communities

{Photo Credit: Mark Tuschman}Photo Credit: Mark Tuschman

Pregnancy and childbirth are times of unparalleled change and hope for the future. But for many women, the arrival of a new baby is also a challenging time — one that can be overshadowed by depression.

The World Health Organization (WHO) estimates that more than 1 in 10 women suffer from postnatal depression, a devastating statistic that too often receives no attention. In African countries and contexts where women are exposed to poverty, persistent poor health, migration, conflict, gender-based violence, extreme stress, and unwanted pregnancy, the estimates are even higher, with up to 25 percent of women experiencing clinical depression after childbirth.  

The effects of depression on social and economic wellbeing and on families are enormous, as the risks and consequences go well beyond an individual woman. Depression in pregnancy is linked to preterm birth and low birth weight, which increases the risk of complications such as undernutrition and heart disease. Women who suffer from postpartum depression are often stigmatized and less likely to benefit from postnatal and preventive health care for themselves and their children. Partners and families may have difficulty understanding why a new mother who should be happy at the birth of a healthy baby is depressed.

A community health volunteer explains the use of pregnancy tests to a client.

This World Health Worker Week (April 2-8), we honor the health workers around the world who work every day to improve health in their communities. This photo essay illustrates the important role that community health volunteers play in strengthening Madagascar's health system.

Community health volunteers (CHVs) play a critical role in providing primary health care services in Madagascar, especially for rural populations who live far from health facilities. In many areas of the country, CHVs often collectively offer services to more people than health centers do. CHVs are important extensions of the Malagasy health system, particularly for women and children.

As of 2016, the USAID Mikolo Project, led by MSH and funded by USAID, supported nearly 7,000 CHVs across 506 communes. They fill a critical gap in human resources for health in support of the Ministry of Public Health’s efforts to improve health care in the country.

[A CHV provides reproductive health education.]A CHV provides reproductive health education.

Zakia, a nurse in Afghanistan, has become a leader in her health center. After participating in an MSH leadership development program, Zakia led a team of nurses in increasing awareness about family planning, resulting in a doubling of the use of contraceptive pills and an eight-fold increase in the number of condoms distributed in two years. “Everyone here no longer thinks of problems as obstacles in our way, but challenges we must face,” Zakia says.

Mobilizing communities in rural Benin to improve health.

The West African nation of Benin faces many challenges in achieving Millennium Development Goal 4---reducing child mortality. In the rural communities in Benin (91% of the population live in rural areas), access to health care and treatment is inadequate in relation to the vast need. Very few people have the appropriate skills and capacity to deliver care in these areas. The US Agency for International Development's (USAID) BASICS Benin project is increasing the capability of villages as far as 50 km away from health centers by training Community Health Workers (CHWs) to perform community case management of children five years-old and under.

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