We visited senior officials Tamrat and Mussie at Manicho Health Centre. They were pleased with the selection of Malga for the BL/DDP project, where HTP rates have been particularly high, and the focus on girls and women, who are most vulnerable.
They are concerned about the health effects of HTP, and one of their priorities is to reduce the number of traditional home births, which often entail questionable umbilical practices. They are trying to encourage women to attend health centres, give birth with the support of trained professionals, and benefit from ante- and postnatal services.
If something goes wrong at home, it is very hard to get an ambulance in time because of the poor phone network and absence of paved roads. So they are glad that our project was able to equip a waiting room at each health centre, enabling women to stay overnight. We looked into their waiting room – a elegant traditional Sidama building, if a bit dark inside – to find an expectant mother, and female relatives of another woman who was in the delivery room.
84% of deliveries used to take place at home, but it has come down to 37%, and the number of stillbirths has been reduced from 5-6 a year to just one in the last 9 months. Maternal mortality is down, too, and their healthcare work goes hand-in-hand with prevention and awareness-raising through health extension workers (HEWs), youth services and work with schools.
Before the project, HTP didn’t get sufficient attention, but the training for staff and officials, HEWs and others has increased capacity and a sense of local ownership; issues like FGM are firmly on the agenda. The age for marriage and pregnancy is going up: now most are 19+, partly thanks to the religious leaders confronting early marriage and polygamy.
Tamrat and Mussie think that eliminating HTP is a very realistic prospect. People used to carry out FGM as a job, but now they have reformed and been assisted into alternative livelihoods. Traditional birth attendants have also been trained and now encourage women to opt for health centre deliveries. “The future looks promising,” says Mussie.