Family Participation Key to Improved Maternal and Child Health, say Health Experts

UNICEF says Sierra Leone leads the world in maternal mortality, with 2,100 deaths for every 100,000 births
UNICEF says Sierra Leone leads the world in maternal mortality, with 2,100 deaths for every 100,000 births

Families and communities have a large impact on the decisions that women make about their health.  Pressure to conform to expectations or traditions can lead women to make poor choices, like rejecting family planning and contraception.  But some communities and families are working together to help women to make smart decisions and gain access to vital resources.

"It's seen as insubordination"

According to the United Nations Childrens’ Fund (UNICEF), many Sierra Leoneans, especially in rural areas, don’t decide on the size of their family ahead of time. The agency says up to one third of all maternal deaths and injuries could be prevented if women used contraceptives to space births or prevent pregnacy.  Greater spacing between births allows a woman to recover from delivery and restore nutrients needed for a healthy baby.

A 2008 demographic and health survey by the group Statistics Sierra Leone indicated that only five to eight percent of women use contraceptives, although they are legal and available at most pharmacies.

<!-- IMAGE -->

A report released last year by Amnesty International, Out of Reach: The Cost of Maternal Health in Sierra Leone found several reasons for the failure to plan ahead.

It found that for families struggling to feed themselves, contraception is not a priority. Also, women in Sierra Leone do not have much say in the size of the family or the spacing between pregnancies.

A single woman is subordinate to her brother and father – a married woman to her husband, who makes family decisions, according to the Amnesty study. “A woman’s social standing depends on her role as a mother, and it increases as she has more children.”

The report also found that many women rejected family planning, including birth spacing, out of fear of being abandoned or rejected by their relatives.

If a woman delays sex after childbirth, she insults her husband, says Brima Abdulai Sheriff, the director of Amnesty International in Sierra Leone.

“It’s seen as insubordination,” he says. “The family of the wife [can be] fined to pay [the husband] rice, palm oil, goat or sheep. Woman will be asked to publicly apologize or explain if she’s feeling sick. Even educated women here cannot refuse their husbands.”

The problems with family planning and poor maternal health are also due a lack of public awareness.

<!-- IMAGE -->

“The community has to be involved and that is paramount, and once you have the community, the family, the health facility and the health worker all working together, then you will have a perfect health system,” says Freetown private medical practitioner Dr. Donald Bash-Taki.

Things are beginning to improve.

Dr. Ibrahim Thorlie, a consultant obstetrician and gynecologist with the Princess Maternity Hospital in Freetown’s East End neighborhood, says recent government reforms provide free health care for pregnant and lactating women. The government is also training more midwives and working to make more clinics available in rural areas that can provide pre-natal care.

Mobilizing families and communities

Everyone, including men, must get involved in ensuring good maternal health, says Thorlie.

“Every individual must play his or her own role. They should know when to go to the hospital when their wives, daughters or relatives are pregnant. If every family knows what to do and [where to go], that should be a way of reducing infant and maternal mortality.”

To encourage family planning, experts recommend social mobilization and awareness-raising campaigns, including dramas and broadcasts about the importance of pre-natal care and assisted delivery.

Amnesty International Director Brima Abdulai Sheriff says his organization uses theatre and other methods to appeal to men to help guarantee a safe pregnancy. It’s part of their role as leaders in the family, says Sheriff. “They’re responsible for the pregnancy,” he adds, “and [a man’s] children carry his surname.”

Traditional leaders are also getting involved.

Sheriff says some now instruct young women to seek pre-natal care at the nearest clinic.

<!-- IMAGE -->

Among these leaders are “Mammy Queens,” he says,“wives to the chiefs or wives of local traditional leaders or [they are] elders of the community who wield a lot of power and have control over women. They may also have relationships with [traditional birth attendants] or local government authorities. So when they take decisions …they are respected within the community.”

He says poor women are [more likely to follow] customary practices and resolutions taken in the communities. They are afraid to go against the law. Abdulai says women in some communities contribute to a common fund to provide for transportation or other needs of pregnant women.

The effort to get families and communities involved in maternal care is beginning to pay off, says Thorlie. That joint effort, combined with the removal of health care fees for pregnant and lactating women, is leading to a decrease in maternal and child mortality rates.

This is part 10 of our 15 part series, A Healthy Start: On the Frontlines of Maternal and Infant Care in Africa

« Prev: Fistula and Birth Injuries Series Index Next: Breastfeeding »
This forum has been closed.
There are no comments in this forum. Be first and add one

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
Russia’s Syria Involvement Raising Concerns in Europei
Luis Ramirez
October 02, 2015 4:45 PM
European nations are joining the United States in demanding that Russia stop targeting opposition groups other than the Islamic State militants as Russian warplanes continue to conduct raids in Syria. The demand came in a statement from Britain, France, Germany, Qatar, Saudi Arabia, Turkey and the United States Friday. VOA Europe correspondent Luis Ramirez reports.

Video Russia’s Syria Involvement Raising Concerns in Europe

European nations are joining the United States in demanding that Russia stop targeting opposition groups other than the Islamic State militants as Russian warplanes continue to conduct raids in Syria. The demand came in a statement from Britain, France, Germany, Qatar, Saudi Arabia, Turkey and the United States Friday. VOA Europe correspondent Luis Ramirez reports.

Video First Self-Driving Truck Debuts on European Highways

The first automated semi-trailer truck started its maiden voyage Friday, Oct. 2, on a European highway. The Daimler truck called 'Actros' is the first potentially mass-produced truck whose driver will be required only to monitor the situation, similar to the role of an airline captain while the plane is in autopilot mode. VOA’s George Putic reports.

Video Nano-tech Filter Cleans Dirty Water

Access to clean water is a problem for hundreds of millions of people around the world. Now, a scientist and chemical engineer in Tanzania (in East Africa) is working to change that by creating an innovative water filter that makes dirty water safe. VOA’s Deborah Block has the story.

Video Demand Rising for Organic Produce in Cambodia

In Cambodia, where rice has long been the main cash crop, farmers are being encouraged to turn to vegetables to satisfy the growing demand for locally produced organic farm products. Daniel de Carteret has more from Phnom Penh.

Video Migrant Influx Costs Europe, But Economy Could Benefit

The influx of hundreds of thousands of refugees and migrants is testing Europe’s ability to respond – especially in the poorer Balkan states. But some analysts argue that Europe will benefit by welcoming the huge numbers of young people – many of them well educated and willing to work. Henry Ridgwell reports from London.

Video Botanists Grow Furniture, with Pruning Shears

For something a bit out of the ordinary to furnish your home, why not consider wooden chairs, crafted by nature, with a little help from some British botanists with an eye for design. VOA’s Jessica Berman reports.

Video New Fabric Helps Fight Dust-Related Allergies

Many people around the world suffer from dust-related allergies, caused mainly by tiny mites that live in bed linen. Polish scientists report they have successfully tested a fabric that is impenetrable to the microscopic creatures. VOA’s George Putic has more.

Video Burkina Faso's Economy Deeply Affected by Political Turmoil

Political turmoil in Burkina Faso over the past year has taken a toll on the economy. The transitional government is reporting nearly $70 million in losses in the ten days that followed a short-lived coup by members of the presidential guard earlier this month. The crisis shut businesses and workers went on strike. With elections on the horizon, Emilie Iob reports on what a return to political stability can do for the country's economic recovery.

Video Fleeing Violence, Some Syrians Find Refuge in Irbil

As Syrians continue to flee their country’s unrest to seek new lives in safer places, VOA Persian Service reporter Shepol Abbassi visited Irbil, where a number Syrians have taken refuge. During the religious holidy of Eid al-Adha, the city largely shut down, as temperatures soared. Amy Katz narrates his report.

Video Nigeria’s Wecyclers Work for Reusable Future in Lagos

The streets and lagoons of Africa's largest city - Lagos, Nigeria - are often clogged with trash, almost none of which gets recycled. One company is trying to change that. Chris Stein reports for VOA from Lagos.

Video Sketch Artist Helps Catch Criminals, Gives a Face to Deceased

Police often face the problem of trying to find a crime suspect based on general descriptions that could fit hundreds of people in the vicinity of the crime. In these cases, an artist can use information from witnesses to sketch a likeness that police can show the public via newspapers and television. But, as VOA’s Greg Flakus reports from Houston, such sketches can also help bring back faces of the dead.

Video Thailand Set to Build China-like Internet Firewall

Thai authorities are planning to tighten control over the Internet, creating a single international access point so they can better monitor content. VOA Correspondent Steve Herman reports from Bangkok on what is being called Thailand’s own "Great Firewall."

Video Croatian Town’s War History Evokes Empathy for Migrants

As thousands of Afghanistan, Iraqi and Syrian migrants pass through Croatia, locals are reminded of their own experiences with war and refugees in the 1990s. VOA's Daniel Schearf reports from the town of Vukovar, where wartime scars still are visible today.

Video Long Drought Affecting California’s Sequoias

California is suffering under a historic four-year drought and scientists say even the state's famed sequoia trees are feeling the pain. The National Park Service has started detailed research to see how it can help the oldest living things on earth survive. VOA’s George Putic reports.

VOA Blogs