Meeting the Traditional Authority
As I dropped off from the car to his house, T/A Kalonga was coming out of the gate with two foreign nationals. “They were here looking for the same information you are looking for” he told me, “I guess this is just the beginning of great things to come”.Outside his house sat several groups of women, most of whom had babies with them. He asked them to wait for him because I was not staying long. They were there to discuss several issues in the area in relation to safe motherhood.
Why maternal and neonatal health
T/A Kalonga first heard of safe motherhood at a chief’s meeting that was called by President Joyce Banda soon after she came to power in April 2010. Before this meeting, he was unaware of the number of women and children dying during childbirth in the country.What was more disheartening for him, was learning that most of these deaths could be avoided if certain things were done right.One chief from each district was elected lead in ensuring safe motherhood in their respective areas. T/A Kalonga was not selected for Salima but that did not stop him from implementing what he had learnt.
Meetings
Every Tuesday, T/A Kalonga meets up with the various committees for reviews and discussions. Realising that he is not an expert, twice a month, a hospital official joins the meetings to brief them on different areas in maternal and neonatal child health.Although a community maternal death is rare nowadays, the committee nevertheless carries out an audit to see how best to prevent another similar death.
Establishment of by-laws and committees
Upon arrival in his area, Kalonga called a village heads meeting. He specifically invited the female village heads. In villages with male representation, he requested the presence of a female council member. He said:
It was a deliberate move. Maternal health mostly affects women and children and I thought that they should take the leading role
“We had a successful meeting and they told me some of the reasons they thought we were losing a lot of our mothers.”
To deal with these challenges by-laws were put in place:
- All Traditional Birth Attendants to stop making deliveries
- All Pregnant women to start attending antenatal clinic at two months
- No early marriages and extra-marital affairs!
- Establishment of a transport system to carry pregnant women to the hospital
- The fine of a goat, for failure to abide by the by-laws
Enforcement of these by-laws is overseen by several committees set up in all the 675 villages in his area. There are women’s secret groups that go around recording all the new pregnancies in the villages and counselling the women on the importance of antenatal; a transport committee that takes pregnant women to the hospital at eight months and the nutrition committee among many others.
The results
Since April 2011, T/A Kalonga says they have had two maternal deaths, one of which was facility-based. According to him, before the interventions there were no less than 10 maternal deaths in a year. These results were achieved by the by-laws and committees to enforce facility delivery, as well as stopping the Traditional Birth Attendants (TBAs) from conducting deliveries. Estimated facility deliveries are now over 90 percent.
The Future
T/A Kalonga says his greatest need at the moment is knowledge on issues of maternal and neonatal child health. He believes that the greatest weapon that can be used to save mothers and babies is knowledge.He hopes for the construction of a health centre at the heart of his area to shorten the distance that women travel to give birth at the hospital, especially for those in villages far from the main road.