Post by Shakilah Bint Shiekh
Improving maternal health and encouraging expectant women to deliver at a health facility is a priority for the Millennium Villages Project (MVP). Several interventions are being implemented to boost institutional delivery. In Ruhiira, Uganda, only 8% of pregnant women delivered in a facility when the project first started. This number has gone up to 89%. Still, the team wanted to know why this figure wasn’t higher.
So in 2008, a study on the obstacles to full utilization of antenatal care services was carried out. It revealed a number of factors that hindered pregnant women from delivering at health facilities. These included lack of baby wrappers, hygiene issues, attitude of health workers, lack of privacy in the delivery room, and delivery posture. Surprisingly enough, a number of women cited the lack of baby wrapper as the biggest challenge.
“To deliver at the health center, you needed to be ready to put up with the nurses harsh words. ‘Why do you have children if you can’t afford a cloth to wrap your baby?’ the midwives would tell us,” says Lovence Katusiime, a mother of three. This pushed the mothers away, and they resorted to delivering at home or with the help of traditional birth attendants.
Faced with this unexpected problem, the MVP introduced the mama kit package which is given free of charge to every pregnant mother who delivers at the project supported health facility.
A mama kit package contains a one meter piece of cotton cloth (baby wrapper), one laundry soap, a pair of gloves, a piece of cotton wool, small gauze, cord ligature, and a meter of polythene sheet which is used on the delivery table. In many health facilities country wide, baby wrappers are not provided to mothers. These essential items are not easily afforded by pregnant mothers in rural areas. They cost the project about USD 5 per unit. Since the introduction of mama kit by the MVP, not only have pregnant mothers had access to the most essential items but it has also led to great reduction in infections in new born babies. Previously, a mother would come with any cloth from home, most of the time an unwashed rag, to wrap the new born. By providing a clean wrapper and the polythene sheet which is for one use only, the mama kit has made a dramatic change in delivery procedures. ‘This has helped us prevent infection of the mother and the new born,” says Kyorasiime Pulkeria, a midwife at Kabuyanda health center.
The mama kits serve as a self selling incentive for institutional delivery. “With this wonder kit, mothers mobilize fellow mothers. The kits sell themselves,” says the health coordinator Dr. Martins Okongo.
Shakilah Bint Shiekh is a UNDP Communications Specialist. She is based in the Ruhiira Millennium Village, Uganda.