Cotonou, Benin – Eager to be seen by a trained medical professional, men, women and children crowd around the door of a small clinic here. In a country where doctors and nurses are scarce, health care—especially prenatal and reproductive care—is at a premium. And for people living in slums, health care is often unattainable. That was the impetus for Theophilus Hounhouedo, a local physician, to open “Le Centre Médico Social de Ladji.”
Located in the slum of Ladji, this private clinic is owned by a nonprofit organization founded by Hounhouedo and called simply “La Vie Nouvelle” or New Life. The clinic helps fill the gap in health services caused by rapid growth in the urban population over the past decade and the public health system’s inability to keep pace with it.
At the start of his career in 1997, after attending a Jhpiego-led workshop on reproductive health, Hounhouedo was inspired to establish New Life and the clinic. He had seen firsthand the great need for such health care services in his community where the lifetime risk of a woman dying in pregnancy is one out of every 17 women.
Today, this bustling clinic provides a range of services—from reproductive health care to community education. The clinic currently reaches approximately 15,000 people each year whose health may be compromised by their living conditions. Clinic staff are committed to New Life’s mission to improve the health of poorer communities through preventive, curative and promotional efforts emphasizing community involvement.
As New Life’s executive director, Hounhouedo is passionate about maternal health and continually looks for ways to improve the skill level of his staff. Through the use of Jhpiego’s Standards-Based Management and Recognition (SBM-R®)—a practical, systems-strengthening approach that provides health workers and facilities with the tools and methods they need to identify problems, develop action plans and innovate at the local level—the New Life clinic has seen a significant improvement in the quality of care provided. By setting performance standards, clinic staff map out the road to improvement. Since 2009, the clinic has improved from an initial baseline performance of achieving 31 percent of the standards to 80 percent in 2010 and to 86 percent in 2011.
With the introduction of SBM-R at the New Life clinic, health care providers are now able to offer integrated quality services while adhering to infection prevention measures.“Thanks to the clinic’s improvement in performance, the level of use of our services has significantly increased,” says Hounhouedo. For example, the number of women admitted for prenatal care at the clinic went up by 23 percent, from 3,640 in 2009 to 4,483 in 2010.
These achievements are particularly noteworthy given that only 17 percent of all health facilities in Benin have the essential medicines, and there remains a lack of trained health care workers in the country. In addition, Benin’s health workforce crisis is acute. There are 1,088 doctors, 999 midwives and 3,563 nurses in Benin, split between the public and private sectors, according to the World Health Organization (WHO). This workforce density of 6-7 health workers per 10,000 people is below the WHO’s recommendation of 23 per 10,000.
For nearly 15 years, Jhpiego has been at the forefront of strengthening health care in Benin by training providers like Hounhouedo. In 1998, the U.S. Agency for International Development (USAID) funded Jhpiego’s technical assistance to strengthen training in reproductive health at the national midwifery, nursing and medical schools. Since then, Jhpiego has collaborated with partners and the government on other USAID-funded initiatives in the country, including a nationwide HIV/AIDS prevention project, regional efforts on treatment for malaria in pregnancy, and currently a family health and HIV/AIDS prevention project.
“Today the majority of the reproductive health and infection prevention tools that we use in Benin have Jhpiego’s signature,” says Hounhouedo. “These tools are extraordinary and of exceptional quality.”
The doctor has gone beyond his local community and has worked to strengthen his country’s health care system nationwide. From 2002 to 2009, Hounhouedo chaired the Beninese NGO Network for Health (ROBS), the largest health network in Benin. He also served as the Vice President of the National Coordination Committee of Benin on activities of the Global Fund to Fight against AIDS, Malaria and Tuberculosis.
Hounhouedo’s leadership in improving health care delivery extends beyond his native Benin. He has served as Chairman of the Board of Directors of the West African NGO Action against AIDS (WANASO), Vice President of the African NGO Action against AIDS (AFRICASO) and member of the International AIDS Society (IAS).
For health care entrepreneurs like Hounhouedo, Jhpiego’s assistance has been crucial in expanding access to reproductive health services.
Hounhouedo and his colleagues in Benin and elsewhere in the region have been able to address the Millennium Development Goals of reducing maternal and infant mortality. “With technical assistance from Jhpiego, we have effectively contributed to the achievement of the Millennium Development Goals 4 and 5,” he said.