Access to safe, quality and respectful obstetric care can significantly reduce this mortality rate. Respectful obstetric care means that women are involved in decisions, their privacy is protected, they can choose social support and are free to determine the birth position.
The organization AFAD (Alliance Fraternelle Aide pour le Développement) runs a health center and a health post in the remote region of Kloto. These facilities have significantly improved healthcare in the region and contributed to the fact that maternal and infant mortality rates there are below the national average. AFAD has been raising awareness among families for years about the risks of home births and closely spaced pregnancies, which increases the use of modern family planning.
AFAD's project coordinator, an experienced doctor, has long advocated the benefits of upright birthing positions. The delivery rooms were equipped with ropes, stools, exercise balls and special birth supports, and the midwives received training on how to use these aids. The new birthing positions were quickly accepted and positively evaluated by the women.
In 2017, the Kpélé health district became aware of the offer. In the 2018-2020 project phase, 20 midwives and obstetricians from 12 health centers were trained in respectful obstetrics and alternative birthing positions. These centers received the necessary equipment to enable women to give birth respectfully with a free choice of birthing position. The program was further developed in the 2021-2023 project phase: An evidence-based argument for respectful obstetric care was created, a training manual was developed and the public was informed through awareness-raising measures. Over 70 midwives, obstetricians and teachers from the midwifery schools in Lomé and Kpalimé were trained, and all participating healthcare facilities received the necessary equipment. Discussions with pregnant women and their accompanying persons reached more than 6,000 women and 4,100 accompanying persons in 2023.
Although the Ministry of Health has not yet officially adopted the approach, AFAD has been able to win over important stakeholders and lay the foundations for broader implementation. The current project phase aims to systematically establish respectful obstetrics in the Plateaux and Maritime regions.
The direct target groups of the project are around 11,500 pregnant women in the participating districts of the Plateaux and Maritime regions, 18 health facilities, men and communities in the project region as well as the Ministry of Health and national and international health organizations, which are to be reached through advocacy measures. The aim is to anchor respectful obstetrics in the healthcare system in the long term.
Partner organisation
AFAD (Alliance Fraternelle pour le Développement)
Project phase
1.1.2024 to 31.12.2026
Media review
