 The Village Health Partnership (VHP) is dedicated to building a healthcare system in southwestern Ethiopia that ensures pregnant women have access to skilled assistance and emergency care during childbirth. Our goal is to prevent maternal and neonatal deaths and related complications. To achieve this, VHP has worked extensively to strengthen 10 health facilities by improving year-round access to water, solar power, sanitation and medical waste disposal. We have also implemented infrastructure for maternal health (including the construction of maternity waiting areas) and have worked to provide essential equipment and supplies. We have focused on training staff in infection prevention and equipping nurse midwives with critical skills for safe deliveries and newborn resuscitation. As this enhanced health system takes shape, it is crucial to ensure that pregnant women can actually access this clean, safe, and effective care. Therefore, in October 2024, VHP conducted grassroots field research to understand the real-world barriers women face in seeking, reaching, and receiving the maternal healthcare they need. We also gathered perspectives from the medical providers delivering this care. Our findings reveal significant challenges. Many women are influenced by traditional home birthing practices, lack awareness of available medical services and their benefits, or face constraints due to childcare and subsistence farming responsibilities. Securing approval from husbands or fathers can also be a factor. Furthermore, long distances, lack of safe or affordable transportation, and security concerns hinder women from reaching facilities. Once there, challenges such as high turnover among nurse midwives, their potential inexperience, and inadequate conditions in maternity waiting areas (like lack of food or comfortable sleeping arrangements) can impact the care received. From the providers’ perspective, nurse midwives often work long hours on the front lines, sometimes without pay or adequate support. A lack of knowledge, essential equipment, and supplies can be demoralizing. Despite these hurdles, we were encouraged to find that pregnant women are utilizing the available care. VHP remains committed to working with local government, community leaders, women and medical providers. Our ongoing efforts will focus on raising awareness in villages, addressing transportation issues, improving maternity waiting areas, ensuring access to birth control and antenatal care, and continuing to support, train, and equip nurse midwives while strengthening referral systems. |
