“The change in mothers’ attitudes towards safe delivery has been enormous in our village,” said Cecilia Dangur, the young Midwife of Golo Watu village. “The whole community is now involved in getting women to the health center on time,” she explained, “which makes my job a whole lot easier.”
The Australia Indonesia Partnership for Maternal and Neonatal Health Program (AIPMNH) began supporting this picturesque village of 2,000 in the green hills of Manggarai District in 2010.
|Cecelia, the village midwife says she has improved her skills and confidence through on-the-job training with AIPMNH support|
Since then, members of the community have united to build a network so strong that no mothers have died during childbirth for almost two years in a region known for having one of the highest maternal and neonatal mortality rates in Southeast Asia.
“Before AIPMNH support, Golo Watu was just like any other village in Flores Island,” said Selvis Mustamu, the Village Secretary. “Even though we had a new health center here with basic birthing facilities, around 90% of women were giving birth at home - because that’s what they’ve always done,” he explained.
AIPMNH’s integrated approach in this village, as in 13 other districts in Nusa Tenggara Timur province (NTT), is to raise awareness and provide training to various members of the community who can persuade women to give birth in a health facility – one of the most certain ways to decrease the deaths of mothers and babies during childbirth.
This means improving not only the clinical skills of health workers, but engaging village leaders, volunteers, traditional birth attendants (TBA) and other members of the community outside of the public health system. Take Bernadita Mbimbus, for example. She has been a TBA, or dukun, in Golo Watu for so long that she cannot even remember how many years she has been delivering babies for women at their houses.
Unfortunately, giving birth at home is one of the main contributing factors to maternal and neonatal deaths because dukuns lack the skills and equipment to handle complications. But because of this strong tradition and low level of awareness, most women in the village would still visit the TBA first upon finding out they were pregnant, even with a midwife and health facility nearby. For this reason, AIPMNH supports TBA-Midwife partnerships, which involve dukuns during women’s pregnancies but leaves the birth to trained midwives in government-run health facilities. “I now take pregnant women directly to the midwife as soon as they come to see me,” Bernadita said.
|Bernadita Mbimbus, Traditional Birth Attendant, works in close partnership with the village midwife|
“I feel relieved to take these women – many of whom are pregnant for the first time - because I know they are in good hands and that we can work together,” she said.
Cecelia, the midwife, improved her skills through on-the-job training at the district hospital with AIPMNH support. Not only did she gain experience and confidence but she also established a network of mentors she could call upon in emergencies. AIPMNH assists 11 district hospitals in NTT to improve management of complicated deliveries, providing life-saving procedures such as caesarean sections.
By supporting better management of small health posts called posyandu, holding meetings with church leaders and village heads, and training volunteers on basic skills related to pregnancy, AIPMNH has brought together different factions of the Golo Watu community. AIPMNH has also supported Golo Watu to take simple steps to make pregnancy safer. For example, a village network for pregnant women now ensures that bloodstocks are prepared in case of haemorrhaging, and that transportation to the clinic or hospital is organised for women well in advance of the delivery.
“At first, we had no idea how to do things like weigh babies, fill in forms, or register clients” said Gerda Ani, a posyandu volunteer, or kader.
“It’s all very simple, but just having training on these basic procedures gave us the skills and confidence we needed to run an effective posyandu,” she explained. The Village Secretary supported this sentiment. “Even if it’s a small-scale meeting, it still makes a difference, because we are discussing important issues and planning for the women in our community,” he said.
Golo Watu may seem like just a small village amongst the rice paddies, but its progress shows how the men and women in a typical community can be empowered to improve conditions for mothers and babies. “Our village was dormant before, but with this constant support over the last two years, we have really made a difference that we are proud of,” Selvis said.
|Team of Desa Siaga Golo Watu in Manggarai District includes the village midwife and nurse, Village Secretary, kader Posyandu (volunteers), and traditional birth attendants (TBA).|