Fighting cervical cancer through improving increased access to diagnostic and treatment services among the undeserved communities in Malawi
The reproductive health programme supports women and children’s right to healthy lives free from harmful traditional practices and access to quality community health services. Each year, 5.4 million children under the age of five and 303,000 mothers die from causes we know how to prevent. According to the WHO, countries need to allocate 10-15% of their national budgets to health to have a viable healthcare system. Access to healthcare is therefore an issue of good governance and economic justice. Sexual and reproductive health plays a critical role in social and economic development. As of 2017, an estimated 58 million women of reproductive age in Africa have an “unmet need for contraception”. As a result, an estimated 21.6 million unintended pregnancies occur each year in Africa.
In 2018, a total of 130,000 children under five received healthcare through the programme.
The programme has worked to ensure that women, men, girls and boys prefer conventional reproductive health services over harmful traditional practices. In Ethiopia, the percentage of women giving birth in conventional health facilities increased from 70% at baseline to 82% in 2018. Additionally, 62 health care providers and 53 health facility heads received training to improve sexual and reproductive health service uptake and quality, while eight maternal waiting rooms were constructed. The percentage of women attending one or more antenatal visits increased from 70% in 2015 to 100% at the end of 2018.
Haydom Lutheran Hospital (HLH) in Tanzania has become a regional centre for safer births and midwifery training in Eastern Africa. NCA, in collaboration with Lærdal Global Health and HLH, developed a hands-on training programme for midwives covering retained placenta management, stopping bleeding after birth, new-born resuscitation, new-born care after birth, respectful maternity care and family planning (including how to insert intra-uterine devices and implants).
Working to ensure a reduction in adolescent birth rates has also been a focus of the programme. In Mali, NCA and its partners set up six counselling centres for adolescents and conducted sensitisation activities to reduce the risk of early and/or unwanted pregnancies. According to the latest regional statistical yearbook from Mopti (2017), the percentage of new users of family planning methods in women aged 15-49 has increased from 0% at the baseline to 22%. Additionally, the percentage of deliveries by women aged 15-19 decreased from 28% in 2015 to 22% in 2018.
Collaboration with relevant local and national authorities at the district and community level is a key success factor in programme implementation. In Sudan, coordination meetings with various departments within the Sudanese Ministry of Health have helped NCA and its partners to facilitate policy changes and scaling up of projects. Additionally, the close coordination and involvement of stakeholders in the target areas has helped to consolidate and scale up results, as well as keeping NCA and its partners well informed of the progress of results.
In Darfur, the use of traditional birth attendants (TBAs) with adequate training in conventional health practices plays an important role in the decrease in maternal mortality rates. Additionally, outreach by TBAs has been partly responsible for a 10% increase in deliveries at conventional health facilities. NCA plans to further strengthen the links between TBAs and conventional health facilities.