Mozambique: The challenge of safe pregnancy and childbirth in Cabo Delgado

Atija Bacar is 66 years old and lives in Eduardo Mondlane, a camp for people who are internally displaced in Mueda, in Cabo Delgado, Mozambique. She is originally from Mocímboa da Praia, a town heavily hit by attacks in the ongoing conflict in the northern province. Atija works with Médecins Sans Frontières (MSF) as a traditional birth attendant, pregnancy and childbirth care providers living in the community, and assists more than 100 women in the camp. Like many of them, she lived through traumatic experiences, witnessing her husband’s and son’s murders. Now, she says she loves doing her job since she can help women in their time of need – “When I arrived here, this place was a forest. Some good people helped me to get settled. Now I can also help pregnant women. I know they need my support.”

In Cabo Delgado, hundreds of thousands of people have fled their homes in search for safety due to an ongoing conflict. Eduardo Mondlane camp is home to more than 2,000 displaced families. Women and children are amongst the most vulnerable and face multiple challenges. Many of them have walked long distances and left their families behind and many were separated from their loved ones or witnessed their death due to murder or poor living conditions and lack of medical care. As well, a lot of pregnant women are still very young and have little to no information on how to lead a healthy pregnancy and the needs and dangers of childbirth.

Since October 2021, the MSF health promotion team in Mueda has partnered with community leaders and traditional birth attendants in Eduardo Mondlane camp, in order to support pregnant women and young children. One of their main goals is to have more women going to the hospital when in labour so they can be supported in having a clean and safe birth. In order to achieve that, Atija and other birth attendants organize regular talks with pregnant women to pass on health promotion messages, practical logistical information and let them know about MSF’s transportation services to the hospital -- A “chopela”, small motorised 3-wheeled vehicle, is available, on call, at all times. They also conduct regular follow-up visits with women before and after childbirth.

MSF’s community work with the traditional birth attendants in Eduardo Mondlane is ongoing, but the team is already thrilled with the positive results the initiative is seeing for women and families. In January 2022, 33 per cent of the pregnant women from Eduardo Mondlane camp delivered their babies at a medical facility. In April 2022, that number reached 75 Per cent. This is a significant increase that is without a doubt due to the work of birth attendants including Atija and the permanent availability of transportation at the camps to refer women to the hospital.