Africa – the battle to save the lives of mothers and children is being won in the field

[21 September 2007 - 14h17]

With only 600,000 condoms distributed in 2006 for a population of 13 million, prevention of HIV infection is far from ideal in Malawi. But thanks to the efforts of a number of partners, this small country in southern Africa, to the west of Mozambique, is already well on the way to sustainable improvement in mother and child health.

“Just remember”, explains Effie Pelekamoyo, executive director of the Malawi Family Planning Association, “in 2005, only a year earlier, we distributed fewer than 200,000 condoms. And barely half that number in 2004.” This spectacular progress is the result of an extensive campaign undertaken 7 years ago with the support of the International Planned Parenthood Federation (IPPF). Around sixty volunteers are working in the field educating mainly women – though not only women – about the use of family planning.

And in this country where, according to official sources, 14% of the population is HIV positive, there is a strong emphasis on the use of condoms: by men – often at their partner’s suggestion – but also by women. Prostitutes for example – or in the politically correct language of the United Nations, “sex workers” – are increasingly asking that their clients use condoms.

As far as female condoms are concerned, their use is often seen as awkward. They are also considered noisy and “unglamorous” by men and their use is therefore progressing (too) slowly. But it’s not for want of field volunteers educating women… and often as part of surprising, but extremely effective initiatives. “Youth centres” have been set up, enabling workers to reach young Malawians on an ongoing basis at the very time when they are becoming sexually active.

These original approaches, which are mutually complementary, do not require extensive funding. In fact they rely mainly on volunteers. But they supplement the efforts undertaken by local government with the support of international agencies – such as UNICEF and the European Commission – to improve the country’s access to healthcare. Between 2003 and 2006 for example, the number of consultations regarding sexually transmitted infections (STIs) increased ten fold. And the number rose by 250% between 2005 and 2006, which shows that far from slowing down this initiative is growing.

All of which together has helped to reduce maternal mortality – a terrible scourge in Africa with over 500,000 women dying in childbirth every year. But the situation is not irremediable. As Dr Chisale Mhango, director of reproductive health programmes at the Malawi health ministry explains, maternal mortality is on the decrease. Within 6 years there has been a drop from 1,120 to 984 maternal deaths per 100,000 births. Which is still 16 per day and to which must be added the 44 newborn infants who also die daily. There is still a long way to go, but the path ahead has been laid out…

Source : from our special correspondent in Lilongwe, interviews with Effie Pelekamoyo and Dr Chisale Mhango

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