I was recently in Ethiopia for the JSI Global Maternal and Child Health Conference and spent a day visiting a health post that’s supported by the Saving Newborn Lives initiative. Saving Newborn Lives works to make sure that more babies are attended to in their first seven days of life.
We left the capital, Addis Ababa, early on a Friday morning and headed south to visit a village health post (the lowest-level of formal health care in Ethiopia) and a health center (the next level up) in Ethiopia’s Oromia District.
Saving Newborn Lives is funded by the Bill & Melinda Gates Foundation and implemented by Save the Children in partnership with JSI. We are working with the Ethiopia Federal Ministry of Health (FMOH) to—as the title says—save newborn lives.
It turns out that many health programs in countries such as Ethiopia focus on the health of pregnant women and child immunization, but somehow newborns are forgotten. This is particularly tragic as more than 120,000 newborns die in Ethiopia every year, and most of these deaths occur within the first week of life. Therefore, having even minimally-trained health workers who can recognize some basic danger signs of severe illness (as well as postpartum hemorrhage among women who have given birth) is critical.
The Saving Newborn Lives project’s Community-based Interventions for Newborns in Ethiopia (COMBINE) initiative helps train volunteers to visit women and their newborns in their homes (or at home) three times during the first week after delivery and check for danger signs. If it looks like the baby or mother is in trouble, the volunteer can call in the health extension worker at the health post.
While in Oromia, we met with three community health promoters at the health post. All three are mothers, and each accepted the role after being selected by her community to be a volunteer. The first skill volunteers learn is how to build a latrine. Each volunteer builds one in her yard and then shows her neighbors. The volunteers are asked to talk with the community about what they learn in their training—from building latrines to keeping water jars covered— and importantly, the importance of visiting the health post if you’re pregnant. In the two years since our JSI Saving Newborn Lives team trained the health extension workers and volunteers at the health post, the rate of women who deliver at either the health post or health center has increased to 10%, but there is still a long way to go.
During our visit, the community health promoters allowed us to accompany them on visits to a few houses where new moms and babies were living. At one home, a child had “fast breathing,” indicating a respiratory infection, which can be lethal. Another child had had terrible diarrhea–an ailment that may seem non-critical to those of us in the developed world, but is the second leading cause of under-five deaths in the developing world. Knowing when to tell a mother to get her child to the health post or being able to make her a simple salt solution to rehydrate the baby can meant the difference between life and death for these vulnerable newborns.
The volunteers were hesitant to talk about themselves, but the three women we met all said that they appreciate being able to help mothers in their community. They’ve also gained social status as a result of their volunteer role, which is significant for illiterate women. Another project I’ve visited here in Ethiopia, the Last 10 Kilometers Project, which is also funded by the Gates Foundation, is looking at how to keep volunteers engaged through “nonfinancial incentives”—not surprisingly, community recognition is a significant incentive. The health post we visited also has posted photos of the health promoters on the wall, which is another form of recognition.
Until social norms change and people know when to visit the health post or understand the importance of prenatal care, the work that the health promoters are doing is critical.
It was a fascinating visit and I was fulfilled to learn that our Saving Newborn Lives team really is saving lives!