Mekelle is the Capital of the Tigray Region. Tigray is situated in the Northern part of Ethiopia with a population of 4,500,000 and an average fertility rate is 4.5. Antenatal care follow up and facility delivery is very low within the Tigray region and the majority of mothers deliver in their homes by traditional birth attendants (TBA) and elder women, where mothers are predisposed to severe maternal and neonatal complications including postpartum hemorrhage, fistula, sepsis and death.
There is limited education and awareness about obstetric fistula and its causes, therefore, fistula is perceived by some community members as an evil spirit illness, not as a childbirth injury, and the victims are ashamed, hopeless, voiceless and socially outcasts. Even after a fistula women learns about the Mekelle Fistula Hospital and receives treatment, she returns to the same environment and often a repeated case of fistula occurs. Fistula women are traumatized by being ostracized by their communities and need counseling and support reintegrating back into their communities.
The Healing Hands of Joy/Safe Motherhood Ambassador Training program aims to directly impact communities by promoting institutional delivery to prevent new cases of fistula and reduce maternal and neonatal deaths. As each Safe Motherhood Ambassador serves her community, she will improve the health of hundreds of women and their children by education by bringing knowledge and experience about maternal & child healthcare and causes of obstetric fistula.
Safe Motherhood Ambassador Training Center:
At the HHOJ Mekelle Center we provide boarding in a calm, clean environment well-supervised and monitored to encourage friendships, self-confidence and support. We survey each incoming fistula survivor and provide counseling based on their need to assist in reintegration.
We have created a curriculum in conjunction with the Tigray Health Bureau to train former fistula patients with basic maternal health communication skills including; reproductive health, hygiene, sanitation, safe delivery practices, antenatal care and fistula education and prevention. In some cases literacy training will be provided in order to adequately spread the message of safe delivery to women in their villages.
After Safe Motherhood Ambassadors graduate, we conduct community trainings of Health Extension Workers, Midwives and Women’s Association Members on Safe Motherhood Activities (including SMA responsibility), Fistula Prevention & identification to properly monitor reintegration and implement program activities.
Mekelle Center, Ethiopia