If you are a pregnant young woman in rural Malawi and you live in a community that is 3 miles from the nearest health center, chances are the only day you will go to the health facility is the day you go into labor. And that’s if you’ve decided against giving birth at home. Many Malawian women rely on a trusted grandmother, mother or auntie instead of a health worker to help them deliver, even though the relative may not have the skills needed to treat the mother or the baby if things go wrong.
In an effort to prevent mothers and newborns from dying needlessly in childbirth, the government of Malawi and Jhpiego, a global maternal and child health nonprofit, are working together with volunteer community health workers to educate women on safe birth practices and the importance of giving birth in a health facility with skilled midwives or nurses.
One such volunteer is Sophie Makoza. Sophie and 14 other Care Group volunteers, as they are called, are supported by Jhpiego with funding from the U.S. Agency for International Development’s Support for Service Delivery Integration-Services (SSDI) Project to keep families in Chilipa district heathy and strong.
Sofilet and George, a newly married couple from Thaulo village, are among the 196 families who have benefited from the effort. When Sophie heard that Sofilet was pregnant, she visited Sofilet and George’s home to share and explain health issues related to pregnancy—for example, the importance of preparing and eating nutritious food and the impact that a balanced diet would have on the baby. She counseled Sofilet on the danger signs to look for during pregnancy, the importance of attending antenatal care classes and getting tested for HIV during pregnancy, and the benefits of giving birth in a health facility.
Sofilet attended four prenatal care visits, the recommended minimum, and with encouragement from Sophie, she prepared for the birth of her baby. Because she and her husband live more than 3 miles from the nearest health facility, Sophie helped them make a plan to have transport available and ready to take Sofilet to the Nsaru Health Center. When Sofilet went into labor on July 24, the couple grabbed their prepared clothes and traveled by bicycle to the health center, with George pedaling the entire way. At the health center, Sofilet gave birth to a healthy baby girl named Gloria.
After the new mother and baby returned home, Sophie was one of their first visitors. She counseled Sofilet on the importance of rest, exclusive breastfeeding to keep the baby healthy and sleeping under a mosquito net to avoid malaria. Sophie also counseled the new mother on the importance of vaccinations and family planning.
“Because she is not my mother I feel like I can ask her anything without feeling shy. When I arrived home with the baby, I noticed that she was not breastfeeding properly. My breasts were always heavy and began to get sore,” said Sofilet. “Sophie demonstrated how to hold the baby and my breast during breastfeeding. From then onwards, I have breastfed with confidence and my daughter enjoys it.”
For Sophie, the bond she has developed with the young family is so strong that she says she will continue to counsel Sofilet until baby Gloria is 5 years old.
Care Group volunteers such as Sophie are well known in their communities. They are often the first line of basic health care for women and their families. The volunteers travel mostly on foot, walking door to door to conduct counseling on nutrition, lead cooking demonstrations to promote healthy eating habits and champion hygiene and sanitation in their villages.
Sophie usually visits 30 families a week. So when she received a new pair of shoes from TOMS, the Los Angeles–based brand that gives back to a person in need for every product they sell, she felt honored.
She could not believe that someone from a faraway country would think of her and send her shoes to show their appreciation for her work. The innovative partnership between TOMS and Jhpiego helps to encourage and retain community health workers in districts served by the SSDI project, where an estimated 544,000 children under age 5 live.
“Please tell them to sleep very far away from fireplaces,” said Sophie, referring to a Chichewa proverb that is spoken when you have run out of words to say thank you. “They must live a long and healthy life!”