Training Programmes
Training programmes were initiated in 2005 to complement the distribution of the Birthing Kits. These involved 3 - 5 day training sessions where Traditional Birth Attendants, Health Extension Workers, Village Nurses and health workers were educated in nutrition, general health care, midwifery and issues relating to HIV/AIDS prevention. These programmes were designed by the local people to meet their needs.
Community Development
Objectives and long-term strategy
The Birthing Kit Project addresses 4 of the UN Millennium Development Goals (MDGs); gender equality and empowerment, reduction in child mortality, improvement of maternal health, and combating HIV/AIDS, malaria and other diseases. The BKFA's strategy to help achieve these MDGs is to ensure a safe and clean birthing environment by providing training to in country health workers (so they can in turn train traditional midwives and mothers) and providing clean birthing kits (to be replaced by local materials from local sources).
The Foundation has researched areas of high need based on the approach to estimating maternal mortality developed by WHO, UNFPA and UNICEF. The Foundation places a priority on countries with the highest maternal mortality risk and is moving towards addressing our activities to areas where we can maximise the impact of our funds, while maintaining the current partnerships in needy communities that are progressing towards sustainability and where very good cooperative relationships have been established.
The Foundation looks at its capacity to provide support to the partners in the form of supplies of birthing kits and/or funding training programmes and also looks at the long term capacity of recipient communities to work towards sustainable solutions for the clean birthing principles that we are establishing.
Individual countries have unique health systems and demographics and so the Foundation and NGOs and health officials work together to effect the most efficient and workable scenario for the training programmes and the distribution of kits to support established health programmes involving traditional birth attendant.
Training programmes
To achieve these objectives in 2008 - 2009 the Foundation initiated training programmes in Vietnam, Kenya, and D.R. Congo and supported training programmes in Ethiopia. This year the Foundation is funding training programmes in Ethiopia, India and Vietnam.
Ethiopia:
Afar region
The Afar people are nomadic pastoralists who live predominantly in the Danakil Desert in the Afar region of Ethiopia. The Afar Pastoralist Development Association (APDA) was formed in 1993 to address issues of literacy and primary health care.
In 2010 the Foundation is funding a Traditional Birth Attendant training course for 40 women run by APDA in Dagaba and Daaba, in the remote Dubte Woreda of the Afar Region. The training will include clean birthing, women's rights and minimizing harmful traditional practices and give the women information beyond their traditional knowledge, equipping them and partnering them within the primary health team. They will have a year's supply of clean birth kits that are made up of locally-sourced components.
This programme will empower women and will improve their community status. In 12 months there will be over 3,000 clean and safer deliveries.
APDA wishes to increase capacity for these very remote nomadic people by providing two to three times more trained women extension workers.
The Ethiopian Ministry of Health has given BKFA official permission to distribute birthing kits and develop health initiatives to make available clean and safe birthing environments in remote communities
India:
The Foundation is funding a Midwifery Training and awareness programme for Traditional Birth Attendants in 25 Tribal Villages of Dindigul District in Tamilnadu State, India.
Nearly 90% of tribal women give birth in their homes without the assistance of trained medical personnel. Birthing kits will be provided to the Traditional Birthing Attendants (TBAs).
This training programme will benefit 200 TBAs and the women and communities they attend and will run over 1 year.
The programme aims to increase the awareness of the need for clean birthing environments, to train TBAs in Safe Birthing Practices and to improve the conditions for women in tribal communities. Awareness and training will help them respond to critical complications of labour, delivery and care of the newborn.
Training Programmes 2008-2009
Vietnam
Ha Giang Province
Following the training programme completed in June 2008, a further 112 very remote communes were identified. A 5-day reproductive health training programme was held, in line with the plan for the year, for traditional birth attendants and health workers in each of the communes. Of these communes, 67 had not had the training programme in the past. A further 59 communes that were part of the last year's allocation of programmes had been identified as needing a repeat course due to difficulties with language. With 22 minorities with very many different languages in remote areas, each of these communes was provided with an interpreter for the courses to address this need. The training was very successful and focused on the need for clean birthing, the use of birthing kits, nutrition, hygiene, immunization, obstetric and neonatal care, and general hygiene. Each of the attendees received an educational booklet prepared by the provincial health authorities for the Foundation.
All communes in this province have now received the training course
Thanh Hoa province
A further 112 communes in Thanh Hoa Province received the 5-day training programme. The course content was the same as for Ha Giang Province.
Comprehensive reporting requirements were met by the province and they continue to supply us with data and statistics on reproductive health and incidence of post partum and umbilical infection. No cases of infection were recorded.
Binh Phuoc province
The training programme model that has been successful in Ha Giang and Thanh Hoa provinces has commenced in Binh Phuoc province in May 2009. This programme will run until March 2010 and will deliver education on reproductive health to traditional birth attendants and mothers in 74 communes. The funding for this training programme was provided by AusCHAM, the Australian Chamber of Commerce in Vietnam, which is a licensed foreign business group in Vietnam established to represent and promote the interests of Australian businesses operating there. The Foundation provided 9,000 locally-produced birthing kits to complement the training
Kenya
Maasai Mara
A 5-day midwifery training seminar was held in April 2009 for 80 Maasai Mara traditional birth attendants in southern Kenya. The people are nomadic and all births take place at home. The women were accommodated in tents and fed for the 5 days. Dr Luc Mulimbalimba Masaruru, who ran the seminar, reported that all the proposed objectives were achieved. Due to the high levels of illiteracy a pictorial training manual was developed for the participants. At the end of the seminar 4,000 kits were distributed to the TBAs.
Democratic Republic of the Congo
Uvira District
In August 2008, a 3-day training seminar was conducted for 60 traditional birth attendants in Kaharoro village in Uvira district, South Kivu province, DR Congo. The village has no health centre, school or amenities such as water. An educational book written in Kiswahili language, with pictorial instructions, was developed for the seminar. Topics covered over the 3 days were use of the birthing kits, midwifery, primary health care, nutrition and food therapy. There was also counselling and social development support for the attendees. After the seminar birthing kits were distributed to the birth attendants for use in their communities. An added benefit was that during the training course the doctors were able to set up a free clinic to offer medical services to the participants and their families who had travelled large distances.
Extended Programme in Ethiopia
Hamlin Fistula Hospital
The Foundation has sent a total of 50,000 kits since 2006 to the Fistula Hospital, which has distributed them via the training programmes conducted by the Public Health officer from their Outreach Centres in Mekelle, Bahir Dar, Harer and Yirga Alem, in conjunction with their Fistula Prevention Programme. There are extensive training sessions in targeted remote woredas for health extension workers (HEWs), traditional birth attendants (TBAs), community based reproductive health agents that incorporate the birthing kits, and sensitisation and awareness programmes for community representatives and elders, religious leaders, women and youth workers.
The kits are reaching our target demographic of women giving birth in remote mountainous regions, and there is anecdotal evidence from the officials of the woredas that the kits are effective in reducing the incidence of maternal mortality and morbidity although there are no statistics.