Pregnancy and childbirth pose major risks of disability or death for millions of women in the developing world who lack access to basic health care. Each year in Rwanda and Malawi, for example, one woman out of every 200 who delivers a baby will die in pregnancy or childbirth, compared to one out of 3,600 in the United States.
Family planning is one proven method for safeguarding women’s health. Women familiar with contraception are more likely to delay childbearing and have fewer children, thus reducing their risk for obstetrical complications. Yet women in poor communities all too often lack access to contraception. Clinics are too far away, fees are too high, and transportation costs are beyond their means. If contraception were available, maternal mortality in poor countries could be reduced by as much as one third.
Prenatal and obstetric care often lag as well. Each year in developing countries, just a little more than half of pregnant women receive the recommended amount of prenatal care, and a quarter of all births occur without help from a skilled birth attendant. This is true despite the fact that potentially fatal complications occur in 15 percent of births.
Mother-to-child transmission of HIV continues to be a concern in resource-poor countries. A simple and effective treatment for prevention of transmission has been available since 1994, yet 16 percent of children born to women living with HIV still become infected each year.
Partners In Health strives to address these inequalities by expanding access to women’s health services in the countries where we work. We provide access to family planning, medical care for pregnancy and childbirth, and antiretroviral treatment for pregnant women living with HIV.
In Haiti, all our clinics have a nurse trained in sex education and reproductive health counseling. Staff members have offered free condoms and contraception for more than 15 years. We have trained community health workers who specifically teach about HIV and sexually transmitted diseases, while they promote family planning and women’s health. This successful model is being replicated at our sites in Rwanda, Malawi, and Lesotho.
Meanwhile, obstetrician/gynecologists and midwives in Haiti ensure that high-quality care for pregnancy, childbirth, and related complications is always available. At Rwinkwavu Hospital in rural Rwanda, specialized nurses are trained in prenatal counseling and delivery as well as family planning. And in Lesotho, our community health workers educate and accompany pregnant women to health centers, ensuring they receive care from skilled health professionals.
For more than 20 years, we have provided antiretroviral treatment to HIV-positive pregnant women in rural Haiti. The HIV infection rate of newborns delivered at our clinics rivals the rates in developed countries. This program has since been expanded to Rwanda, Malawi, Lesotho, and Russia.