Implementing My Ashoka Idea

The thrills and joy of expecting a new baby can be overwhelming for a lot of couples, especially first-time parents. The excitement comes with breaking the news to family and friends, deciding what birth plan to go for, reading up articles and books about the stages of pregnancy, choosing what midwife and doctor will carry out the delivery, making and going for prenatal appointments. Spending time on the internet getting information. Getting to know the sex of the baby, buying fancy clothes and accessories, organizing luxury baby showers and generally planning for the arrival of your bundle of joy.

In a situation where there is no internet to get information about pregnancy, no books to read or doctors and midwives to make prenatal appointments. No money to organize luxury baby showers. No scan machines. No fancy baby clothes for your bundle of joy. The birthing process is no longer a period of excitement but one of burden, fear, uncertainty and sometimes near-death experiences. For the women who live in Evboroko Community in Edo State, this is the stark reality of their lives.

A fairly large settlement, Evboroko is located in Ovia North East local Government area of Edo State. The community has about 1,500 residents and their main occupation is farming. This community, inhabited by mainly the Urhobo-speaking people, is about forty minutes' drive from Benin City. Evboroko women are beautiful, strong and hardworking farmers, whose realities are different from most women in metropolitan cities. They lack access to quality health care because there are no hospitals or health centers around their community, the closest primary health center (PHC) is 20 minutes away from Evboroko and the PHC is closed most of the time with health personnel absent from work.

Evboroko community has only one traditional birth attendant who attends to the needs of the pregnant women. Mama Napo, as she is fondly called, is a middle-aged woman, a traditional birth attendant as well as a farmer in the community. She delivers the women using herbs from her farm and a bottle of olive oil that has been prayed upon by her pastor. She has no knowledge about orthodox medicine; when pregnant women in the village come to her for their delivery, she uses her olive oil to help bring out the baby and then she cuts the umbilical cord with a razor blade and thread. If any complication arises she cuts some leaves and squeezes the juice out of the leaves, which she gives her patients to drink. When asked how she knows if her patients need medical attention, Mama Napo simply says she only knows by looking at their palms. If the palms of the pregnant woman looks pale then she asks her to go elsewhere or visit a hospital. She says she only knows how to use herbs in helping women to deliver. The traditional birth attendant uses her home as the maternity. She delivers women in her home which has two compartments; she shares one of the rooms with her aged mother and a son who is presently blind, and the other room she uses as her maternity for delivery. Mama Napo carries out the deliveries for a fee of N1500 (10 dollars). And if complications arise because she is not equipped to handle complications, she advises that the pregnant woman should be taken to the hospital.

The idea that got me selected for the first international maternal health fellowship as an Ashoka young champion in 2010, and which took me to the Birthing Project USA to intern for nine months, is a maternal health project that would increase access to maternal and neonatal health care through provision of prenatal home-based care, teach birth preparedness, link women to health facilities and respond to emergency obstetric complication through recruiting and rigorous training of traditional birth attendants, and equipping them to become first responders to emergency obstetric complications.

Evboroko community was selected for the implementation of the Birthing Project Nigeria as a result of its peculiarity and because the community is in dire need of a maternal health care system that would meet the needs of the women who live in that community.

The project team made contact with Evboroko community to introduce the Birthing Project Nigeria to the village elders. During the community dialogue with the elders of Evboroko community, the village Chairman and elders were enthusiastic and excited that their community had been picked for the maternal health program and begged that they should not be disappointed as the women and the entire community need a maternal health intervention for the women of Evboroko.

A fall-out from the community dialogue is a needs assessment program scheduled for the 15th of April 2012.The needs assesment will be a focus group discussion to determine the health needs of the women -- the health challenges that the women face,the maternal and neonatal death rate and the health hazards faced by the women delivered by the traditional birth attendant -- and also get input from the women on what maternal health intervention will work for their community.

I am very excited about this project and so far things have been working out fine. It will be amazing creating a safe space for these women to trust enough and share their experiences. I am looking forward to the meeting with enthusiam and hope that it will be a success.