Maternity waiting homes in Namibia: Hope for the future

17 March 2015

On 17th March 2015, all PARMaCM stakeholders, including the former First Lady of Namibia and the former Health Minister as well as Health Partners came together to view the first PARMaCM documentary on the importance of maternity waiting homes in Namibia.

The documentary “Maternity waiting homes in Namibia: Hope for the future” focuses on one of the core components of the programme, the importance of keeping pregnant women and young mothers safe via the construction of maternity waiting homes (MWH) in Namibia. The movie is the product of concerted efforts of the Namibian TV Production Company Quiet Storm and the three PARMaCM stakeholders, the Ministry of Health and Social Services (MoHSS), the European Union (EU) and the World Health Organization (WHO).

PARMaCM stands for “The Programme for Accelerating the Reduction of Maternal and Child Mortality” and its objective is to accelerate the achievement of MDGs 4 and 5 of reducing child mortality and improving maternal health in Namibia.

Namibia is a stable, young democracy in south-western Africa that attained independence in 1990 and characterized by its vast and beautiful landscapes. Even though Namibia is classified as a middle-income country, Namibia is among countries with insufficient progress towards achieving the Millennium Development Goals (MDGs) 4 and 5 which call for improving maternal health and the reduction of maternal mortality ratio by ¾ and Child Mortality Rate by 2/3 by 2015 from the levels in 1990.

In Namibia, 18.6% of women delivered babies outside health facilities in 2013. The reasons for women to do so are due to socio economic factors like lack of transport to go to the hospital, lack of money to pay for transport or accommodation in town. Without access to any public transport, pregnant women from rural communities must travel substantial distances, often over a hundred kilometers, to reach the health centers.

Maternity waiting homes (MWH) represent a suitable solution to strengthen the health system and respond to maternal and child health needs in the country. The homes allow pregnant women to access quality maternal and new born care by bringing them closer to health facilities thus avoiding complications during pregnancy, child birth and the postpartum period. Most importantly, prior to the construction of MWHs, pregnant women suffered when living in their own make-shift tents in which they waited in fronted of the hospital before giving birth. MWHs also provide an opportunity to educate women and men on various health topics that include Prevention of Mother to Child Transmission of HIV, to receive antenatal care and counselling, and to live in dignity while preparing for giving birth.

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What is PARMaCM?

The Programme for Accelerating the Reduction of Maternal and Child Mortality (PARMaCM), a partnership between the Ministry of Health and Social Services (MoHSS), the European Union (EU) and the World Health Organization (WHO) with a total budget of 10 million Euros was launched on the 27th of February 2013, by the First Lady of the Republic of Namibia.

PARMaCM aims to complement the programs of the MoHSS in order to accelerate the achievements of Millennium Development Goals (MDGs) 4 and 5, reduction of Child Mortality by 2/3rd and Maternal Mortality by 3/4th by 2015 from the levels in 1990. PARMaCM focus its actions in the districts of Okongo, Outapi, Engela, Opuwo, Katima Mulilo, Gobabis and Keetmanshoop. PARMaCM partners with UN Agencies, civil society, bilateral and multilateral partners to optimize its support to the MoHSS and maximize results.

Several key milestones have been reached since inauguration until 2015:

Capacity building and training of health workers is one of the cornerstones of the Programme. To date, PARMaCM has contributed towards the strengthening of the capacity of health providers through the

training of 400 Health Extension Workers from Omusati, Ohangwena, Karas and Zambezi Regions;
training of 70 health providers in Life Saving Skills; the training of 136 health providers from ten regions in Integrated Management of Newborn and Childhood Illness (IMNCI);
national training on the International Code of Marketing of Breastmilk substitutes;
training of doctors in Anesthesia, Comprehensive Emergency Obstetric and Neonatal Care (eMONC), and sonography for maternity care;
training of MoHSS officials from all the 34 health districts in Namibia on Workload Indicators of Staffing Needs; and
training on Emergency Medical Care to 14 ambulance drivers.
Furthermore, the former First Lady of the Republic of Namibia, Madame Penehupifo Pohamba and PARMaCM inaugurated the Okongo based maternity waiting home and officiated the ground breaking ceremony starting the construction of the Gobabis based waternity waiting home. These two events signified an important contribution to reducing maternal and child mortality in Namibia as maternity waiting homes are situated close to the hospital and provide a safe, healthy environment for the women to receive antenatal care and counselling, and to live in dignity while preparing for giving birth.

Another milestone reached by PARMaCM is the strengthening of Namibia’s immunization system through the provision of technical support 18 districts in seven regions to each nationwide Maternal and Child Health Week and African Vaccination Week held in Namibia since 2013.

During these weeks, PARMaCM provided routine immunization, Vitamin A supplementation, deworming medicines, iron and folic acid supplementation to pregnant women, distribution of condoms and health education on various topics. Preliminary reports indicate that 92.4% of children 6-59 months were immunized against measles, while interventions such as Vitamin A supplementation and deworming achieved a 85% coverage. PARMaCM also supplied 95 refrigerators, 680 vaccine carriers and 37 vaccine ice packs as part of the cold chain as well as 17.000 insecticide treated nets against malaria. This was rounded off by the extensive provision of technical support to the introduction of two new vaccines against pneumonia and diarrhea.

PARMaCM also addressed the transportation problems in the country and provided support to the alleviation of and improvement of access to Emergency Obstetric and Neonatal care services via the provision of 9 ambulances to the PARMaCM districts and three intermediate referral hospitals. Additionally, successful improvement of health logistics for transporting equipment, supplies, vaccines including transporting health care providers for monitoring and supervision in the regions was achieved via the provision of 6 vehicles to the PARMaCM districts.

Steps ahead

The way ahead will be paved by the construction of three more PARMaCM Maternity Waiting Homes, technical support to the introduction of Human papilloma virus (HPV) vaccination protecting women from cervical cancer, continued strengthening of the immunization system, procuring further medical equipment to PARMaCM regions, training of up to 280 nurses on eMONC, training of MoHSS officials on Health Management, supporting neonatal and death reviews in Namibia, equipping simulation rooms in National training centres, and the deployment of successfully trained Health Extension Workers in the PARMaCM regions.

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