Although CHWs do their best to promote facility deliveries, the system doesn’t solve every challenge a mother faces. In the case of Sumni, the CHW had registered her months earlier in the Safer Deliveries program, but Sumni’s family remained leery. And when it came time for Sumni to give birth, her family summoned a traditional birth attendant to Sumni's home. The umbilical hemorrhage wasn't noticed until after she left.
Still, the Safer Deliveries system saved lives. When Amina heard Sumni had given birth at home, she headed to Sumni’s home in Kachongwe. “I came four hours after the baby was born. I knew the danger signs, and I saw the baby was bleeding very severely from the cord,” said Amina. “I asked the mother, ‘How long has the baby been bleeding?’ ‘All night. He has lost his color, and his eyes are yellow.’”
Only one day old, Hassan was brought to the Matemwe health facility, designated as a Primary Health Care Unit Plus. As a PHCU+, the facility provides basic health facilities for adults and children; antenatal care; breastfeeding counseling; delivery; the diagnosis and treatment of HIV, malaria, and tuberculosis; and some dental care.
Amina called a driver registered with the Safer Deliveries program, who responded immediately and rushed the child to the Matemwe health facility, about five kilometers away. Matemwe is designated as a Primary Health Care Plus-level facility that is capable of providing basic health services, including delivery services, and the staff there were able to care for Sumni and her baby. "I'm very happy with Amina," said Sumni. "As you can see my baby is alive today and very happy."
So, too, are thousands of other children, thanks to D-tree, the Zanzibar Ministry of Health, and its partners. Together, they succeeded in scaling up the Safer Deliveries program in 10 of Zanzibar’s 11 districts. Working with 404 CHWs and 67 supervisors, the program served over 54,000 pregnant women, almost 43,000 of whom delivered while part of the program.
They included Sumni's neighbor Patma Mcha, who also credits Amina and the Safer Deliveries program for saving her baby, Hajra. Amina had registered Patma in the program and encouraged her to receive antenatal screenings at the closest health facility. Patma did so and was told on her last visit that her baby was in a breech position. She was advised to give birth at Kivunge Hospital—a facility about 6 kilometers in the opposite direction—because Kivunge is a higher-level facility better equipped to handle complicated births. “When Patma was in labor she called me to help find transport…because she tried to find other means of transport without succeeding,” recalled Amina. “I called the driver and he came immediately, the driver picked me on the way going to the client’s home. We picked the client immediately and she was even not able to walk.”