Citizens Hearing at Ludala Village in Dodoma Region. Image Credit: WRA Tanzania.

Citizens Demand Quality Maternal Health Care Services

Engaging men in prenatal care is essential to saving the lives of mothers

By Anna Sawaki, White Ribbon Alliance Tanzania, Communication and Media Officer

In Lugala, a village that is 10km from the Dodoma Region in Tanzania, it is common for a man to disappear in thin air when the partner gets pregnant only to reappear when the baby is born. This was shared by several women who said men do not support their partners when they get pregnant. This kind of entrenched financial and social neglect of pregnant mothers has left several women struggling with pregnancies alone without much support, even in times of emergencies.

Felistar Charles, a nurse/midwife, who works at Lugala Dispensary in this locality has experienced first-hand the pain and challenges faced by expectant mothers in this time of need at the hands of their partners. Felistar conveyed one of those experiences:

“One day, a woman came in at midnight when she was in labour. I attended to her and when I asked her the whereabouts of her husband, she said the husband had been away from home for some time. I had to call him and I requested that he sends some money because the wife completely had no money on her. I am glad the husband understood and he sent some money.”

One of the citizens giving speaking her mind during the citizens hearing. Image Credit: WRA Tanzania.

Money is needed in cases of emergencies such as a transfer to the health centre because dispensaries cannot manage cases that require Comprehensive Emergency Obstetric and Newborn Care (CeMONC). Tanzania is among the countries with a high maternal mortality rate (576 per 100,000 live births) and lacks CeMONC services in most health centres across the country.

While Felister is recognised by women in Lugala as a model for being helpful and caring in situations like these, male involvement in the lives of expectant partners could go a long way in improving maternal health outcomes. Felister is the only nurse and midwife serving Lugala and the neighbouring Chiikwi village 5km away. Felister together with her clinician companion are the only health workers serving a population of 8,000.

In the search for solutions, White Ribbon Alliance for Safe Motherhood Tanzania (WRA Tanzania), organized a Citizens Hearing at Lugala Village on October 4, 2017. The hearing brought together more than 450 citizens, the Ward Executive Officer, Hon Sylivester Palamang’ati, the Member of Parliament for Dodoma Region, Hon Felister Bura, and the Regional Medical Officer who was represented by the Regional Health Secretary. This meeting was organised with the support of the Municipal Reproductive and Child Health Coordinator, and the Lugala Dispensary Health Committee.

Citizens hearings give people a voice in their local community. Image Credit: WRA Tanzania.

The issue of abandonment by husbands upon conception came out strongly. One of the women said, “Our husbands/partners have been deserting us the moment we tell them we are pregnant. We have been suffering alone with the pregnancies and the husbands just wait for babies. We only see them when the baby is born.”

Citizens were concerned about the quality of health care in their community, mostly maternal and newborn health, and how to reduce maternal and newborn mortality rates. In addition to having only two health staff for the Lugala Dispensary which serves two villages, people talked about the lack of water at the facility because the plumbing system has been down for some time now, something which is not safe for new mothers and their babies. Home deliveries and teen pregnancies are common in Lugala, sometimes resulting in deaths when complications arise. Chiikwii village, which is 5 km away, has poor roads that make it difficult to access the dispensary and other health facilities.

As people spoke about these issues, it became clear what they want and need for quality health services: an upgraded facility with running water, improved roads to get there and supportive partners. These were things that could be addressed.

Honorable Silvester Palamang’ati speaking during the citizens hearing. Image Credit: WRA Tanzania.

Rose Mlay also made it clear that the responsibility is shared, “Pregnant women should attend clinics the moment they realise they are pregnant. Husbands and partners should make some savings to support in case an emergency occurs during the entire process.

After hearing the citizens’ concerns and demands, Hon. Felister Bura and Hon. Silvester Palamang’ati both agreed to move these issues forward for discussion at an upcoming council meeting on October 28th, 2017, including considering infrastructure improvements for nearby roads and plumbing for the dispensary. The Reproductive Health Coordinator and Health Secretary on behalf of District Medical Officer, promised to explore upgrading the Lugala dispensary to a health centre and increase number of staff at Lugala dispensary with the regional level authority.

Honorable Felister Bura speaking during the Citizens Hearing. Image Credit: WRA Tanzania.

WRA Tanzania National Coordinator, Rose Mlay, encouraged the citizens to continue sharing ideas about how they can contribute toward the reduction of deaths due to childbirth. She also encouraged the citizens to take keen interest in their health facilities to make sure they are running effectively and meeting community needs. And where there are gaps, Mlay encouraged the people to bring them to the attention of their local authorities so that actions to fill the gaps can be taken.

Mlay also made it clear that the responsibility is shared. “Pregnant women should attend clinics the moment they realise they are pregnant. Husbands and partners should make some savings to support in case an emergency occurs during the entire process. In case of any danger sign, pregnant women should rush to a nearby health facility. Pregnant women should plan to deliver at the health facility and not at home,” she urged.

Pictured: Hon. Felister Bura, Hon. Silvester Palamang’ati, and WRA Tanzania National Coordinator Rose Mlay during the citizens hearing. Image Credit: WRA Tanzania.

In addition to the government commitments, citizens also pledged to do their part, including:

· Women will start attending antenatal clinics the moment they realise they are pregnant.

· Pregnant women will deliver at the health facility and not at home.

· Husbands/spouses will start saving and prepare for deliveries.

· Husbands/spouses will support and attend clinics with their partners when they are pregnant.

WRA Tanzania will follow up these commitments in the coming months to ensure they are fulfilled and help them through any challenges that arise along the way.

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