In Uganda the lifetime maternal mortality risk is 1:44, comparatively in Canada it is 1:5200 (World HealthOrganization). This shocking disparity is largely due to a shortage of healthcare centers and lack of properlytrained medical attendants. Despite the risks involved with home deliveries, many women are distrustful of clinical settings and still prefer to deliver at home for a variety of reasons including; lack of information about options and the associated risks, inability to pay delivery fees, negative past experiences with poorly trained staff at government hospitals, refusal by husbands to allow access to maternity care,
When a mother is lost her family suffers and the effects ripple out to the entire community. Our Village Mother Program is a continuation of a very successful pilot project that was co-created in February 2017 by our Director, medical officer, midwife and concerned local women with the intent of building trust in the community and strengthen the working relationship between nurses, midwives and expectant mothers.
Six ‘VillageMothers’ were elected and provided with T-shirts, with the name “VillageMother” printed on the front, as well as business cards with clinicinformation. Village Mothers agreed to move through their communities and speak one-on-one with women, counsel them about the services offered at our clinic and encourage them to come for prenatal appointments. Additionally, they worked hand in hand with our midwives to mobilize weekly maternity outreaches and when they encountered a woman birthing at home and in distress, they brought her to our clinic by taxi. To compensate Village Mothers for their work, we provide a small incentivefor every new prenatal patient referred and for each maternity outreach organized. This helped to build localsustainability and empowered our Village Mothers with a small income to independently care for their ownchildren and families. By creating a strong circle of women and encouraging them to work together to meet theneeds of their communities, we are building relationships that promote recognition, mutual respect andcollaboration. By creating a bridge into the community and allowing mothers to experience compassionate care in a medical setting, we are building trust one mother at a time, and as our reputation develops, it continues to ripple out naturally.
The Village Fathers program is a new initiative for 2018, inspired by our own Village Mother program and the Paternity Project implemented by Cameroon Agenda for Sustainable Development (CASD), which is part of the Healthy, Compassionate Birth Network sponsored by our partners at Global Force for Healing. The objective of the program is to increase paternal involvement and improve birth outcomes by offering knowledge resources for maternal care to expectant fathers in limited resource settings. Recent studies suggest that a father's involvement before his child is born may play an important role in preventing death during the first year of life. According to a report by Amina Alio PhD, University of Rochester, paternal support can
- decrease a mothers emotional and physical stress
- lead to healthier maternal behaviors (better nutrition, less heavy physical labour, earlier prenatal care
- decrease risk of preterm birth, low birth rate and fetal growth restrictions
A growing body of evidence is making it clear that fathers who are engaged in pregnancy and birth are more likely to remain engaged in their children's lives. Families are the building blocks of society, by involving fathers in all phases of pregnancy, birth and childrearing, and by broadening their contributions, we are encouraging a positive impact on the overall welfare of mothers, children and communities as a whole.
In rural Uganda a very small percentage of men accompany their partners to health care centers and an even smaller percentage attend births (since we opened our clinic in 2010 not one father has accompanied a mother into the birthing room). The village father program aims to build trust and break down barriers that label childbirth as a “woman issue," so expectant fathers can be receptive to one-on-one educative talks in safe “man-friendly” corners. Male community health workers will be trained by our male nurse on how to present the CASD curriculum (Antenatal Lesson for Men) in a safe, approachable way and will receive a T-shirts with our clinic logo on the front and the title “Village Father” on the back. Village Fathers will move through their communities and approach expectant fathers and invite them to sit for friendly lessons on how they can best support a healthy pregnancy. Village Fathers will receive an incentive to compensate them for their efforts and male participants will receive a small incentive to encourage them to complete the full curriculum.
Topics discussed in the curriculum will include
- Signs and symptoms of pregnancy
- Physical and psychological development of the mother and baby
- Roles of the expectant father
- Labour and delivery
- Newborn survival & postnatal care
- Importance of breastfeeding
- Family planning