“On average, women in labour walk 4 – 5 hours over steep hills and uneven rocky paths to reach care.
These journeys present even greater challenges at night and during the rainy season, often resulting in tragic consequences for mother and child.”
Following a request from our communities for a maternity unit at Chilaweni, AMECA commissioned a Maternity Needs Assessment for the entire region, to identify gaps in service provision, in order to ascertain the level of need for maternity services. The study enabled AMECA to make an informed decision, backed up by thorough research, on the requirement and justification for a new maternity clinic at Chilaweni.
Findings indicated that 24% of the population consists of Women of Child Bearing Age, 18% of children being below the age of 5 years and 5% children being under 1 year.Women faced difficulties in accessing obstetric services due to the distance, terrain and high cost of travel to the nearest health facility. On average, a pregnant woman walks about 4 – 5 hours to reach care, often over uneven steep hills. These journeys present severe challenges when in early labour, at night and during the rainy season, often resulting in tragic consequences for mother and child.
Architects plans were drawn up and a Memorandum of Understanding was signed with the Blantyre District Health Office. On the 9th September, 2019, construction began on the maternity unit and 2 staff duplex houses, which will provide accommodation for a further 4 staff members and their families. On the 9th October, a Foundation Stone ceremony was held at Chilaweni, to mark the commencement of the building project. Read about the ceremony at this link. One month after the start of the building, the foundations were completed.
In spite of the challenges of Covid, excellent progress was made on site and by November 2020, construction was completed. The maternity clinic comprises a 3-bed Delivery Room, a 4-bed Antenatal Ward and a 6-bed Postnatal Ward, together with an admission room, a large out-patients waiting area, examination rooms, nurses station, a sluice and a staff room.
Antenatal and family planning clinics take place during the week and postnatal consultations are arranged with mothers, following their delivery.
Two new duplex houses were constructed, providing further accommodation for four staff members and their families. One of the houses was initially used to provide accommodation for midwife mentors who were contracted by AMECA for the Maternity Mentorship Programme.
More details of the construction of the maternity clinic can be viewed at this link.
Individual patient cubicles were fitted in the delivery room in keeping with AMECA’s vision to provide safe, respectful and women-centred maternity care. The cubicles provide an atmosphere of privacy and dignity, allowing mothers in labour to move around and also allowing sufficient space to have their patient guardian or partner by their side. The maternity clinic was equipped with solar panels, ensuring that there will always be power available for the oxygen concentrators and suction machines.
In October 2020, AMECA rolled out the second phase of the maternity project comprising a 2-year mentorship programme to upgrade maternity staff skills and competance. We recognise that any facility, however well built, is only ever as good as the services it provides; an integral part of AMECA’s vision is the provision of maternity staff mentorship and training in order to implement high standards of care by well-trained staff. We are most grateful for the support for this initiative from Dr. Kawalazira, Blantyre District Health Officer and his Team.
In January 2019, with generous funding from the Addax & Oryx Foundation, the 2-year Midwife Mentorship Programme commenced at the newly built AMECA Maternity Clinic. AMECA contracted 2 experienced midwives to provide mentorship, teaching and support for clinical staff at the maternity clinic. The programme ended in December 2022 and feedback from the mothers who delivered their babies at the new maternity clinic has been hugely positive.
All mothers continue to comment on the quality of care and the excellent attention given to them by maternity staff. They love the maternity unit and felt it to be bright and clean and welcoming. Some mothers who have previously delivered at other facilities commented that it was quite a contrast to their previous experiences and that they felt respected and treated with dignity at AMECA’s maternity clinic. This is a testament to the professionalism of the midwife mentors and the maternity staff.
Over 95% of expectant mothers now receive ultrasound scanning during antenatal visits. In this photo, Isaac, a local teacher, is attending an antenatal consultation with his wife Esimea, whom, it turns out, is expecting twins. We are really encouraged to note the presence of fathers at antenatal visits, which staff are actively promoting. Early detection of twins by ultrasound scanning will result in this mother receiving the appropriate care and being referred on time to a tertiary facility as a high risk case.
British midwife Rachael Macleod was responsible for delivering a truly inspirational and unique mentorship programme, which has resulted in cohesive, confident, competent and enthusiastic midwifery staff.
Nearly one year on from the ending of the mentorship programme, standards at the maternity unit remain high and Matron Priscilla continues to maintain excellent recording systems.