Monday, September 27, 2010

Making childbirth safer in Ethiopia

Photo by Nathan Golon.

Poul Olson writes in Emory Report:

More than 100,000 newborns die each year in Ethiopia, many within the first 48 hours after delivery. The Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) aims to improve the odds for babies and their mothers through a community-oriented program designed to bring health services into the home.

During the summer, nine Emory students, led by Emory anthropologist Craig Hadley and Rob Stephenson, from the Rollins School of Public Health, took part in surveys of more than 1,000 women and frontline health workers in the Amhara Region to understand patterns of childbirth and attitudes toward maternal and newborn health (MNH) services.

In Ethiopia, more than 90 percent of childbirths take place in homes with the aid of only family members or traditional birth attendants. Ethiopia’s fledgling Health Extension Program has been stymied because health workers receive limited training in MNH care and people don’t understand their value or roles.

MaNHEP is helping train frontline health workers to deliver a basic home-based package of interventions, including clean delivery and essential care in the immediate and early postnatal period. These workers will then share these practices with pregnant women, their families and traditional birth attendants, with the goal of building trained "birth teams."

One of the biggest risks to women during childbirth is excessive post-partum hemorrhaging. In their research, Emory anthropology students Jed Stevenson and Yemesrach Tadesse found that women typically associate this event with spirit possession and address it by cracking a whip, shooting a gun into the air, or making a loud noise.

“Part of our intervention is to provide the correct information about labor and delivery,” Hadley said. “We want them to understand that excessive bleeding is an emergency requiring transport to a health facility.”

Emory researchers found that most families already make at least some preparations for safe childbirth. This includes acquiring clean razor blades to cut the umbilical cord and soap to prevent infection. At the end of the project, Hadley expects to find changes in attitudes, priorities and practices around MNH services. “We know that delivery can be dangerous in Ethiopia,” Hadley said. “Hopefully, our follow-up research will reveal that more mothers are taking steps to make childbirth safer.”

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