This is just to remind the Facilitators that once the Groups are formed, the next meetings are to do with helping the women to identify why women and children die ...
... and then looking for the roots of these problems.
(as described in the manuals, which can be found here: http://yellowchuckchucks.blogspot.co.uk/)
Later, the Facilitators will be leading the hamlets in a process where the people decide which of these roots they want to tackle, (with our help).
But meanwhile, you Facilitators need to be really familiar with the causes of deaths, and their roots.
The picture cards you already have will help a lot.
But just so that you have something at your finger tips, please save these lists below onto your Notepad, so that you can check them whenever needed.
Alex - can you kindly make sure that this message also gets through to Noadia?
Can you please check their knowledge and understanding of it?
It would be great if each Facilitator had this list in Kiswahili on their Notepad.
Wilbard and Alex: please feel free to add to the list, or modify it.
Please let me have any updated version for the records.
Asante sana!
Best wishes
Laurence
Causes and Roots of Maternal and Child Mortality in Tanzania
Main causes of mothers dying
Four causes account for three quarters of deaths:
- Haemorrhage
- Obstructed labour
- Eclampsia (very high blood pressure leading to seizures)
- Infection after childbirth, abortion or miscarriage
Roots of these problems
- Pre-existing weak mother – eg anaemia from malaria
- Not getting iron if anaemic
- Women at risk from bleeding – eg twins and those who have had many children – delivering at home
- Poor TBA training – don’t know what to do with bleeding or with difficult labour.
- Poor TBA hygiene, and no clean birth facilities.
- Poor transport and roads
- Poverty – can’t afford hospital so leave it late
- Never having BP checked, especially those at risk such as young women in their 1st pregnancy, and older women in their 5th or more.
- Use of traditional medicines which rupture the uterus, or make the BP rise.
- No access to emergency obs care.
- Women fearing hospital and clinic.
- Not being able to afford the time and/or money of being in the waiting mothers’ house
- Having too many children
- Getting a uterine infection (eg postpartum or after miscarriage), and not seeking help
Main causes of babies and children dying:
Neonatal deaths (ie within the first month) account for nearly half of under-5s deaths:
- Prematurity
- Birth hypoxia and/or hypothermia
- Sepsis
- Congenital abnormalities
- Pneumonia
After the first month, up to the age of 5, the main causes of death of children are:
- Malnutrition, making the child more susceptible to the causes below
- Pneumonia
- Diarrhoea
- Malaria, measles, HIV and other communicable diseases
- Injuries and burns
- Congenital anomalies
Roots of these problems
- Not knowing how to deliver and dry a baby
- Not knowing how to keep it warm, and/or not having the clothing
- Poor antisepsis
- Not breast feeding long enough
- Not getting HIV check and treatment if the baby is positive
- Inadequate access to proteins, micronutrients, and other good nutrition
- Not knowing that the child is malnourished (no growth charts)
- Not knowing what food is best
- Not being able to afford enough food or food supplements (esp Vit A to reduce death from measles)
- Too many children in the family sharing limited resources
- Not taking malaria precautions eg nets; and not dealing with places where mosquitoes breed
- Not being immunised
- No clean water for drinking or washing hands
- Poor toilet facilities
- No hand-washing after bowels opened
- Sleeping in a hut with smoke
- Falling in fires
- Not knowing about germs causing diarrhoea, and so doing things that cause it
- Not knowing how to do oral rehydration when the child has diarrhoea
- Poor availability of health facilities with a sick child
- Especially, no access to treatment (eg when the child has malaria, pneumonia, measles with secondary pneumonia, or meningitis)
- Poor transport health facilities with a sick child
- Not being able to afford health facilities with a sick child
