Maternity Waiting Home
Introduction
Every woman and girl has the right to a safe pregnancy, good health care and the opportunity to shape her own future. In the rural Tonkolili district in Sierra Leone however, these opportunities are not self-evident. Long distances to healthcare facilities, limited transport options and difficult living conditions can make access to professional pregnancy and maternity care considerably more difficult.
The Maternal Outreach Project (MOP), started in 2021 by the Wouter Nolet Foundation, offers maternal health care to pregnant women living in rural areas in Sierra Leone. The program focuses on conducting ultrasound scanning examinations and diagnostics. As a result thereof, High-Risk-Pregnant (HRP) women are identified and referred to the nearest hospital for safe delivery. These women should not deliver at home.
However, the MOP program does not include a shelter for staying at the hospital. And the hospital would rather not occupy beds of patients for these pregnant women waiting for delivery. What is needed is a place where these pregnant women from remote areas may stay during the final phase of their pregnancy.
Maternity Waiting Home (MWH)
The Wouter Nolet Foundation considers to create a Maternity Waiting Home (MWH) -on the grounds of Masanga Hospital- to remedy this shortcoming. It perfectly fits into our outreach chain as the final link of the chain. We already diagnose and refer these women to the hospital but leave them alone to implement this.
It must become a safe, hospitable place, taken care of by a team of caregivers with great empathy. Every woman and girl should feel welcome, respected and safe, regardless of age, background or social position.
We also see the time that a woman stays in the MWH as an opportunity to let them meet other women, share experiences and develop new skills. In addition to prenatal (and antenatal) care, we want to offer a simple program that focuses on empowerment, life skills and personal development.
Teenage pregnancies
A special group of attention are the teenagers who, once pregnant, often face great social pressure, insecurity, shame or lack of future prospects within their community. Teenage pregnancies require a specific and integrated approach. A pregnancy at a young age has a major impact on the position of the girl within the family, school and even livelihood. These young girls not only need special medical care, but also an environment in which they feel safe and accepted. They must grow in knowledge, self-confidence and independence.
Basic skills create new opportunities
Education and skills are important building blocks for independence. That is why we want to create a MWH in which awareness and learning are a basic components of the program:
Information about pregnancy, childbirth and baby care
Family planning and contraception
Nutrition and hygiëne
Personal development and self-esteem
These supplements give young mothers practical knowledge and skills that they can use at home and in their community. Knowledge gained today can be passed on tomorrow to a child, a family or an entire community.
By the numbers
We have made a general estimate of the size of a Maternal Waiting Home (MWH) that would be suitable for our purpose. Tonkolili has 570,000 inhabitants. The average age is 57 years. If we assume that the population group remains the same size, that means 10,000 babies per year, or roughly 10,000 births/postpartum women per year.
If we take the same percentage of HRP’s as we now see in our MOP scanning (10%), the total annual 'market' would be about 1,000 HRP’s (we refer now 750 HRP’s). Assuming that 50% of these HRP’s will come to the MWH and that each woman stays in the MWH for an average of 7 days, we would need roughly 10 units (room plus toilet) to cover the need.
Conclusion
A marvelous idea that aligns with our philosophy and vision: a place where health care, self-esteem and opportunities come together. A place where a mother can safely wait for the birth of her child. A place where a teenage girl can regain confidence in her future. A place where women can meet, learn from each other and strengthen each other. Because when we invest in a woman, we don't just invest in herself. We invest in her child, her family and ultimately in the strength of the entire community.
