| In settings where maternal mortality
is highest, the "universal barriers" of cost,
distance and transport reduce skilled careseeking. Activities
to improve birth preparedness and complication readiness
at household and community levels have been a standard
component of programs to improve maternal survival. A
decade of program experience with community mobilization
activities, mainly community education, transport and
financing schemes have been effective in strengthening
links between women who need skilled care and facilities
and health workers who can provide it.
Some safe motherhood programs have included the use
of birth preparedness cards as one method of increasing
timely use of skilled care. The birth preparedness cards
to help women and families plan for safer births. They
include basic information on danger signs, guidance
on choosing a birth location and attendant, arrangements
for supplies, transport, fees and finding a chaperone
and blood donor in case of emergency.
CHANGE recommends adding several essential elements:
- Basic information on newborn danger signs;
- Choosing a source of routine and skilled early postpartum
care for both mother and newborn, and making advance
arrangements with that care source;
- Obtaining an HIV test for woman and partner as early
in pregnancy as possible, to determine need for PMTCT
interventions during pregnancy, birth and postpartum;
and
- Arranging medical and social support if HIV test
is positive.
CHANGE partnered with the Population
Council in Kenya to adapt and field test birth preparedness
cards, users guides and recordkeeping forms.
Summary: A Community-Developed
Birth Preparedness Intervention in Western Kenya
Tools
>> Maternal Survival Toolkit
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