Confessions of a converted midwife

A maternal ward at Zingwawa Health Centre in Blantyre
© UNICEF Malawi/2019/Thoko Chikon

By Sellina Kainja

Bvumbwe Health Centre is located along the M2 Road in Thyolo district, some 23 kilometres from Blantyre.

The first thing one notices once inside the health facility is people sitting or sleeping on the lawn close to the health centre’s main gate. Then one is hit by the sounds of a hospital—crying babies afraid of needles.

Malawi is one of the developing countries with a high neonatal mortality rate. The 2015 UNICEF report on Maternal and Newborn Health Disparities in Malawi, indicates that neonatal mortality rate is 22 deaths per 1,000 live births for urban areas. The report further reveals that neonatal mortality rate among the poorest households, is at 31 deaths per 1,000 live births as compared to 24 deaths per 1,000 live births among the richest households.

Chimwemwe Kanyenda, a midwife, has worked at Bvumbwe Health Centre for five years. She  is one of the beneficiaries of UNICEF support towards quality maternal and newborn health care. Kanyenda confesses that she had been using shortcuts to help mothers and babies in her care. But now that is a thing of the past, thanks to UNICEF’s intervention.

In 2018, Chimwemwe was trained in emergency obstetric care in maternal and newborn health. The training  is one of the interventions within a UNICEF project to improve maternal and newborn health in Malawi. The project is supported by the Korea International Cooperation Agency (KOICA). Chimwemwe says the training has transformed her and her attitude towards helping mothers and newborns.

She explains that much of her knowledge in maternal and newborn health before UNICEF stepped in, was based on theory and not practical because they lacked the necessary tools to translate theory into practice.

Chimwemwe Kanyenda at Thyolo District Hospital
© UNICEF Malawi/2019/Sellina Kainja

“The training was quite refreshing. I have benefitted a lot. The skills I acquired have also helped me to treat patients with confidence and much ease. I am glad that I was part of the training,” Chimwewe said.

With the training and support from UNICEF, Chimwemwe says she is now able to apply the right skills at the right time to save mothers and babies’ lives. She believes this has significantly helped reduce maternal and newborn deaths at the health centre.

Among many other skills acquired, Chimwemwe highlights a few of them such as; how to handle a breech baby, neonatal resuscitation and helping baby to breathe.

“There were so many shortcuts that we were using before the training. For instance, I knew how to administer medication to stop bleeding, but I didn’t know how I could effectively estimate blood loss and apply the critical immediate monitoring actions to check effectiveness of the medication given,” she said.

In addition to training health workers, UNICEF has provided equipment to health centers.

Bvumbwe Health Centre received a manual vacuum extraction machine to help babies breathe and  monitoring machines. Chimwemwe says monitoring machines have  tremendously helpedto monitor the condition of the baby before birth and mothers in labour to detect any complications and reduce neonatal deaths.

“The health centre used to register about 6 to 7 neonatal deaths in a month but with the training and equipment that UNICEF provided, neonatal deaths have been reduced to one and sometimes we do not register any death all month,” Chimwemwe said.

Twenty-three year old Eliza Stewartof Kwenengwe Village in Thyolo district is a mother of two children. She says she has seen the difference in how midwives such as Chimwemwe are handling pregnant women. Her second baby boy was born on May 13 2019.

A mother carrying her child at Zingwangwa health center in Blantyre
© UNICEF Malawi/2019/Thoko Chikondi

“I gave birth to my first born right here [Bvumbwe Health Centre] two years ago. This time around I was skeptical because I thought I would get the same treatment. But I must admit that I have noticed a difference. I was well cared for. The nurse kept on checking on me until the baby was born. I am satisfied with the treatment the nurse gave me,” Eliza said.

Esme John Mpunga was Eliza’s guardian throughout her hospital stay and she agrees that there is a big improvement in the way pregnant women and their newborns are treated.

“We were well welcomed and cared for. I came in a bit late after Eliza had already given birth without a guardian. But she was well cared for. When I came here, they welcomed me and explained everything calmly. Eliza too told me how the nurse looked after her. In the past, they would have been very angry if a patient gave birth without her guardian. I hope it will remain like this,” Mpunga said.

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