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MATERNITY HOME PROJECT PHASES

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Maternity Home project by Afrikable phases

The project is composed of a first phase of investigation and assessment, and three more phases of implementation and realisation.

Initial Stage: Viability Analysis of the Project

Women health has always been one of the main goals of Afrikable from the beginning, understood as the essential part of the women integral empowerment. From our way of understanding empowerment before starting with a health care in the reproductive and sexual health field is indispensable to work as a base other aspects of empowerment: the women social and psychological empowerment.

Thus we started since 2010, raising awareness and informing women about issues related to their reproductive and health rights, family planning programme, leadership and self-esteem, gender violence, etc. Also, we provide grants in order to be able to guarantee the labour assistance as safe as possible, even thought there are services and means shortage in Lamu.

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During the last 2015, the viability study of the Maternity Home project by Afrikable was made, thus interviewing women and conventional midwives, local authority, several members of the district hospital and private clinics, as well as skilled health personnel in Spain with experience in international cooperation (gynaecologists and midwives). Several organisations with experience in this field have been contacted in order to share ideas and knowledge.

The interviewed women, all in risk of exclusion and extreme poverty, have never had routine gynaecological check-ups, and practically any of them know what a gynaecologist is or what is her or his role apart from childbirth care and pregnancy monitoring. They will attend to check-ups if these were free and carried out by female health workers.

The district hospital has a good offer of contraception in its Family Planning Unit. Unfortunately, it does not spread its offer neither make aware to population about its use. While it continues offering such a broad range and this being free, Afrikable’s role here will be to make awareness and inform about the different options available and send women to the district hospital.

Regarding pregnancy and delivery, women don’t attend to private clinics due to lack of financial means; neither regularly attend to the district hospital for various reasons: some of them say they suffer from discrimination for being poor or belonging to certain tribes. Many of them don’t attend to because hospitals have not got showers where they can clean themselves with hot water after delivery. Women complain that the hospital beds are not appropriate because they do not have handles and are very tight, what women find extremely uncomfortable at childbirth, and they are not allowed to give birth in their tribe usual positions.

Many other do not attend to the hospital because it is quite common that mothers either end up giving birth by themselves on the floor, or waiting for the doctor in the gurney.

Being free the birth assistance in the district hospital, paradoxically women are obliged to bring their own washing-up bowl, bleach, soap, disinfectant, cotton fabric and even latex gloves. The stay is not free beyond certain times after the delivery; consequently, when the time comes women are invited to go home if the delivery has not had any difficulty, thus under these circumstances, women prefer to give birth at home so that they can recuperate more time without needing to move too much.

At home, they feel more comfortable and safer, but actually, the hygienic conditions are highly inadequate. Many of them do not even have a proper bed available; consequently they give birth on the sand floor with the protection of just a palm-leaf rug or used sacks. The traditional midwives cut the umbilical cord and do episiotomies with cheap razor blades sold in any market, without sterilize them previously. The water used to clean the baby as well as the mother is well water, non-potable and unboiled.

To help with the disinfection and cicatrisation of the newborn’s umbilical cord, many women burn it with ember, causing habitually infections that easily result in neonatal tetanus and umbilical hernias as children grow up.

The traditional midwives have a lot of experience, although when they feel that the baby is coming with any problem, they do not achieve to change the foetus’ position so that he or she can be born upside down, they tend to send the pregnant woman to the hospital. Many times it is too late and the baby’s life as well as the mother’s is in serious risk. It is essential the continuous training of the midwives in hygiene in delivery and as much as in first aid.

It is necessary to achieve a balance between traditional and conventional medicine. To achieve a safe birth assistance respecting the cultural diversity is a key for Afrikable.

First Phase: Education and Awareness Workshops

During this first stage we have been educating and raising awareness to women and local midwives in different issues related to women general health, health during pregnancy, VIH and other sexually transmitted diseases, family planning programme, reproductive and sexual rights, safe home birth, diet during pregnancy, first aid, etc.

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Local midwives are provided with a delivery assistance kit, where there are gloves, sterilized gauze, disinfectant, oils, sterilized razors, etc, which make easier the delivery assistance.

It is a continuous development stage, providing such training and awareness to distinct communities on a regular basis.

Second Phase: Gynaecological Consultation

During this second stage it will be built a basic gynaecological consultation where it will be provided free gynaecological assistance, routine checkups for the ETS detection and other diseases, pregnancy monitoring, nutrition during pregnancy, and birth kits.

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A gynaecologist and a nurse-midwife, both local, will be hired. The building will have a consultation with basic equipment, and a waiting room where the education and awareness workshops as well as cleanliness module will also be given.

More than 200 women will directly benefit from the project every month, thus being given quality gynaecological care, a safe monitoring of pregnancy as well as training and awareness on matters of Women Health.

The cost of the implementation of the gynaecological consultation is estimated in 15,000 €

Third Phase: Maternity Ward (Childbirth Care).

During this third and last stage of the Maternity Home project by Afrikable, a delivery room will be build, with the required equipment to attend the delivery safely and healthy. A room will be build with beds to take care of women at pre and post-delivery moments. This room will have a bathroom available with hot water as interviewed women requested, matter that made many women desist going to the district’s hospital because this has no bathrooms and women couldn’t clean themselves after the delivery.

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It will be attempted, to the extent possible, find a balance between the traditional forms of giving birth at home with the standard techniques of giving birth at hospital (another requirement of the interviewed women), where besides the midwife hired by the project, the women’s reliable traditional midwife could also attend the delivery.

The cost of the maternity ward is estimated in 25,000 €

If you want to know how women give birth at their home in a traditional way according to each tribe click here.

 

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Translator: Jeannette Canet

ABOUT AFRIKABLE

Afrikable is a Spanish charitable organisation, registered in the National Register of Associations under number 1/1/594088 and in the Spanish Agency of International Cooperation for Development (AECID)'s Register of Non-Governmental Organisations under number 2033.

 

In Kenya our association is called Afrika Able Organization and is registered with Kenya's NGO Coordination Board under number 10976.

WHERE ARE WE

  • Lamu, Kenia.
    Madrid, Spain
  • +34 605 722 162