approach to prevention of mother to child transmission (PMTCT) of HIV that addresses the health of the mother. Recently my MSH colleague Erik Schouten and his colleagues in Malawi wrote a commentary in the Lancet about Malawi’s innovative, public health approach to PMTCT. Malawi calls its model “B+” because it complements the World Health Organization’s (WHO) B option, whereby a mother’s CD4 cell count, a measure of the volume of HIV circulating in her blood, determines her eligibility for lifelong antiretroviral therapy (ART).

Blog post updated Dec. 27, 2011.

Nursing Officer in Charge Nancy Thiong'o checks on a mother and her new baby

 

In 2003, after dwindling funds, low staff morale, and accusations of patient neglect had eroded community confidence in Kiriaini Mission Hospital in Kenya, the Catholic Diocese of Murang’a decided to shut it down -- leaving locals to seek treatment at the distant provincial capital of Nyeri.

Six months later five Franciscan nuns arrived from India to reopen the hospital. They hired new staff, renovated the dilapidated structures, and restored much needed services to the rural community. Eight years later the hospital is a clean, efficient, well-run facility with 70 beds, friendly staff, and multiple in-patient and out-patient services.

I’d like to call attention to an important set of articles in the recent HIV/AIDS themed issue of The Lancet. Erik Schouten of Malawi Basic Support for Institutionalizing Child Survival (BASICS) has published a commentary (free registration required) about Malawi’s push to be the first country to implement a “B+” approach to reducing mother to child transmission.

Safoura Amadu and her son Ibrahim

Safoura Amadu is the 19 year-old mother of Ibrahim, who was born preterm on March 8, 2011 at 1.46 kg (3.2 pounds). Baby Ibrahim did not grow well in his first days of life. Safoura was very worried---her first child had died at birth---and she did not want to lose Ibrahim, her second child. Safoura sought help and when Ibrahim was ten days old she and the baby were admitted to the new Kangaroo Mother Care (KMC) center at the Maternité Issakha Gazoby in Niger. Ibrahim’s weight had dropped to 1.07 kg (2.35 pounds).

The KMC center cared for Safoura and her child by showing Safoura how to take two simple, lifesaving measures: provide skin-to-skin contact for Ibrahim, by wrapping his unclothed body directly to her bare chest, and breastfeeding him exclusively. After 47 days at the KMC Centre, Safoura and two month-old Ibrahim were released to go home. Ibrahim weighed 2.12 kgs (4.67 pounds).

The community midwife sitting with Suzanna Ile and her son, Modi, in South Sudan. {Photo credit: MSH.}Photo credit: MSH.

Blog post updated Dec. 27, 2011.

Suzanna Ile is a 26-year old woman from Lokiliri Payam in South Sudan. Suzanna lost her first two babies in child birth. During her third pregnancy, a community midwife at Lokiliri Primary Healthcare Centre -- a health facility supported by the US Agency for International Development (USAID) through the MSH-led Sudan Health Transformation Project (SHTP II) -- recognized Suzanna’s contracted pelvis and identified her high risk pregnancy.

Without access to emergency services and a health facility capable of performing a Caesarean section, the midwife knew Suzanna would likely lose her third child as well. A contracted pelvis often results in obstructed labor, fistulas, postpartum hemorrhage, or the death of the infant and mother. The midwife discussed with Suzanna alternative delivery options during an antenatal care visit.

Women waiting for health services outside of Tambura PHCC, South Sudan.

 

Sitting under the lush mango trees in rural Tambura, South Sudan, I realized Mother’s Day was approaching and I needed to send my mom in Chicago a gift. More and more each year, I treasure my mom, who raised four children. But this year, while working on a health project in South Sudan, my appreciation and wonderment is also for mothers worldwide.

This is a guest blog post written by Derek Lee from Pathfinder International.

The donkey cart ambulances were built by local craftsman.

On October 15, 2010, dozens of Kenyan women in bright headscarves gathered beneath the acacia trees scattered outside Balambala sub-district hospital.  The area chief was in attendance, as were members of the local women’s livelihood groups.  Despite the oppressive heat, everyone was in jovial spirits because this sunny day marked a momentous occasion for their “Care for the Mother” project.

Last week, the United Nations Commission on Population and Development (CPD) met in their 44th session to negotiate next steps on a resolution for fertility, reproductive health, and development.  The Commission helps inform the United Nations (UN) on their global efforts and provides crucial recommendations to form UN Resolutions.

MSH, with over 80 partners and advocacy organizations, sent an open letter to the delegates of the 44th session. Together, we called on the Commission on Population and Development to:

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