Brief Summary (For those who just want the concise version!)
We plan to increase access to attended births for pregnant mothers who live in rural southern Haiti in outlying communities from our birthing center, Maison de Naissance (MN). We will accomplish this by training matriarchs in these outlying communities to become modified community health workers and create a "Safety Net" of education, communication and transportation to facilitate bringing mothers into MN for prenatal care, labor and delivery. We will provide education for these selected matriarchs, cell phones for communication, and have an ambulance on call 24 hours/day for transportation. We need your help to make this program a reality and truly impact the lives of mothers and babies in Haiti!
More in Depth Program Description
Background: Our target population resides in a 40 square kilometer rural area of southern Haiti, centered in Larnage Village, not far from the town of Les Cayes. Most homes have dirt floors, no plumbing, and no source of electricity and most women walk an average of 6-8 hours to access medical care. According to our 2004 census survey, 51% of mothers had a single prenatal visit during their most recent pregnancy and only 23% delivered in a healthcare institution, despite the fact a regional public hospital is in a city 10 kilometers away.
Top reasons for not seeking prenatal or delivery services include: disbelief prenatal visits would impact the outcome of pregnancy; more convenient support from local traditional healers; lack of transportation; user fees at hospital; marked lack of confidence in the hospital (ineffective, corrupt, or unsafe). These are the reasons we operate a fully Haitian midwife staffed birthing clinic, MN, in this community and why expansion of our services to neighboring communities is imperative.
Program Details:
This program will target those pregnant women in inaccessible communities and provide a safety net for them to access obstetric care at a very high-risk time in their life. We plan to create a “safety net” by selecting matriarchs in the community and creating a network of communication in order to access obstetric care at the time of delivery. We will select and train community representatives to become a “Matrone,” or “matriarch” in French, which will be considered, a modified type of community health worker. Building relationships with all women in their neighborhoods, particularly those who are pregnant, Matrones will provide targeted services that are essential to improving maternal and newborn survival.
Program Steps:
1) The Matrones will attend training sessions regarding their roles, responsibilities and pertinent, pregnancy–focused health topics.
2) Matrones will be issued cell phones with solar chargers and phone cards to facilitate communication between the MN midwives, ambulance driver and pregnant women in the their communities.
3) Matrones will perform monthly home visits to monitor women’s pregnancies and relay a new health education message, which will be communicated monthly through MN nurse midwives via text message.
4) Matrones will provide pregnant women basic pregnancy education especially regarding signs/symptoms of impending labor. Matrones, using their provided cell phones, will alert MN staff and driver as needed.
5) Program evaluation will be conducted throughout including resource uptake, % of women reached, # of deliveries transported and maternal and infant mortality rates within the targeted communities.
