PROMOTING A HEALTHY FAMILY AND THE FIGHT AGAINST MATERNAL AND
NEONATAL MORTALITY IN THE NORTH WEST REGION OF CAMEROON
- An initiative of TALK PREGNANCY WITH DR NOELLA
A REPORT ON AN OUTREACH CAMPAIGN TO INCREASE AWARENESS ON THE
IMPORTANCE OF PREMARITAL SCREENING AND THE IMPORTANCE OF FAMILY
PLANNING AS A MEANS TO DECREASE UNWANTED PREGNANCIES AND
SEXUALLY TRANSMITTED INFECTION
INTRODUCTION Marriage is the fundamental building block of the society, and the cornerstone in building emotional, healthy and family relationships (1). A healthy marriage guarantees preventing the family members from the hereditary and infectious diseases; thus building a happy and stable family.
Premarital screening is defined as testing couples who are planning to get married soon for some common genetic blood disorders (e.g. sickle cell anemia and thalassemia) and infectious diseases (e.g. Hepatitis B, Hepatitis C, HIV/AIDS and sexually transmitted infections) (1). Thus, it is aimed at decreasing the spread of these diseases from one spouse to the other and even from mother to child. Sickle cell disease (SCD) is a public health priority as declared by the World Health Organization (WHO) due to its high birth prevalence. The disease is most frequently found in Sub-Saharan Africa (SSA) where approximately 15 million people out of the estimated 25 million worldwide live (2,3). Africa has high mortality rates ranging from 50 to 90% for those aged less than 5 years. Cameroon has a high carrier frequency of SCD (20- 30%) as reported by WHO in 2006 (4). It is the 6th country with the highest number of sickle cell births per year. As such, prevention through an increase rate of premarital screening is ideal.
Maternal death or maternal mortality is defined by the World Health Organization (WHO) as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes (5). Maternal mortality is unacceptably high. About 295 000 women died during and following pregnancy and childbirth in 2017 (6). According to the United Nations Population Fund (UNFPA) 2017 report, about one woman dies every two minutes and for every woman who dies, 20 or 30 encounter complications with serious or long-lasting consequences. Most of these deaths and injuries are entirely preventable. The vast majority of these deaths (94%) occurred in low-resource settings.
Women die as a result of complications during and following pregnancy and childbirth. Most of these complications develop during pregnancy (6). The major complications that account for nearly 75% of all maternal deaths are (4): · severe bleeding (mostly bleeding after childbirth) · infections (usually after childbirth) · high blood pressure during pregnancy (pre-eclampsia and eclampsia) · complications from delivery · unsafe abortion.
Unsafe abortion is a major cause of maternal death. According to WHO 2020 report, 3 out of 10 (29%) of all pregnancies and 6 out of 10 (61%) of all unintended pregnancies, ended in an induced abortion. Among these, 1 out of 3 were carried out in the least safe or dangerous conditions. And 3 out of 4 abortions that occurred in Africa and Latin America were unsafe (6). Thus, increase awareness on the importance of family planning serves as a means to decrease unwanted pregnancies and STIs with aim to decrease maternal mortality.
OBJECTIVES PREMARITAL SCREENING - Prevent the spread of some genetic disorders and some infectious diseases. - Decrease infant mortality related to diseases; - Promote awareness on a comprehensive healthy family; - Reduce financial burden on families whose children suffer; - Reduce psychological trauma which occurs in families with affected children.
UNSAFE ABORTION - Comprehensive sexuality education - Importance of family planning and the various types of planning to prevent unwanted pregnancies.
ABOUT THE ORGANIZATION
The organization is called Talk Pregnancy with Dr Noella founded by Gwanyama Noella
Ngendab Bobimwo. She is a medical doctor at the Regional Hospital Bamenda in Cameroon, an Open Dreams Scholar, a Gender Based Violence Expert and Certified trainer for Advocacy for Comprehensive Abortion Care. She is passionate about the health of mothers, children and adolescents. Her inspiration for the creation of the organization was based on her own pregnancy story. Thus, aimed to fight against mother and child deaths and improve sexual and reproductive health rights among adolescents. The organization was founded on the 31st July 2020. The organization is made up of 11 members alongside volunteers.
ACTIVITIES
PUBLICITY
A flyer was made announcing the outreach program. On topics: premarital screening and importance of family planning. This was pasted on our main social media pages and other platforms. Also, sensitization was done in some churches. There was a total of 40 participants including men and women aged 20 years and above.
SENSITIZATION
A detailed discussion was done on premarital screening, its importance and various tests required. Emphasis were made on the fact that its important to do the test at 3 months before marriage and also on the importance of getting vaccinated against the hepatitis B virus. Furthermore, the relationship between unsafe abortions and maternal mortality was hammered on. This, thus pave the path to increase access to family planning by all irrespective of their age group as such a decrease in unwanted pregnancies. Participants were encouraged to continue with the sensitization in their various communities. This in effect to increase the number of people sensitized.
DISTRIBUTION OF FLYERS AND T-SHIRTS
Flyers containing the main tests to be done during premarital screening and the importance of family planning was distributed to all participants. T-shirts were also distributed to all participants who made it to the end of the program. This will serve as a reminder of what was learned and thus continue the spread of information to many others.
CHALLENGES FACED
- Publicity not sufficient since sensitization was done mostly on social media in which
many could be from different towns and even countries.
- Lack of a website which could be a source to increase publicity;
RECOMMENDATION - More of physical publicity especially in the area where the campaign has to take place, also radio announcements and more publicity in schools and churches in order to capture a good number of people. - Create a website such that there is increase sensitization of the public.
REFERENCE 1. Ministry of Health – Kingdom of Saudi Arabia © 2021 Last Update : 30 / Sep / 2021 2. Modell B, Darlison M. Global epidemiology of haemoglobin disorders and derived. service indicators. Bull World Health Organ. 2008 Jun;86(6): 480-7. PubMed| Google Scholar. 3. Makani J, Ofori-Acquah SF, Nnodu O, Wonkam A, Ohene-Frempong K. Sickle Cell Disease: New Opportunities and Challenges in Africa. The Scientific World Journal. 2013;2013: 193252. PubMed| Google Scholar. 4. World Health Organization. Sickle Cell Disease in the African region: Current Situation and the Way Forward Report of the Regional Director. 2006. Accessed on 02 October 2016. 5. From Wikipedia, the free encyclopedia. 6. https://www.who.int/news-room/fact-sheets/detail/maternal-mortality.