The story you are about to read is part of an ongoing series about Texas Children’s efforts to care for women and children around the globe. The series highlights Texas Children’s efforts in Malawi, one of the 17 countries we currently serve. Today’s story focuses on the importance of well-trained midwives in Malawi, a county where many babies are born but not enough OB-GYNs are employed.
In Malawi where close to a million babies are born each year, there are only a handful of OB-GYNs to support the midwives and clinical officers who are largely responsible for the care and safe delivery of babies nationwide.
Such is the case at Area 25 Health Center in Lilongwe, the country’s capital, where a unique private-partnership between Texas Children’s, Baylor College of Medicine Children’s Foundation-Malawi and the Ministry of Health of Malawi has made great inroads.
Part of Area 25 Health Center’s success is its midwifery training program led by Rachael MacLeod, a highly skilled midwife from England who has spent many years in Malawi sharing her skills. Hired in March 2019 to oversee the program at Area 25 Health Center, MacLeod is a hands-on mentor who works alongside the midwives she is training. She is also leading an in-depth educational program based on the International Day of the Midwife topic ‘Midwives: Defenders of Womens’ Rights,’ which highlights the vital role that midwives play in protecting the rights of women and girls by ensuring they can exercise their full human rights, particularly their reproductive and sexual health rights in their communities and countries of practice.
“I firmly believe that the way women are treated and cared for throughout their pregnancy plays a huge part in the outcome of their labor,” MacLeod said. “If you care for a women in a centered way, it makes a difference, and that is what we are teaching and doing here at Area 25.”
MacLeod’s students come to her via Malawi’s Ministry of Health’s District Health Office. They spend anywhere from six months to a year at Area 25 Health Center learning in the classroom, the Maternity Waiting Home, on-site OB-GYN Clinic, and Labor and Maternity Ward.
Rose Swai, a midwife and the manager of the Labor Ward at Area 25 Health Center, has worked with MacLeod since she arrived at the Health Center and said the vast amount of knowledge and information she provides both to the existing midwives and the midwives in training is invaluable.
“Rachel is a very experienced midwife,” Swai said. “She’s also a very good teacher, one who truly wants you to understand how to care for your patients in the best possible way.”
In addition to helping train midwives, Swai said MacLeod is helping her standardize the way things are done in the Labor and Delivery Ward, which was recently upgraded to nine beds situated in private rooms, providing women a private place to give birth, and clinical workers more space to deliver the same amount of babies per year born at the Pavilion for Women.
These efforts, and the work of so many others, has caused word about the health center to travel across the region As a result, the number of babies delivered has gone up exponentially over the past few years reaching more 6,000 this year.
The focus on holistic care and the addition of a four-room operating theater is also helping reduce the number of maternal and fetal deaths in the area, Women and children are disproportionately affected by lack of access to health care services, particularly in resource limited settings. Malawian women have some of the worst odds with 675 deaths per 100,000 live births – among the highest maternal mortality ratios in the world. By contrast, the ratio for US women is 14 deaths per 100,000 live births.
To improve these odds, the Global Women’s Health program has invested a lot of time and effort into expanding the quality and quantity of services offered at Area 25 Health Center, significantly alleviating the burden of increasing demand for maternal and neonatal services at Kamuzu Central Hospital (Lilongwe’s referral hospital) and Bwaila Maternity Hospital, the largest maternity unit in the region with 17,500 plus deliveries per year.
Formed in 2012, the Global Women’s Health program is a collaboration between Texas Children’s Hospital, Baylor College of Medicine Children’s Foundation- Malawi and the Ministry of Health of Malawi. This public-private partnership leads the way in the development of transformative programs that benefit thousands of women and babies as well as scores of learners in low resource settings – including midwives.
“I believe in strong partnerships and I believe what Texas Children’s, Baylor and the Malawi government is doing here at Area 25 is working,” MacLeod said. “The majority of the women who come here leave with a healthy baby, a wealth of knowledge on how to care for that baby, and most importantly, a compassionate, caring birthing experience to look back on.”
https://www.texaschildrens.org/blog/working-lockdown
Read more about MacLeod’s experience during the pandemic in her recent blog.
For more information about Area 25 Health Center, click here. To make a donation to Texas Children’s global health efforts, click here.
