Part of marking Women’s Month is celebrating South African women who work to save the lives and ensure the health of women and mothers worldwide.
For nine months, the same time as a full-term pregnancy, Fezile Kanju, 28, from Acornhoek in Mpumalanga is on assignment with Doctors Without Borders (MSF) in Pakistan where she is working to help to ensure the survival of mothers and their infants through advocacy. MSF is an international, independent, medical humanitarian organisation providing medical care to people during conflicts, crises and health emergencies in 63 countries.
Fezile’s work as advocacy manager focuses on improving maternal and child healthcare by promoting greater awareness of the risks of unregulated labour-inducing drugs and how the public accesses them.
Many pregnant women in Pakistan end up in unregulated private facilities where they are given labour-inducing drugs when this isn’t always necessary, endangering mother and child. Tighter regulatory control of labour-inducing drugs and enhanced training of mid-level healthcare workers can make a difference, Fezile explains.
A crisis of maternal and child healthcare
According to the World Health Organization, approximately 830 women die every day from preventable causes related to pregnancy and childbirth.
In Pakistan, healthcare for women and children is a particular concern: women regularly die from preventable complications during pregnancy, neonatal care is inaccessible for many and one in 10 children dies before their fifth birthday. The maternal mortality rate of 170 per 100 000 live births is among the highest in the world.
Women regularly die from preventable complications during pregnancy and neonatal care is inaccessible for many. One reason for this is that public health services are poorly resourced and only a handful of people can afford to pay for healthcare in the private sector. Another issue is that over 75% of all deliveries happen at home and skilled personnel attend to only about 20% of them.
“Lack of access to healthcare in remote rural areas are some reasons why women are left without adequate quality care. Many women are forced to use makeshift facilities closer to their homes where there are no health practitioners, which puts their own and their babies’ lives at risk,” explains Fezile. “Inadequate infrastructure and high insecurity in these areas contribute to medical professionals not committing to working where the needs are greatest.”
MSF supports provincial and district health authorities in responding to some of the country’s most urgent needs. Improving healthcare for mothers, babies and young children is one of MSF’s priorities in Pakistan.
In the Khyber Pakhtunkhwa province, Fezile is developing an advocacy strategy to help improve women’s access to safe, quality maternal and child healthcare in that province.
Fezile’s advocacy work
Part of her work and that of MSF health promoters centres on identifying and interacting with community and religious leaders, traditional birth attendants and the mother-in-laws — all of whom play influential roles in women’s experience during pregnancy.
“I’m identifying medical universities, medical professionals and other organisations working on maternal health in the area on effective ways to lobby health authorities and community actors like traditional birth attendants to encourage women not to use labour inducing drugs and to also train more birth attendants to assist women giving birth at home.”
In carrying out her work, Fezile is doing policy reviews and seeks to better understand factors influencing pregnant women to demand labour inducing drugs when visiting health facilities. Among the reasons frequently cited is that most women try to speed up labour in order to spend as little time possible in hospital in order for them to return home and care for their other children and family.
From her research and interactions Fezile understands that it’s not culture or religion that puts women’s lives at risk in Pakistan, but certain practices indicate gaps in the accessibility of quality healthcare. “Most women who resort to non-medical makeshift private practices for maternal healthcare don’t have alternative options of quality healthcare close to them. So relying on traditional birth attendants becomes an easily available option.”