Community leaders in Burkina Faso leading on women’s and children’s health
In the Sahel region in northern Burkina Faso, a remote, arid area on the edge of the Sahara Desert, maternal and newborn mortality levels are substantially higher than in the rest of country. The majority of women, particularly in the Sahel’s hundreds of small, semi-nomadic villages, still give birth at home, without the help of a skilled birth attendant. Family Care International has been working in the Sahel for several years, in partnership with the UN Population Fund—UNFPA, the national Ministry of Health, and local grassroots organizations, to educate women about their maternal and reproductive health, increase use of the maternal health services that are available at the health center in the provincial capital, ensure that women with childbirth complications are able to access the emergency care that can save their lives, and arrange for surgical treatment for women living with obstetric fistula, a devastating injury that results from prolonged or obstructed labor.
Over the course of this work, it has become increasingly clear that local leaders — clergymen, traditional chiefs, elected officials — have the potential to influence women and their families to utilize available health services and avoid harmful beliefs and practices that are rooted in the religious and cultural traditions. Because these leaders play crucial roles in the promotion and preservation of traditional practices and beliefs, it will be difficult to spark meaningful change — like the abandonment of child marriages — until traditional leaders are educated and mobilized to promote the cause.
FCI has therefore focused on working with approximately 30 religious and traditional leaders in each of the four districts that make up the Sahel region. At a series of training workshops, they have learned about all aspects of maternal health care, and have come to better understand the community determinants of maternal health and the ways that encouraging uses of health services, and particularly skilled attendance at birth, could play a large role in saving women’s and babies’ lives. At the end of the workshops, leaders were asked to implement what they learned in their communities. Some time later, a feedback meeting was organized. Here are some stories that the leaders shared at that meeting:
- Bani is a rural town in the Seno province, located about 25 miles outside of Dori, the regional capital. After attending an FCI training session, the Imam of one of Bani’s mosques was committed to promoting maternal and infant health. With educational materials in hand, the Imam held awareness meetings at his mosque and in each of the town’s five neighborhoods, where he discussed the importance of prenatal care, of giving birth at the health center, of preventing obstetric fistula, and of treating fistula when it does occur. The Imam also approached Bani’s mayor to arrange for discussions with the members of the town council, brought health workers to meet with representatives of the five neighborhoods and of 16 surrounding villages, and invited the Dori “Khoolesmen” Association (a grassroots group that works in the community to improve maternal and newborn health) to lead discussions at four mosques and 21 adult literacy centers.
- Diguel is a town located about 37 miles outside of Djibo, capital of the Soum province, and almost 100 miles from Dori. After attending a training workshop in Djibo, Diguel’s Imam also led a series of community discussions, focusing on the critical importance of prenatal care and skilled birth attendance. He spoke about the importance of protecting women health at the end of Friday prayers, at the special Walima marriage ceremony, and at baptisms. During a special prayer for rain, in June 2013, the Imam shared with the worshippers in his mosque what he had learned about pregnancy danger signs, emphasizing the need for husbands and other men to be involved in health issues affecting women and children. As he spoke with the men, the Imam arranged for female community outreach workers to speak with the women in another corner of the mosque’s courtyard. He also spoke with traditional chiefs in order to engage them in these efforts, and is planning to begin visiting families un their homes and to travel into more remote surrounding villages, in order to ensure that lifesaving information gets to those harder-to-reach populations.
One day, when I returned home after a short errand, I met a suffering pregnant woman wandering the street, probably returning from the fields. She was writhing in pain and I quickly recalled the signs of danger that we were shown during the training in Djibo. I went up to the woman and asked her which family she was from. I quickly drove her back to her home and when we arrived I asked for her husband, but he was not there. I then asked if the woman had received any prenatal care; but she had not, so I urged her to go to the health center to get checked out. Our religion teaches us to always care for the well-being of others to the best of our ability. I think, with the knowledge I’ve received from the training, it would be unjust not to use it to help others.
- Imam of Diguel town, Soum province, Burkina Faso
- During May and June, 2013, the radio station of the Ahmadiyya Muslim community in Dori broadcast a program called “Health Mission,” covering topics on maternal and newborn health; the Ahmadiyya community also conducted outreach to several villages through its network of mosques.
- The Sunni Muslim community in Dori held three awareness sessions, after the afternoon prayers in the mosques, concerning women’s health, the responsibility of men in issues of maternal and infant health, and the importance of prenatal care.
- Leaders of the evangelical Christian community were also engaged in these efforts: 65 pastors from the towns of Dori, Sebba, and Gorom-Gorom attended a training meeting, after which they to shared what they had learned about maternal health with the congregants in their network of churches.
- Dori’s Catholic Mission participated as well: after the chaplain and priest received training, they conducted 25 awareness programs after Saturday and Sunday masses. They then held programs with three grassroots Christian Committees, including both women and men; two awareness meetings in the rural villages of Karo and Koumbri; and a meeting with members of the Association of Catholic Women.
These few examples show these leaders’ commitment to raising awareness in their communities about women’s and newborns’ health, and their potential influence on traditional practices that are deeply rooted in social and religious norms and customs. This commitment is durable and sustainable, and they will continue working – with FCI’s partnership – to make these efforts to encourage healthy practices bring real change in the lives and health of women in their communities.