By Luke Chiwala, White Ribbon Alliance Malawi, Citizen Journalist/Midwife
White Ribbon Alliance Malawi (WRA Malawi) recently conducted a training of trainers (TOT) on Respectful Maternity Care (RMC) at Malawi Sun Express in Blantyre. The training aimed to equip midwives with knowledge on RMC so that they can be able to avert incidences of disrespect and abuse in maternity care. This, in turn, will help to improve usage of skilled birth attendants by all women.
Speaking during the training, WRA Malawi Board Secretary Lennie Kamwendo said that most women are delivering at the hands of Traditional Birth Attendants (TBAs) due to poor reception when they come to seek maternal and newborn care at the hospital. And, in most cases, women complain of being shouted at when they come to the labor ward for delivery.
“We always blame women for not delivering at our health facilities and yet it is us (midwives) who chase them away. The way we treat women and their families eventually discourage them from delivering at our facilities,” Kamwendo said.
She further added that midwives must be at the forefront to advocate for the reproductive rights of all women, and that there is no excuse for acts of disrespect and abuse due to tiredness, or any other cause.
“No midwife can give an excuse for abusing a woman due to tiredness. We must make sure that women are not being abused when they come to seek maternity care. It is our responsibility to ensure that those abusing women should receive disciplinary measures so that these acts stop,” Kamwendo added.
Nancy Kamwendo, the National Coordinator of WRA Malawi, stressed that most maternal deaths are preventable. She said RMC, if fully implemented, can be the best tool to avert such preventable deaths. She mentioned that women who have had good experiences at the hospital will usually come back to deliver at the hospital, hence preventing several complications that can occur when birth takes place at home, and eventually leading to an overall reduction in maternal deaths.
“I attended a function at Lambulira in Zomba where one of our midwives, Felix Mangani, was being praised by the community for being the best midwife. One of the women said that she stopped giving birth but that she wishes to have another one because she admires how other women are being assisted at the hospital. This shows that our attitude is important in ensuring that women are coming to deliver at the hospital,” Nancy said.
The training was attended by 19 participants from 10 districts in the southern region of Malawi. The districts from which the participants came from included; Chikwawa, Nsanje, Mulanje, Phalombe, Chiradzulu, Blantyre, Machinga, Balaka, Ntcheu and Neno. Most of the participants were midwives who work in the maternity unit. Among the 19 were also five citizen journalists who were trained by the WRA Malawi to report on midwifery issues across Malawi. A similar training took place in Salima District and included midwives from central and northern region of Malawi, together with five citizen journalists who are also midwives.
Patricia Yosiya, one of the RMC training participants, said the experience was an eye-opener, "because we discovered that there are other hidden contributing factors to maternal deaths, which is disrespect and abuse in health facilities."
The WRA Malawi advocacy in RMC is in line with the World Health Organization (WHO)'s Global Strategy and Ending Preventable Maternal Mortality goal, which seeks to address inequalities in access to, and quality of, reproductive, maternal, and newborn health care services, and of ensuring accountability in order to improve quality of care and equity.