Maternal and Child Health News from Ghana

Upper East Region Midwife wins Midwife of the Year award from Jhpiego:
http://www.theworld.org/2010/06/11/midwife-of-the-year/


Family Planning in the Upper East:
http://www.ghananewsagency.org/s_health/r_16663/

Abigail's First Journey to the Upper East

There is always a firs time to do something and I had the opportunity to travel to the Upper East region for the first time, precisely to Navrongo. Since it was my first time to travel that far, I decided not to sleep on the way so that I can look at things on my way through out my journey. Personally for me it was a sightseeing journey. On my way to UER, just at Tamale I noticed that most people are using motor cycles and bicycles. Traffic wardens give way to these cycles to go before the cars, I found that very interesting especially the way they direct the traffic, because in Accra there is nothing like that. Also I realized that animals like sheep, goats, donkeys and cows cross the road most often.

PURPOSE FOR MY JOURNEY
Finally, I arrived in the UER (Navrongo) where our project site is and the main reason to be here is to train nurses in each of our selected CHPS zones, launch the MoTeCH project and then register patients on MoTeCH.

ORGANISING DURBARS

Due to the low level of technology and undeveloped areas in the UER, communicating information to the people effectively is through durbars. So far I have enjoyed all the durbars I attended and I have learnt new things about these people and their tradition. Some of these things are:

• At their durbar grounds the women sing to welcome us, even to the extent of bowing down to greet us. The men also drum and dance to welcome and greet us, they do this separately.
• In most of the communities I visited, they have used calabash and sheep’s skin to make a drum. The drums are played accompanied by whistles curved from wood to produce good sounds for dancing.
• They perform a “strength needed dance”, that believe me you need extra strength to this dance. Honestly, I tried to learn their dance but I didn’t get it so well because it needs so much strength.
• Talk of their environs; I call it nature at it best. A lot of baobab trees , Shea-nut trees with lots of cows, sheep, goats, pigs and donkeys grazing and some taken to the farms by the owners to carry their load to their homes. Also you find the birds also feeding on these cows, sheep etc.
• They have these fascinating names for their communities such as kayoro, Kurugu, Mirigu, nyanyai, ketui, kajelo, kananai etc.
• Languages spoken here are Kassem and Nankam and I have decided to learn the languages while am here. I have started with Kassem and here a few of the common ones spoken often.
• Good morning - Din Wor
• Good afternoon -Din wi
• Good evening -Din didan
• General greeting -din l
• Sorry -Din la
• Thank you -Akin le

TRAINING OF NURSES AND PREPARATION TOWARDS THE LAUNCH

So far, so good! The training is going down well with the nurses and they are finding it very interesting. They hope it is really going to ease the pressure and then feel good about their work. Also the people of these communities are also very welcoming and ready to join MoTeCH for this wonderful and quality health gaining project.

We are still training the nurses and preparing for the official lunch of the MoTeCH project in the first week of July. Like I said earlier on that, so far it’s been very good and we are hoping to achieve the best result out of this project.  

I am really enjoying my stay here, thanks to MoTeCH!

--Posted by Abigail Annang, MoTeCH Ghana Administrative Assistant

Introducing MoTeCH to Communities One Durbar at a Time

Durbars are community entry ceremonies that must be done in all of the 11 zones where we are working with Mobile Technology for Community Health (MoTeCH) .  They include bringing offerings to the Chief, telling the community members about MoTeCH, dancing and hopefully getting the community members to formally “accept” MoTeCH as a valuable health service.  Durbars last for several hours, usually take place under a tree and we’re holding them for all 11 zones this week so we can keep on schedule with our launch activities. 

Both of yesterday’s durbars were received very differently.  One community was very excited, engaged and asked great questions (several questions from men about whether they could sign up even if they don’t have a wife!).  The community emphatically “accepted” MoTeCH when asked by their chief.  The other community had many questions and concerns about services provided by Ghana Health Service, so wasn’t  able to engage in discussion about MoTeCH.  These experiences provide an important lesson, that we need to realize that each community will be different and will have a different set of experiences with other NGOs and health care providers that will influence how they feel about MoTeCH in the beginning.

Posted by:  Kirsten Gagnaire, MoTeCH Project Manager

"Wired Mothers" in Tanzania

Jim and Neal Lesh tipped me off to a similar initiative to MoTeCH being done in Zanzibar called Wired Mothers, which sends SMS reminders of required care to pregnant mothers and allows them to call/connect with their health facility via voice calls.

http://www.i-m-s.dk/files/publications/Stine%20Lund%20Wired%20Mothers.pdf

http://www.enrecahealth.dk/archive/wiredmothers/

I've reached out to Dr. Lund to find out more about their program and to see if there are opportunities to learn from their implementation so far.

Maternova

I just ran across a great site highlighting innovations in maternal  and newborn health:


http://maternova.net/
 

Day in the life of a midwife in rural Congo

BBC photoessay on a day in the life of a midwife in rural Congo. 

http://news.bbc.co.uk/2/hi/africa/8378919.stm

Field photographic and cartoon approach testing

Overview

We tested both approaches with 11 women and 9 men at Wagliga CHPS compound and Chaina health centre. These were divided in 2 separate groups to enable both genders share their views more comfortably. In general, men seemed to interprete the pictures more accurately as opposed to the women. Men also seemed more literate and could read a few words unlike their female counterparts.

Cartoon Vs Photos

Photos were preferred to the cartoons and these were interpreted more accurately. Photograph (d) below, “Helping baby grow” was most loved. Coincidentally both sexes chose it as their best. While women liked it because they admired the healthy, smiling babies while men liked it because they learn from the picture what they need to provide for their own babies to look like them. Men also mentioned that the children in the picture are well taken care of by their parents by the way they look. Women wanted their children to be like them.

Most disliked by the women was the 080 020 6001 picture because they were seeing people making their own phone calls. Men disliked the 6001 picture most because to them all the people in it looked sick!

Documented below are responses got to each picture. Male responses in italics.

Cartoon approach

080 020 6001

• Not Ghanaians from the dress code
•  See people holding their phones
• Don’t know why they are calling and who it is
• They see a number to call in case of an emergency e.g. fire, ambulance
• A boy standing holding his ears
• People are standing in a queue
•  Pregnant woman making a call
•  A man is sneaking into a man’s phone call
• There are 2 young unmarried ladies

6001

• They see a pregnant woman, a doctor, 2 friends and a mother
• These are people at an outreach
• Didn’t seem to get the whole picture of people Smsing
• Mother talking to her baby
• Mother going for ANC
• Mother calling for help because she is labour
• They are reading a text message
• They look like modern Ghanaians
•  One of the girls feels shy to say something they want to say

Hotline

• Breastfeeding woman and mother trying to make a phone call
• “Here most women don’t have phones,” said one of the women
•  Calling someone but they are not sure who. It could be a doctor or a nurse
• Pregnant woman is in labour
• Mother with child is taking her child for immunization
• "May be they are calling their husbands,” said one of the men present

Photographic approach

a.      Breast milk

 

 

• They see a breast feeding mother
•  A woman who wants to fight
• A woman waving bye
•  Didn’t see the water bottle
•  Woman with baby looks happy
•  Woman waves hand to reject a message
• Woman looks like she wants to take some water

 

 

b.      Start breast feeding baby

 

·         Mother lying down for a baby to suck

·         Why is the mother lying down while sucking? She is supposed to sit.

·         Baby is too old for a new born

·         They didn’t see/notice the nurse in the picture nor the watch

-          Mother and child sleeping

-          Child has breastfed and slept

-          Woman’s breast look heavy indicating that baby was not born long before

-          Baby appears to be troublesome and mother has to breastfeed while sleeping

-          Looks like there is a person supporting or examining mother’s breast

c.       The best protection

 ·         Kind of food to give the baby

·         2 healthy babies

·         All this food is not available here

·         "Poverty can’t let us buy this food but it’s good to know in case we get the money we can buy,” said a pregnant woman.

·         These look like Ghanaian babies

-          One baby breastfeeding and the other eating because he is older

-          Breastfeeding child is healthier that’s why the other mother is giving the baby food so he becomes like the breastfeeding one

-          Mother is feeding older child with other healthy foods

d.      Helping baby grow

 

 

·         Very nice healthy babies

·         Babies playing together

·         Babies are fat because they eat healthy foods

·         “Our babies are not as healthy because of poverty” lamented an old woman

·         “We have no time to buy these foods” said another.

·         They can see fish, eggs, black tea, groundnuts, beans, palm oil

-          Children are playing happily with their toys

-          There are different foods infront of the children

-          The children are satisfied and happy

-          It means the children are eating well

-          “It means we should give and healthy food to our children,” said one of the men.