At 675 per 100,000, the levels of maternal mortality in Malawi in 2012 represented a tragedy not just for the women and families involved, but for the whole country. Even compared to neighbouring states, who share many of the same problems, this figure was worryingly high. These pregnancy-related deaths were a sign that Malawi was failing its women, and the country’s first female president, Joyce Banda, was determined to put an end to it.
In 2012, she launched the Presidential Initiative for Maternal Health and Safe Motherhood. This emphasised the importance of modernising medical care for mothers before, during and after labour. Since most of the population lives in rural communities, it focused primarily on improving awareness and care in these villages. The changes set out to disrupt traditional systems of maternal care, including banning traditional birthing attendants (TBAs).
Embraced by the community
As Aljazeera reports, these changes have been embraced by local communities, such as the people of Mpanje village. Acceptance of the initiative has primarily stemmed from the women’s groups that have developed to discuss and circulate maternal health advice. According to Abigail Nyaka, a programme officer for the NGO MaiKhanda, these groups have placed women at the heart of maternal health decisions and are a driving force behind change in rural communities.
It might be assumed that those who have been displaced by this move away from traditional systems of maternal care, the TBAs and village elders, would reject the changes. However, in Mpanje village this has certainly not been the case. Talking to Aljazeera, Tannes Kalinda, a former TBA, says that she is enthusiastic about the opportunity to help women access better care during pregnancy. At the heart of this enthusiasm is the awareness that women’s groups have been able to create.
Planning for success
As gatekeepers of village life, chiefs were always going to be instrumental in the success or failure of this initiative. Rather than side-lining them, Banda has sought to involve them in the process from the very start. They are taught the benefits of modern medical care and have collaborated directly with women’s groups to promote it throughout the country. As a result, around 12,000 chiefs out of a total of 20,000 have been recruited to the cause so far, and this has had a major impact for thousands of rural women.
Writing for Oxfam America, Dorothy Ngoma, the national coordinator of the initiative, says that the maternal mortality rate has now fallen to around 460 per 100,000. This is a drop of more than 200 per year over two years, and demonstrates the effectiveness of helping local communities to collaborate on issues like this. Obviously Malawi still has a lot of work to do in order to combat pregnancy related deaths. However, keeping up this grassroots momentum will remain central to success.
This year, SOS Children celebrates two decades of helping Malawi's neediest children. We provide care in three key locations for children who cannot live with their families. Find out more about our work in Malawi.