Don’t throw out the baby with the bathwater! Traditional birth attendants as advocates for quality hospital deliveries
Increasing the rate of hospital deliveries in two of Cairo’s largest slums by engaging illegalized traditional birth attendants as the bridge between expectant mothers and the public health facilities they avoid for delivering their babies.
About You
Section 1: You
First Name
Diana
Last Name
Perez Buck
Website URL
Organization
Country
Spain, ML
Section 2: Your Organization
Organization Name
Mothers at Risk
Organization Website
Organization Phone
(32)497481379
Organization Address
23 Rue Darwin, 1050 Brussels, Belgium
Is your organization a
Non‐profit/NGO/citizen sector organization
Organization Country
Belgium
Your idea
Name Your Project
Don’t throw out the baby with the bathwater! Traditional birth attendants as advocates for quality hospital deliveries
Country and state your work focuses on
Egypt
Describe Your Idea
Increasing the rate of hospital deliveries in two of Cairo’s largest slums by engaging illegalized traditional birth attendants as the bridge between expectant mothers and the public health facilities they avoid for delivering their babies.
Website URL
Innovation
What makes your idea unique?
We are swimming against the current of consensus in the maternal health community. Worldwide, the trend for governments and international organizations is to shun traditional birth attendants (TBAs), since the decades-long focus on them has not delivered desired results in the fight against maternal mortality. They have become persona non grata everywhere – banned, illegalized, ousted from safe motherhood concepts and programs, the focus now on ensuring skilled care and institutional deliveries. Our innovation is to suggest the counterintuitive idea that these ‘troublemakers’ can in fact become ‘changemakers’; they can go from being the break in the link between women and the health system, to serving as a bridge to it; from being considered irrelevant to becoming patient advocates to be reckoned with.
Do you have a patent for this idea?
No
Impact
This Entry is about (Issues)
What impact have you had?
We have had the very first level of impact, which is to start to give a voice – albeit still barely a whisper – to women in the urban slums. Pregnant women in the slums of Cairo are making a conscious, informed choice to deliver with illiterate, untrained, illegal, traditional birth attendants (with inherent risks to mother and baby) and to forego available, affordable, accessible health centers with skilled personnel. We have found that nobody was asking ‘why?’, so we did. And just asking that question to hundreds of mothers with a survey had the impact of allowing mother after mother to stand up and speak. And the answer was: ‘Because we deserve respect. And delivery rooms have good doctors and machines, but respect is nowhere to be found’.
Problem
The underutilization of institutional deliveries and life-saving obstetric interventions by women from the slums. The enduring involvement of illiterate, untrained, illegalized traditional birth attendants in deliveries. The lack of a culture of respect for all patients, regardless of gender and socioeconomic status in the public health system.
Actions
We are quietly sharing the results of our survey, one key interlocutor at a time, and gaining the support and endorsement of local health officials, medical doctors and academics for the idea.
Results
Having developed a solid network of key institutional and intellectual supporters who can help steady the disruptive introduction of the idea in practice.
What will it take for your project to be successful over the next three years? Please address each year separately, if possible.
Year One: Is all about understanding the incentives and expectations of our three constituencies: mothers, traditional birth attendants and public health agents. Only if we understand those fully can we pinpoint precisely where interests converge. Year one is also about articulating the key messages effectively: To the health authorities: the importance of such an innovation as key to accelerating Egypt’s progress towards Millennium Development Goal 5. To the TBAs: the value of continuing to serve their communities with an officially-sanctioned recognition. To the mothers, the importance of hospital deliveries to protect mother and baby, and their right to be informed, proactive patients .
Year Two: is about developing consensus on new strategies and curricula for the three constituencies. (1) A curriculum for dayas’ new role as community health promoters and advocates for institutional deliveries, including a new incentive system to encourage them to channel their ‘clients’ and ‘business’ to the formal health system. (2) A strategy and training workshops schedule to enhance the quality of patient care in hospital delivery wards.(3) An awareness-raising community-outreach curriculum for mothers to become informed patients.
Year Three: is about implementing the aforementioned strategies and curricula, and ultimately starting to ‘walk the talk’, and start testing our main success indicators: an increase in the rate of hospital deliveries and a decrease in homebirths attended by traditional birth attendants, as well as an improvement in the quality of patient care in hospital deliveries.
What would prevent your project from being a success?
Abject rejection, resistance to change by any of the three constituencies – mothers, TBAs, health personnel.
How many people will your project serve annually?
101‐1000
What is the average monthly household income in your target community, in US Dollars?
$50 - 100
Does your project seek to have an impact on public policy?
Yes
Sustainability
What stage is your project in?
Idea phase
In what country?
Egypt, XX
Is your initiative connected to an established organization?
Yes
If yes, provide organization name.
Mothers at Risk
How long has this organization been operating?
1‐5 years
Does your organization have a Board of Directors or an Advisory Board?
Yes
Does your organization have any non-monetary partnerships with NGOs?
Yes
Does your organization have any non-monetary partnerships with businesses?
No
Does your organization have any non-monetary partnerships with government?
No
Please tell us more about how these partnerships are critical to the success of your innovation.
The two slums we start with are but a fraction of the total slum population of Cairo. The conditions and dynamics that motivate our project are comparable in all other slum areas, affecting millions of people. Our existing partnership with the Association for Development and Enhancement of Women, recognized as an established and reliable actor in the slums, and the institutional and academic partnerships we are building will provide a solid and permanent framework on which to scale up these efforts beyond the two first slum areas.
What are the three most important actions needed to grow your initiative or organization?
Shifting from a fully volunteer-based, no overhead initiative to an organization with some paid staff and a minimal operations budget.
The Story
What was the defining moment that led you to this innovation?
Discovering Changemakers and this competition 5 hours before the deadline! As I read through what Changemakers is about, and reviewed the competition guidelines I realized..... we have an innovation! What we are thinking is not just an idea we believe in, it is a completely novel idea, it is something no one else is doing, something no one else has thought about. So that was the defining moment in which I realized we have an 'innovative' idea. The idea itself came as I sat in a crowded house in the slums hearing woman after woman tell of abuse and neglect in hospital deliveries, of the way they are slapped, yelled at and humiliated, and they compared this to the supportive, affectionate, personable care of TBAs. And I sat there thinking, I think in this tiny room surrounded by garbage dumps, I am on to something – I think here is one answer here to the elusive improvement in maternal health.
Tell us about the social innovator behind this idea.
DIANA PEREZ-BUCK has Spanish and US nationalities. She was born and raised in Southern Spain - in the beautiful cities of Granada and Sevilla and in the sherry-making Jerez de la Frontera. Her American family, on her mother's side, hails from West Virginia, where Diana attended Bethany College, a tiny liberal arts college in the foothills of the Appalachian mountains. She moved with her mother to Los Angeles where she earned a Master's Degree in journalism at Pepperdine University in Malibu, while she interned at CNN, taught Freshman Spanish and wrote a thesis on the role of Spanish language in civic education of Hispanic communities. She accepted a Fulbright Journalism grant for Germany, where she worked at the Deutsche Welle radio, the German Public Diplomacy. She joined the United Nations headquarters in Bonn, working for the United Nations Volunteers Program for six years, as external relations adviser and then as liaison officer at the UN office in Brussels. She served briefly as adviser for the US non-profit Vital Voices in a capacity-building program for Afghan women parliamentarians. After the birth fo her children Diana founded and is the President of Mothers at Risk, a non-profit organization devoted to supporting pregnant women and mothers with small children in situations of extreme vulnerability. www.mothersatrisk.org. She is a Member of the Board of the 40-year old Brussels-based shelter for disadvantaged mothers ‘Chevrefeuille’. She has lived in Brussels for eleven years and has two children, aged 4 and 7.
How did you first hear about Changemakers?
Newsletter from Changemakers
If through another, please provide the name of the organization or company
50 words or fewer
 | 86 weeks agoDiana Perez Buck updated this Competition Entry. |
| 86 weeks agoDiana Perez Buck submitted this idea. |
