ANN BAY LAVI JARET: Give Life Helping Hand
A training program for traditional birth attendants
Ann Bay Lavi Jaret, our traditional birth attendant training program, started in June, 2020, with the knowledge that many women in our community prefer to give birth at home with traditional birth attendants, or matwòn.
This is concerning for several reasons. Haiti’s maternal mortality rate remains the highest in the Western hemisphere. About one in every 80 women in Haiti will die from childbirth or pregnancy-related causes. The odds of a woman delivering her child with a skilled birth attendant in rural Haiti are low because of the mountainous terrain, poor roads and distance from a hospital or clinic.
The onset of the Covid-19 pandemic has placed pregnant women at increased risk when coming to the clinic for prenatal care and many forgo those trips for fear of infecting themselves with the virus. Additionally, the recent hurricane Laura devastated the rugged rural roads with flooding and landslides, adding another barrier to access to professional prenatal care.
In March 2020, HHP hired midwife Ruth LaFleur, who, while studying at Midwives for Haiti, learned how to build a training program for matwòn – 90 percent of whom don’t read or write. She helped design Ann Bay Lavi Jaret (ABLJ), a program that trains 18 matwòn and community health workers in three remote regions in our zone over 24 months.
Groups of 6 matwòn attend a 5-month course that meets once a week and covers the basic principles of hygiene, safe birth practices, recognition of high-risk pregnancy and much more. Community health workers of each of the 3 regions attend trainings on promoting family planning among their constituents. Ruth makes home visits with the matwòn and tracks their outcomes. So far we have completed 2 months of the first 5 month course.
The Centre de Santé Union de Grand-Gosier (CSUG) is the clinic in the mountainous region of southeast Haiti that HHP has been partnering with since 2013. Conceived of and constructed by locals with the assistance of HHP, CSUG now provides 24/7 primary care as well as programs in hypertension, cervical cancer screening, children's vaccinations, family planning, perinatal care, with a pharmacy, lab and ultrasound services.
Currently, the matwòn are present at 70% of births in our region. Matwòn are respected members of the community who women know will treat them with dignity and respect. A recent British Medical Journal Global Health article finds:
Pregnant women in rural Haiti must overcome substantial structural barriers and forfeit valued support from traditional birth attendants when they pursue facility-based childbirths. If traditional birth attendants could be involved in care alongside midwives at facilities, women may be more inclined to deliver there. While complex structural barriers remain, the inclusion of matrons at facilities may increase uptake of facility-based childbirths, and ultimately improve maternal and neonatal outcomes. (Raymondville; 2020, p, 1)
But many matwòn lack the equipment and training to identify high risk pregnancies and treat serious complications.
With a grant from Global Force for Healing, we were able to train matwòn and community health workers in Covid-19 prevention, provide personal protective equipment and distribute hygiene kits and peanut butter as a diet supplement for expectant mothers and their families. Ann Bay Lavi Jaret extends this investment beyond the life span of the pandemic, and provides a long-term contribution towards a crucial infrastructure improvement.
Following the HHP philosophy of building from the ground up, Ann Bay Lavi Jaret enhances service to the region by utilizing our community’s human resources to help give every mother and baby a healthy start.
Maxi Raymondville, Carly A Rodriguez, Aaron Richterman, Gregory Jerome, Arlene Katz, Hannah Gilbert, Gregory Anderson, Jean Paul Joseph, Molly F Franke, Louise C Ivers (August, 2020) Barriers and facilitators influencing facility-based childbirth in rural Haiti: a mixed method study with a convergent design. British Medical Journal Global Health. Retrieved October 25, 2020 from https://gh.bmj.com/content/bmjgh/5/8/e002526.full.pdf