Above: TBA Rosa Lazaro, at the Furquia Health Center
Due to a low number of institutional births in the region, the main health center in the village of Furquia set a goal of identifying pregnant women in their communities to encourage them to use antenatal services and the existing maternity ward for giving birth. The health facility staff was aware that this would provide appropriate counseling and testing to the pregnant women and their partners and ensure the overall health of mother and baby. However, cultural norms, stigma and other factors can often prevent community members from seeking such care. It is because of this that the Furquia health staff, with the help of the Mobile Clinic team, decided to engage local traditional birth attendants in their efforts.
The Mobile Clinic nurse realized that the traditional birth attendants (TBAs) or traditional midwives could have a major impact on understanding and uptake of institutional deliveries. After reaching out to the local cadre of TBAs, it seemed they were open to increasing referrals to the health facility for antenatal care and delivery. In their daily interactions, they have motivated communities to seek the facility’s services and receive the benefit of antenatal care, safe delivery, post-partum consultation, family planning and other general health services. The Mobile Clinic team working with the TBAs received a testimonial from one of the midwives during a recent encounter. She shared the following:
"My name is Rosa Lázaro, and I am a 44-year-old traditional birth attendant living in Ronda, Furquia. I have been a TBA for 10 years, and I see my job as sensitizing the community on the importance of pregnant women seeking health services. Many lose their babies at birth or soon after due to serious complications during childbirth; they are left to die in the community due to a lack of information on the need to access health facility services. I have a schedule to meet patients at the clinic every Thursday. It is not easy work, and even with our hard work of lecturing and raising awareness there are still some that do not come. However, in the last three months I have noticed a large flow of deliveries within the health center. This is a really positive change, and I am happy to have the trust of the institution that allows me to continue with this work.”
The Mobile Clinic team, along with health facility staff, continues to collaborate with TBAs to find ways of reaching more mothers in the communities. A recent consultation with Antonia, a 26 year old mother from Batela, Furquia who had recently delivered in the health facility, shed light onto the type of tragedies experienced with previous births in the community.
“I have had two children, but my first delivery was at home with my neighbor. Labor became so intense that I fell unconscious. I had lost a lot of blood in the two days before the baby was born, and after delivery my son was very weak and lost his life. My family claimed this was due to witchcraft, but I knew that was not true. It was the lack of involvement of health professionals.
Sharing this story hurts, but when I conceived again, I went to the health facility at four months to open a prenatal record and begin consultations. This time delivery was completely different, and I have a healthy two-month-old son. To this day, when I think about the tragedy of my first birth, I get tears in my eyes from the giant scars in my heart that do not heal.”
As Antonia wiped her tears away, she shared that how deeply she understands the dangers of childbirth at home without a health professional and the importance of antenatal care at the health facility.
Above: Antonia recounts the pain of losing her first child soon after birth.
RMF’s Mobile Clinic in Mozambique is a new model of healthcare provision for our organization, conceptualized to reach remote and rural communities with no prior access to health care. Since its inception in 2008, our Mobile Clinic has been hugely successful and remains the only mobile clinic in all of Mozambique. The clinic, a collaboration between RMF, Vanderbilt University’s Friends in Global Health, and Medical Mission International, is currently deployed in one of the most populous provinces of Mozambique, Zambézia Province, located in the central coastal region with a population of almost 4 million.
- To improve the quality of life and provide access to health services, particularly access to maternal-child healthcare and anti-retroviral therapy (ART) for people living with HIV and AIDS, Tuberculosis and other diseases.
- To provide access to healthcare in remote areas of Zambézia Province, Mozambique.
- To reinforce the expansion of HIV care and treatment services initiated by the Zambézia Provincial Health Directorate (DPS), by providing temporary reinforcement in terms of staff, training, and space for peripheral health units initiating implementation of ART until such time as the DPS can organize the infrastructure and resources necessary for these sites to function independently.