Rural health

Safe Motherhood Burkina Faso

Connecting Deou’s 28,000 Inhabitants to Medical Care

AMURT’s activities are spread within a radius of about 50 kilometers of the Sahel region, comprising more than 35 villages and a population of over 28,000 inhabitants. The Sahel is a particularly poor and environmentally damaged region of Africa south of the Sahara that became infamous in the 1970’s when almost 200,000 people died as a result of drought and famine.

The more remote villages have nothing resembling a medical center. Most people either have to walk or ride donkey carts up to 20 hours just to reach the nearest center. These clinics are around 50 kilometers away and are poorly equipped, often lacking doctors to care for patients. This distance is especially hard on pregnant women. In addition to the normal difficulties encountered during childbirth, they rarely receive medical checkups and are exposed to heightened risk of anemia and malaria.

Deou Birth Attendants

Traditional Birth AttendantsTraditional Birth Attendants (TBAs) are women selected in each village within AMURT’s area of coverage in Deou. Their main duties are to bring the mothers to the nearest clinic for delivery, and to lead talks and encourage discussions about issues such as hygiene, family planning, the importance of prenatal care, HIV protection and screening, and the refusal of female genital mutilation. When needed, pregnant women receive iron pills, malaria medicine and general checkups. The TBAs were also trained to help women deliver when there is no possibility to access a government clinic, have become the link between the health authorities and the villages.AMURT’s coordinator in Deou visits the TBAs on a monthly basis to supervise their work, provide them with medicine and sanitation supplies, and fill out a report about their activities. One hundred kilograms of millet are given to each TBA per year as an incentive for the important role they play in their community.

One of our trainers, Madame Oubda, takes time to answer questions after her class on breastfeeding.Fanta, from Boulekessi Soum, was trained in 2005 and has established herself well in her communityComponents of the Program

  • Basic and specialized training, equipment and supplies for TBAs.
  • Literacy training TBA network
  • Food assistance for TBAs: one 100 kg sack of millet annually at the time of grain shortages.
  • Monthly follow-up and supervision for TBAs. Monitoring of instruments and refill of supplies. Data collection.
  • S.M.I. Mobile Sante Maternel Infantil: weighing and check-ups of infants and pregnant and nursing mothers, health education for women in the villages, including audio/video.
  • Mobile out-reach to the communities by health department team.
  • Donkey cart ambulance to transport emergency cases to nearest clinic.
  • Training and supervision of village health promoters.

Before the program started, virtually no women of the Bella tribe would come for pre-natal consultation or deliveries at the medical centers. With the efforts of the TBAs, these attitudes have started to change, and the Bella tribe no longer remain aloof from the health infrastructure of the country.Fostering LeadershipThe TBAs are earning much respect within their communities. Overcoming rigid cultural norms, they are now assuming positions of leadership; ones that have historically been unavailable to women in the past. The TBAs are also becoming respected advocates of maternal health. Their training has brought them to the frontline in raising awareness about concerns crucial to the welfare of women.

The Peuhl AV at Ndiawe village gets help from visiting UK midwife Suniiti Crowther to understand how to better use the instruments in her midwife kit

The AV from Bungelday gets read to practice oral resuscitation. The use of teaching aids (visuals and dolls to demonstrate/practice on) are particularly important when teaching the illiterate, who find it difficult to follow theoretical classes.

Bissiri Clinic

Located near a large lake in Bissiri Village, Bazega Province, AMURT runs a primary health clinic. It serves an area with 5,000 inhabitants, who live between 15 and 25 km from the nearest health facility. The clinic employs two nurses and offers a low cost alternative to the community. It is especially busy during the rainy season, seeing up to 250 patients per day. Most people come to receive treatment for malaria, diarrhea, and infections. As many of the diseases are preventable, the clinic also offers patients guidance on best practices related to hygiene and sanitation.


Mafi-Seva clinic Ghana

Community Health Clinic

In 2002, the communities of the Mafi-Zongo Water Project Area requested AMURT’s assistance in meeting the healthcare needs of the communities. Strengthened by the confidence gained from the water project, they felt ready to address the lack of health care in the area. In May 2003 the Mafi-Seva Community Clinic opened as a community based project, initiated by, owned by and managed solely by locals.  AMURT role is that of a partner to bring technical assistance and training and help expand and improve the services available at the clinic.  All the staffs hail from the project area. The clinic provides 24 hours primary health services and a maternity ward. In 2005 AMURT and the clinic staff started health education outreach programs in the project area. In early 2009, the clinic installed a laboratory that can test for all the most common complaints in the area, including malaria, typhoid, STD’s, anaemia, HIV, etc.   In the fall of 2009, the clinic opened a family planning clinic, giving the local population many new choices for contraception.


The staff at Mafi-Seva Community Clinic – December 2009

Community Health Education – The Kekeli Women – Village Health Promoters

Participatory video made by the Kekkeli women themselves

Since 2005,  AMURT and Mafi-Seva Community Clinic has been collaborating on health education out reach program. More than 30 communities, with the population of over 10,000 people benefit from regular health education and out reach services. The long list of issues addressed includes hygiene and sanitation, malaria prevention, child nutrition, high blood pressure, sexual health, HIV awareness, maternal health, alcohol and drug abuse, etc.  The strategy has been to train local women village as health promoters, called Kekeli Women (Kekeli means brightness). The candidates, elected by the women in their community,  join a one month training course, and work as front line health workers, concentrating on health education and consciousness raising. The Kekeli Women work in groups, often choosing to teach through drama and role play.

Kekeli Batch 2
The 2nd batch of Kekeli Women village health promoters

SAFE MOTHERHOOD – TRAINING TRADITIONAL BIRTH ATTENDANTS In rural Ghana the majority of women still prefer to give birth at home, thus the importance of the TBA’s,  Traditional Birth Attendants.  AMURT and Mafi-Seva Community Clinic provide ongoing training for more than 30 TBA’s. They are also given equipment and supplies to enable them do more hygienic deliveries.  The cooperation between the TBA’s the community clinics and the district hospital is now greatly improved to ensure greater safety for mothers and children. Since the summer of 2009, we have started an antenatal anaemia program, providing iron supplements to all pregnant women in the project area through the network of the TBA’s.

TBA meeting August 2009
AMURT has trained Traditional Birth Attendats for more than 30 communities in the Mafi-Seva Project area