The Democratic Republic of the Congo has one of the highest maternal mortality rates in the world – one in thirteen women die in child birth. HEAL Africa’s Safe Motherhood Prenatal Care and Micro-Insurance program is an extremely innovative initiative that increases access to health care for birthing mothers. Women of reproductive age pay into maternity micro-insurance groups that ensure that they can receive proper medical support through pregnancy, delivery and neo-natal care. The insurance groups are locally managed on a micro-level, with each member paying into the program and each member receiving the needed support from an appropriate, health facility when it is their turn to have a child. The appropriate level of medical care might be care from a re-trained traditional birth attendant, the local health center, or a local hospital. Early screening and prenatal care is essential to identifying high-risk deliveries and assessing the needed care levels for birthing mothers.
Each maternity micro-insurance group starts with 8-10 members and a small grant of money for them to manage for their own childbirth costs. They receive training in family planning, in managing a small business, and in the concept of a Solidarity Group. They meet weekly, get to know each other and develop trust. Their husbands become involved in the classes on family planning. They arrange to work together to transport the wives who will need to go to the clinic to deliver, it may be two days walk.
The process is creating new ties in communities that have been split by war and mistrust. It provides a valuable service to the midwives who have been well-trained, equipped, and now work in cooperation with the nurses in the clinics, and not in competition with each other. The nurses in the clinics also receive training and equipment that will help them provide good service to the women of the community.
It is a situation where everybody wins. Birthing mothers are assured that they will get the care they need, traditional birth attendants receive updated training and inclusion in the process of midwifery, and all work in cooperation with the clinics. And, once the group members pay back their original start up grant, it is paid forward to start another maternity micro-insurance group, expanding access to maternity care for another 8 to 10 women. What’s not to love? The best part? Preliminary findings show that in all the areas Safe Motherhood has begun, maternal mortality is dramatically reduced. Click here to support safe birth in DR Congo.
Safe Motherhood began in 2000 in response to the question: Why do so few women deliver in a health center (26%), The responses to this question enabled HEAL Africa staff to design a most unique community-based program to reduce infant, maternal and neonatal mortality through safe childbirth practices.
The stated obstacles preventing women from having a safe delivery were:
- Lack of trained staff for a safe delivery using a cartogram
- Lack of decent facilities with functioning equipment for safe delivery at the level of health centers and hospital responsible for emergency obstetric care
- Lack of finance in the family economy to pay five dollars and safe delivery
- Traditional attitudes and approving home birth and opposition by mothers in law to delivery in a health centre
- The power and influence of the traditional birth attendants
- Distance to hospitals able to give emergency obstetric care, and lack of transport
- Fear of the unknown felt by village women. Will they be criticized by their in-laws if they leave their families for health care?
- Who will care for her family in her absence? Or her garden?
The Safe Motherhood program addresses two needs:
- Informing and supporting mothers at risk
- Training and supporting health workers and caregivers who assist birthing mothers.