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Special Reports - Public Health
Case Study 2
Maternal Health Improvement Program in The Gambia
formal agreements at the end of August stating that the
Ministry of Health and Social Welfare would be primarily
responsible for the day-to-day implementation of the
project. We also dispatched our own project manager to
the Upper River Region in September to jointly implement
the initiative.
The project is taking four core approaches to
reducing maternal and neonatal mortality rates:
•
Training seed teachers:
A group of outstanding local
midwives have been selected to receive training in
Taiwan. This will improve their midwifery skills so that
they can go on to become seed teachers themselves.
•
Expanding on-the-job training:
On returning to The
Gambia, these seed teachers will handle on-the-job
training in midwifery for health care personnel working
at all levels throughout the Upper River Region. This
will comprehensively build the professional skills of
midwives and similar personnel in the area.
•
Integrating operations with the TaiwanICDF
International Higher Education Scholarship
Program:
Each summer, a number of trainee midwives
who are studying in Taiwan as part of our scholarship
program will return to The Gambia to assist in midwifery
training courses. In addition to improving the quality
of the local courses, the training experience will also
improve the scholarship recipients’ own practical
know-how. This ensures that once they have graduated
and returned home for good, they can continue to assist
in the sustainable implementation of associated projects
in The Gambia.
•
Improving facilities and referral systems:
Facilities
will be improved at 11 basic health clinics throughout
the Upper River Region. Each clinic will be equipped
with a range of donated instruments and equipment
designed to support maternal health operations. Local
midwives will also make regularly scheduled visits to
expecting mothers for checkups, which will ensure
better antenatal coverage and the early detection of
problems. This means that treatment will be provided
sooner and allows mothers to be sent through the
referral system and receive timely and appropriate
assistance from the relevant medical unit.
Overall, we expect that this project will reduce
maternal and neonatal mortality throughout The Gambia’s
Upper River Region by improving the coverage of pre- and
post-natal health care, improving associated facilities at
basic health clinics and strengthening the quality of local
maternity services.
A mother and baby health monitoring activity is carried out at Basse Hospital
in The Gambia’s Upper River Region as part of efforts to reduce maternal and
neonatal mortality in the country.
Maternal health and child health are the foundations
of national health well-being. The UN attaches great
importance to these issues with both the fourth and fifth
MDGs targeting maternal and child health and related
issues.
The Taiwanese government has been promoting
comprehensive measures to address maternal and
child health since 1952, effectively reducing Taiwan’s
maternal mortality rate to the eighth lowest in the world.
By contrast, the maternal mortality rate in The Gambia
is nearly 40 times higher than in Taiwan. We have
therefore stepped in to share some of Taiwan’s successful
experiences and, at its request, assist the Gambian
government to improve the country’s maternal health.
After performing in-country appraisals and consulting
The Gambia’s Ministry of Health and Social Welfare, we
decided to implement this project in the Upper River
Region, which suffers from the country’s highest rates of
maternal and neonatal mortality. Although as many as 60
percent of pregnant women in the region are attended
to by a traditional birth attendant (TBA) during childbirth
and receive pre- and post-natal care, only 125 of the
226 TBAs working in the region have previously received
any kind of formal training. This is the main reason why
maternal mortality rates (mortality during a mother’s term
of pregnancy plus 42 days following the end of the term)
and neonatal mortality rates (mortality during the first
28 days of a newborn’s life) both exceed the national
average.
Four Core Approaches to Reducing Maternal and
Neonatal Mortality Rates
The project has been designed to follow the principle
of ownership. After a negotiation period, we signed
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