News of Senior Chief Kwataine of Ntcheu as Malawi’s model traditional leader in safe motherhood initiatives has spread far and wide. His village is a glimpse of what a solution to the safe motherhood problem may look like.
Wherever you look, residents have painted safe motherhood slogans on their walls. Kwataine’s initiative urges women to give birth in hospitals. To achieve this, he organised counsellors to advise pregnant women, launched an education campaign and had houses in his village painted with maternal health slogans.
When the increase in maternal health patients threatened to overwhelm the district hospital, he organised villagers to construct their own clinic. They moulded 700 000 bricks, sought a plan from Ministry of Health and started the construction in 2010.
President Joyce Banda intervened when the structure failed to move with the desired speed, and National Bank of Malawi supported her in 2012.
Today, the imposing structure stands at Madzanje, his headquarters where there is also a primary school. A borehole was also sunk to provide water, a critical resource during delivery.
But the structure may turn into a white elephant if electricity is not provided by Escom, who are demanding a whopping K10 million (about $25 000) to connect to the national grid.
“The only problem is electricity. It is a challenge on our part to contribute that money at village level,” said Kwataine.
Escom public relations manager Kitty Chingota justified the K10 million capital contribution.
“It is true the clinic is supposed to make a capital contribution of around K10 million. The quotation was issued, the total project for the works to be done is K13 221 953. Capital contribution payable by the customer is K10 807 117,” said Chingota.
Outlining the scope of works to be done, Chingota said, it will involve construction of 1.5km of 11 000 volts three phase overhead line, installing one (1) 50kVA, 11000/400volts transformer and constructing 300 metres of medium voltage overhead line.
The clinic is out of connecting range of 500 metres for the existing transformer, she said.
But what is more important is that Kwataine’s villages are undergoing an organisational and attitudinal transformation. Today, the villages have 48 safe motherhood committees, each comprising 10 community members who have distinct roles to promote good health among the villages’ mothers and young children.
With these safe motherhood committees, there has not been a single maternal death in the area for over three years, says Kwataine.
Family planning counsellors, for example, spread the word about modern contraception methods; growth monitors ensure small children are getting the health care they need in the first five years of life.
One role of the committee is especially innovative. It has some ‘secret mothers’, usually elderly women, who serve as liaisons between an expectant woman and the professional health workforce from the time of conception until 42 days after delivery.
These days, when a woman becomes pregnant, she is required to report her pregnancy to the local “secret mother,” who is responsible for monitoring the expectant woman’s health and ensuring that she accesses prenatal care, delivers the baby in a health facility, and receives postnatal follow-up.
Kwataine is proud of the initiative, saying secret mothers disrupt the dangerous part of the tradition—giving birth with unskilled and unequipped attendants, far from modern medical care—while preserving the value of secrecy and intergenerational bonding.
“In other words, they serve as a life-saving connective tissue between progress and tradition,” he said. “There is no simple blueprint for leading this kind of attitudinal change at a national level, but the safe motherhood committees are a savvy dissemination tool at the tribal level. They serve as safe, familiar conduits for potentially disruptive, new health information,” says Kwataine.
He has stepped up to influence other chiefs, as well, charging them with spreading the word about safer alternatives.
As chair of the Chiefs Committee for the Presidential Initiative on Safe Motherhood, he has recently stepped up discussions on maternal mortality and outlined his own system of safe motherhood committees.
Kwataine is supporting President Banda’s Safe Motherhood Initiative. The President has created a bold plan to improve maternal care nationwide.
The effort to empower chiefs to become evangelisers of modern maternity is not without complications.
On a recent visit to Luwalika Village, T/A Katuli in Mangochi, it was learnt that women who were giving birth with qualified attendants were being fined—often a goat or K3 000.
Alesi John, 42, from Luwalika believes that the fines are effective because women have now turned to skilled midwives for delivery.