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MOGADISHU – Somali local authorities have launched a project to train urban and rural traditional birth attendants to raise awareness and provide reproductive health services to reduce maternal and neonatal mortality.
The goal of the Midwifery Rehabilitation Project is to provide a safe delivery service to approximately 300 villages in one year, with each midwife benefiting from the Train the Trainers project who visited 24 villages and trained midwives. traditional women in these villages.
Fifteen traditional midwives participated in a session recently organized by the Somali Foundation for the Protection of Integrity and lasted approximately two weeks.
Midwives came from all parts of Somalia, including Western Somalia, which is controlled by Ethiopia.
One of the 12 Somali pregnant women is at risk of dying from pregnancy-related complications and not going to health centers early in pregnancy.
"The decrease in health awareness in Somalia, especially in remote areas, has contributed significantly to the increase in maternal and neonatal mortality rates due to the lack of necessary health care during pregnancy," he said. said Diqa Adam, gynecologist and president of the local Hagril organization.
"The causes of maternal mortality can be avoided if they have access to health centers and sensitize cities and isolated areas to health, as well as monitoring the beginning of pregnancy until birth. so that they do not become vulnerable to death, "Deka said.
She explained that this course "aims to provide Somali women with safe reproductive health by training rural midwives and educating them about modern safe delivery methods, especially in cases of hardship during pregnancy. l & # 39; childbirth. "
Halima Mahmoud Ali, a gynecologist and trainer, said, "Birth has become a death directive for Somali mothers, as they cling to a traditional culture that encourages them to use the skills of midwives rather than health centers in which all the possibilities of delivery are available in case their life is in danger. "
"Since this traditional culture is widespread in society and the maternal mortality rate is increasing, even in cities, there is an urgent need to educate the traditional midwife to prevent continued maternal mortality," he said. Halima said.
The traditional midwife is an important reference for the birth of many Somali families, despite the proliferation of hospitals in major cities.
This situation increases the female mortality rate, which has prompted local organizations to work to rehabilitate midwives to reduce the risk of maternal death.
Fatima Hassan, a traditional midwife for thirty years in Central Shabelle province, said that "traditional birth attendants have given Somali mothers a lot in recent decades, despite the lack of potential."
"The courses for traditional midwives will change many of the perceptions they have during childbirth, which helps reduce mortality in women and counsel them during pregnancy," Fatima said.
According to local agencies, 55% of pregnant women use traditional birth attendants in remote areas and in some cities, which increases maternal mortality due to pregnancy-related complications, such as anemia and internal bleeding. .
The majority of Somali rural areas lack health services, which has worsened women's health status since the beginning of their pregnancy and puts their lives at the mercy of unqualified midwives in a situation that often ends with death of the mother or fetus.
Habiba Adam, a 25-year-old midwife in the southwestern province of Bay, says "pregnant women trust traditional midwives".
She attributed this situation to the lack of awareness of health and the unavailability of health centers in rural areas and at their crazy prices, if any, while the cost of the traditional midwife is still low.
"She gave birth to four children through traditional birth attendants, which is the case for many pregnant women and I've never visited a clinic to monitor my condition during my pregnancy," Halima said. Bilal, 7 months old.
"When my eldest son was born, my life was in danger, I lost consciousness for hours because of my intractable situation, which was attended by several midwives," she said.
The small amount paid by the traditional midwife at birth is the leading cause of maternal mortality.
The contrast is different if the child is a man or a woman, which has led the midwives to remain attached to women while the workers seemed to be men, even in difficult cases, which led to life mothers because of the return.
In rural areas, fees vary from midwife to midwife: 600,000 Somali shillings (30 dollars) on average if the child is a man and 400,000 shillings (20 dollars) if she is a woman.
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