Safe Childbirth Close to Home
A mother in Senegal names her newborn after her midwife to honor the quality of care she received at community-invested health post
As Djiba Balde neared the end of her pregnancy, she grew worried. Her journey to the closest hospital, located 15 kilometers away in the city center of Kolda, was far away and her husband was often working out of town, leaving her to care for her other children alone. So when a community health post was constructed in her village of Sarre Bilaly, Dijba was so grateful to have a health facility close by.
She was so appreciative of the quality of care she experienced during her delivery that she named her baby after one of the post’s midwives.
“[The community health post] … allows women, as members of the community, to benefit from health care,” said Djiba. “It makes it easier for [us] to ensure [our] own needs are met. As we always say, without health, you can’t work. In reality, the opportunities that accessibility offers in terms of geography are so important.”
Aissatou Diarra, matron in the health center of Sarre Bilaly, examines Djiba Balde’s child, Aissatou Balde, in Kolda region, Senegal.
Jean-Baptiste Joire for USAID
USAID partnered with the Ministry of Health and Social Action of Senegal to upgrade 20 health huts into health posts in the Kolda and Tambacounda regions, and to construct new, upgraded facilities. Unlike a health hut, a health post can provide skilled health care providers during delivery, antenatal and postnatal care, long-term family planning options, vaccinations, and treatment for moderate acute malnutrition. Community collectives in Kolda then pooled funds to invest in the community’s health services, such as collecting mutual aid to help women seeking care and financing small equipment purchases.
In partnership with the Government of Senegal and USAID, the community collectives invested in health post upgrades to have buy-in to the financing of the health posts and services. This grassroots creation of a community financing system encourages sustainable investment and helps provide local ownership and leadership to strengthen the health system in the long run.
“A health post is managed by qualified staff, like a nurse or an assistant nurse or a midwife, in contrast to a health hut, which is managed by community staff, such as a community health worker or a matron,” explained Dr. Souleymane Sagna, who is currently the regional coordinator of the health post upgrades and formerly the Chief Medical Officer of the Kolda district.
Djiba Balde breastfeeds her child, Aissatou Balde, in the health center of Saree Bilaly with the matrons, Aissatou Diarra (right) and Penda Balde (left) in Kolda region, Senegal.
Jean-Baptiste Joire for USAID
The Government of Senegal supports the continued operation of the health posts through a local endowment fund. To complement this initiative, USAID invested in the health posts by providing new equipment, such as beds for delivery and monitoring tools, as well as hiring and training essential health workers. USAID also supported 10 midwives and 10 nurses with salaries for the first two years, which gave the ministry more time to budget for the providers in the public health salary system.
“Ever since the population was made aware that the health hut would be turned into a health post, they were supportive of it, despite the lack of means,” said Djiba. She said the community wanted “a health post that is well-equipped not only with materials, but also with human resources.”
Aissatou Diarra, matron in the health center of Sarre Bilaly, takes a patient’s file out and writes a prescription at her desk in the Kolda region, Senegal.
Jean-Baptiste Joire for USAID
A huge component to ensuring quality care is evaluation. In Senegal, health providers routinely gather daily impact metrics that inform community health needs. The Ministry of Health and Social Action conducts regular surveys to document and cross-check the data.
“The committee followed up with the beneficiaries and verif[ied] whether the activities planned were not only implemented on the ground, but that they are justified, too,” said Dr. Mamadou Ndour, Kolda district’s acting Chief Medical Officer.
At the Sarre Bilaly health post, this data-informed decision-making translates into quality care when moms need it most and ensures that community funding is used well.
Djiba Balde holds the health book of her child, Aissatou Balde, after a consultation at the health center of Sarre Bilaly in the Kolda region, Senegal
Jean-Baptiste Joire for USAID
“I was very well received by the midwife who advised me, guided me, and really looked after me during the rather delicate period of prenatal consultations and even during the delivery,” said Djiba. “I would like to seize this opportunity to pay a well-deserved tribute to the midwife [Aissatou] — whom I named the baby after — and to pray for the baby’s long life and good health.”
In the past five years, the 20 health posts have helped nearly 5,700 women with prenatal care, assisted with more than 1,000 births, and seen more than 2,400 postnatal consultations.
By partnering with local governments and encouraging community investment, USAID is supporting women and children in Senegal to have sustainable access to high quality health services for improved health outcomes over the course of their lives.
Djiba Balde with her child, Aissatou Balde, after a consultation outside the health center of Sarre Bilaly in the Kolda region, Senegal.
Jean-Baptiste Joire for USAID
About the Author
USAID’s Office of Maternal and Child Health and Nutrition works to ensure that all women and children have the same chance of a healthy life, regardless of where they live or are born.