Eight years later

Ntcheu, Malawi – During her first pregnancy, a local midwife haphazardly treated Linley Mwandre long after her water broke. During her second pregnancy, health care providers laughed her out of the hospital because she was too weak to give birth – forcing her to walk to a second hospital and receive an emergency C-section.

“I was a little bit scared because at that time there were a lot of maternal deaths,” Mwandre said about her first two pregnancies. Now pregnant with her third child, Mwandre has witnessed significant changes in maternal health care in her village.

About 96 percent of women in Malawi seek out health care from skilled attendants after giving birth to their first child. Because of the lack of prenatal care in first pregnancies, more than 12 percent of these births result in neonatal deaths.

In 2012, CARE implemented the Community Score Card process to bring health workers and community members together to identify barriers to maternal health and jointly identify solutions. The score card identified issues like access to and appropriate provision of health care.

Based off of community members and health care providers scores, Mwandre’s health clinic, the Champiti Health Center, has improved by 24 percent in the reception of clients. Meanwhile, the availability and accessibility of health care has increased by 10 percent.

“Nowadays the maternal deaths have been minimized,” Mwandre said. This decrease in maternal deaths can be credited to some of the indicators revealed in the score card.

So far, Mwandre’s third pregnancy has been a polar opposite from the first two. Each month she attends checkups at the local clinic. Health care providers have helped her through every step of the process, ensuring that this birth will be easier than the past two.

“CARE International has helped a lot of mothers to have a good child spacing,” she said.

Mwandre and her husband decided to get pregnant with their third child at the five-year mark because of the contraceptive and education program. Extending spacing between children from 1-2 years to 3-4 years lowers the death rate by 5 percent.

Mwandre was also tested in the second month of her third pregnancy for HIV. Though she was HIV negative, fetuses with an HIV-positive mother have a 15 percent chance of contracting the disease. If treated within the first trimester, the chance of infection decreases to 5 percent.

Nine months pregnant, Mwandre is nearly due.

Even though I went through a very painful experience (in past deliveries), I am still looking forward to my new baby,” she said. “I try not to think about the negative experience and concentrate on the positive side.”