Local women's groups play key role
As part of the trial, more than 700 women's groups, each with 20-30 members, were formed with MaiKhanda support. "These groups met monthly, guided by a trained volunteer, to discuss health issues and problems encountered during pregnancy and childbirth," says Ros Davies, Chief Executive of Women and Children First, a UK organisation that provided support for the community part of the trial.
"The women in the groups identify problems themselves and come up with ideas for how to solve them," reports Martin Msukwa, Executive Director of MaiKhanda. "We found that needs and solutions varied."
With guidance from MaiKhanda, the groups identified a variety of solutions, including:
Some mid-programme changes
Changes were made midway to strengthen MaiKhanda.
In the hospitals, health workers were trained to address the three leading causes of neonatal death: asphyxia, sepsis (infection) and prematurity.
Because staff did not know how to deal with asphyxia, weekly asphyxia training drills were introduced, infection prevention protocols were established, and to keep premature babies warm, new mothers were trained in kangaroo mother care holding their infants skin-to-skin.
At the community level, 365 safe motherhood committees or "task forces" were created. Each task force was comprised of about 10 elected members, five female and five male, each representing a village in the area. Task force members worked closely with a Ministry of Health community worker to identi
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