The ‘Continuum of Care’ approach to Mother and Newborn Child Health recognizes that the health and well-being of women, newborns and children are closely linked and need to be managed in an integrated manner. It ensures that the health care needs of women and their children are addressed from pre-pregnancy on through the early years of a child’s life. The first dimension of the Continuum is ‘Time’ -- from pre-pregnancy through pregnancy, childbirth and the early days and years of life. The second dimension of the Continuum is ‘Place’ -- linking home, community and health facilities.
The purpose of the training was, first of all, to emphasize the importance of TBAs providing education in their communities and linking pregnant women with their local health centres to allow for early screening of complications and the four visits necessary for the full range of antenatal services and delivery. They learned about the importance of a Birth Plan for every pregnant woman, and about the development of referral plans. They learned about PMTCT (Prevention of Mother to Child Transmission of HIV).
In the event of unforeseen circumstances where a TBA must perform a delivery, the training focused on the elements of a clean, safe delivery. (Although pregnant women are encouraged to deliver at the health centre, in reality in Bunda around 70 per cent of pregnant women deliver at home.)
TBAs learned about recognizing and responding to danger signs during pregnancy, delivery and immediately after delivery (e.g. the most common emergencies are hemorrhage and birth asphyxia). The mother must be visited within the first 24 hours of delivery, and again within 24-72 hours to examine mother and child for bleeding and infection. The TBAs learned the basics of hand washing, clean cord care and a clean cloth to wrap the baby. They discussed the importance of immediate and exclusive breastfeeding. Other important topics were Immunization and Family Planning.
Training aids included babies and pelvic models...
The TBAs were provided with safe delivery kits equipped with razor blades, soap, sterile gloves, string and a rubber mat.
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| TBA Leticia Mussa receives her safe delivery kit |
The TBAs also received bicycles which will help them reach pregnant women for education, counseling and referral plans.
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| TBA Subyeki Eliasi with her new bike |
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TBAs offer a great entry point for education – for example, engaging pregnant women in discussions about malaria and use of bednets for both the women themselves and children under the age of five can have a huge impact on Mother and Child health.
