Malawi: Rolling Back Maternal Deaths Through Community Involvement
Following her twelfth pregnancy, Faustina, age 40, lies swaddled in a thick blanket in the maternity ward in Malawi. Although she has just lost a baby, Faustina feels lucky that she did not become another statistic in Malawi’s ongoing maternal mortality tragedy.
As soon as Faustina’s labor began she went to the local HeathCenter. Because she was bleeding heavily, she was transferred to the DedzaDistrictHospital for expert attention. That decision saved her life.
Annually, nearly 6000 Malawi women are dying from preventable or treatable complications of pregnancy.
In Chichewa, Malawi’s principle language, the words for pregnancy -- “pakati” and “matenda”-- translate into “between life and death” and “sick”, respectively.
The maternal mortality rate in Malawi currently stands at a staggering 1120 deaths per 100,000 live births, according to Dr.Chisale Mhango, Director of the Reproductive Health Unit in Malawi’s Ministry of Health. That’s almost twice as high as the rate in 1992 – 620 per 100,000.
The Dedza District with an estimated population of 624,000 has 31 health centers and only one government referral hospital staffed by two UN Volunteers medical doctors, seven clinical officers and 48 nurse/midwives. Eleven nurse midwives struggle to provide 24-hour care in the maternity unit.
Of crucial importance to strengthening healthcare delivery and rolling back maternal deaths in Malawi is the role of village communities. “The idea is to empower village communities, including men, women and young people to take care of their own healthcare, explains Juliana Lunguzi, a program officer for UNFPA in Malawi. Since this is an inclusive process involving collective decision making, it ensures that appropriate and timely actions are taken when there are complications in pregnancy and childbirth.”
Programs are now in place to deter traditional birth attendants, without formal medical training, from delivering babies.
Mawandiwe Mtchauya, a traditional birth attendant, no longer delivers babies, but instead monitors the progress of pregnancies and refers women in labor to the nearest clinic or to the District hospital. Mtchauya was trained by UNFPA to identify pregnancy-related, complications that could threaten a woman’s life. She now makes a living by counseling women on contraception, child spacing, and HIV prevention.
Juliana Lunguzi of the UNFPA is elated by the overall results of the initiative. According to her, “in a society steeped in traditional and cultural beliefs and practices, success in health service delivery is dependent on strong community involvement. Use of existing community 
systems and structures enhances acceptability of new ideas and promotes unity of purpose.”