Safe Motherhood

Twenty-three-year-old Hosna, calmly cradles her eight-week-old son, playing with him as she narrates the experience she went through during her first pregnancy. Hosna did not receive any antenatal care and when it came time to deliver, she sought the services of a Traditional Birth Attendant. The baby was born at home, after a long anxious labour. Hosna recounts that the services of the traditional birth attendant, cost her a handsome fee, however, she did not receive the proper medical care neither were any vaccines administered.

During Hosna’s second pregnancy, she was fortunate to attend a health education session where she was encouraged to attend antenatal care at Ottash clinic. She registered and attended all her antenatal visits and subsequently delivered with the help of a skilled birth attendant. The necessary vaccines were also provided at the clinic free of charge. Hosna describes the experience of her second pregnancy as a joyful one for her family.

“Now Ali is only 8 weeks, but he is big and healthy because I attended antenatal sessions and gave birth at the clinic with the help of a midwife and also got vaccinated. I thank World Vision staff at Ottash clinic for helping me and my family,” she says.

Hosna and her family live in Ottash camp in Nyala North locality of South Darfur state, which is home to 56,530 internally displaced persons. Conflict in 2013 resulted in a new wave of displacement forcing 160, 000 people in South Darfur out of their homes into camps near Nyala, which include Al Salaam, Kalma and Ottash. World Vision is providing humanitarian assistance in the camp including primary health care services at Ottash clinic funded by WV US and the United States Government through Office of Foreign Disaster Assistance. Reproductive health services provided at the clinic include safe motherhood, family planning, management of sexually transmitted infections, and clinical care for survivors of sexual and gender based violence.

While the availability of free maternal health services in the camp has significantly improved the number of safe deliveries, not all mothers are accessing this service. During a focus group discussion held with women in Ottash camp, those present lauded the free lifesaving support being provided at the clinic. However, the women cited a key challenge of the clinic being closed during the night; coincidentally a time when many of the pregnant mothers go into labor.

“Most difficult deliveries occur at night and are conducted by traditional birth attendants who cannot manage complications. Many times, this has resulted in the death of both mothers and babies. World Vision is our midwife, when she is not there at night, we are helpless,” a woman leader in Ottash says.

While overnight services are available at Nyala referral hospital, the mothers say they are unable to access the facility due to insecurity, lack of transport and lack of money to pay for delivery services.

With almost half (41%) of clinics in Darfur being managed by NGOs, majority of these clinics are not open during the night due to insecurity. Referral facilities, which open at night are inaccessible, inadequately staffed and or ill equipped; and require service fees. World Vision remains committed to contributing to reduction of excess illness and deaths of vulnerable women and children especially in conflict and disaster affected populations; however still faces several challenges. Humanitarian imperative recognizes the need for women in Ottash camp to receive humanitarian assistance (including safe motherhood) and yet the risk of making this a reality is the cost for The Midwife at Night.

World Vision in collaboration with SMoH, community leaders, UNFPA and other partners plans to strengthen local capacities within the camp to make Motherhood safer, even at night.