By Zachary Read
With an $8-million grant from the Bill and Melinda Gates Foundation, UNC Project-Malawi will reduce maternal and neonatal morbidity and mortality in Malawi by strengthening President Joyce Banda’s Maternal Health and Safe Motherhood Initiative. The effort builds on UNC’s more than two-decade commitment to research, training, and care in the nation.
As part of the Gates Foundation grant, UNC, in collaboration with Malawian health care workers, will seek to improve safe motherhood in several ways. Due to the shortage of trained clinicians and the small number of facilities capable of treating high-risk pregnancies, UNC will construct two maternity waiting homes that will serve as models for the development of similar homes across Malawi. These homes will place high-risk women closer to medical facilities in the months before delivery.
“The problem with maternal mortality is generally that the woman doesn’t have access to proper emergency obstetric care, is unable to reach the facility in time, or once she reaches the facility, there is limited capacity to deal with the problem,” said UNC Project-Malawi doctor Jeff Wilkinson, MD, associate professor of gynecology at UNC and leader of the project. “So the idea of a maternity waiting home is that a woman who lives remote from a health care facility or is deemed to be high-risk in pregnancy will come to the home early and either await onset of labor or in some cases be scheduled for an elective Cesarean delivery, if needed.”
Wilkinson’s work in emergency obstetrics has saved hundreds of women from the devastating impacts that can result from childbirth complications, including obstetric fistula and death. UNC OB-GYN faculty member John Thorp, who two years ago helped establish the department’s presence in UNC Project-Malawi, believes that, if done properly, maternity waiting homes can play an important role in the improvement of safe motherhood in Malawi.
“If a woman is in a very rural area of Wautaga County (N.C.), she can look out her window on a beautiful day and see for 15 miles, uninterrupted by civilization,” said Thorp. “But at the same time, if she identifies the need, she can drive eight miles into Boone and get a Cesarean-section within an hour. That infrastructure does not exist in Malawi.”