OVERVIEW OF THE PROBLEM
The uptake rate of antenatal consultation in the Northwest is low, reducing
progress in attaining the target for maternal mortality. Thus, using a community
based approach will serve as a strategy to improve attendance of antenatal care.
SUMMARY
According to the United Nation, over 2 million people are internally displaced in
Cameroon and among these are pregnant women. The antenatal consultation
coverage in the Northwest stand at about 60%, that means that 40% of the women
deliver without attending any antenatal consultation. To improve ANC we need to
target this 40% missing.
Our project therefore targets the Wum Health District which had the second
highest number of maternal deaths in 2021. This will serve as a pilot phase with
future plans to scale up to other districts. So we seek to train two community
health workers, two nurses, one doctors in this hard-to-reach communities where
access to healthcare is limited due to no health facilities or with non-functional
health facilities. Then followed by a health campaign to screen 200 pregnant
women in this Health District in the Northwest region of Cameroon and thus,
identify those who have not started ANC and also refer those with high risk
pregnancy for better follow up and continuation of care.
This project will be carried out by Talk Pregnancy with Dr Noella an organization
that fights maternal and neonatal mortality in Cameroon, founded by Dr.
Gwanyama Noella in 2021.
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Aviva Women in Science Fund Project (Open Dreams) carried out by Talk Pregnancy with Dr Noella (TPWDN) 2023
BACKGROUND
Every day in 2020, approximately 800 women died from preventable causes
related to pregnancy and childbirth - meaning that a woman dies around every two
minutes. About 70% of these deaths occur in Africa (WHO 2023). The maternal
mortality ratio in Cameroon has improved from 651 in 2000 to 438 in 2020 which
is still high (World Bank). This is far from reaching the sustainable development
goal of 70 deaths per 100.000 live births.
The Northwest region is experiencing a humanitarian crisis which has led to the
displacement of many people. The situation has resulted in the collapse of essential
services and infrastructure in some of the most affected areas. People in crisis
affected regions have limited access to healthcare. As of April 2023,
approximately 18% of health facilities have been forced to close, and a
number of operational ones are struggling to function adequately (United
Nations 2023).
In 2021, the number of maternal deaths was 46 and among this, about 70-80% had
no antenatal consultation. As of 2023, the antenatal coverage in the Northwest,
stands at 60% which is low. Therefore, the pilot phase will first target one out of
20 health districts in the Northwest region which is the Wum District which had
the second highest number of maternal deaths in 2021, which is 6(13%) after
Bamenda Health District which had a total of 12 deaths. Thus, an increase in the
number of quality antenatal consultations and education of pregnant women will
go a long way to reducing the number of maternal and neonatal mortality in the
NW region of Cameroon.
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Aviva Women in Science Fund Project (Open Dreams) carried out by Talk Pregnancy with Dr Noella (TPWDN) 2023
PHASE ONE OF THE PROJECT -TRAINING OF HEALTH PERSONNEL
We trained five healthcare workers from the Wum Health District and ten
healthcare volunteers of Talk Pregnancy with Dr Noella (TPWDN) and Open
Dreams to serve as ambassadors in the fight against maternal and neonatal
mortality. These personnel included doctors, nurses, and community health
workers.
The training was done by Dr. Ambe Lionel, the Focal Person for sexual and
reproductive health in the Northwest; Dr. Ombaku Kingsley, an Obstetrician
Gynecologist at the Regional Hospital Bamenda and Mr. Azang Livingstone, the
head of the Labor room Regional Hospital Bamenda. This gave the participant
first-hand knowledge of the standards of care a woman needs during labor and
delivery, identify high-risk pregnant women to ensure early referral in case of
complications, and lastly, the role of Community health workers in the fight
against maternal and neonatal mortality.
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Aviva Women in Science Fund Project (Open Dreams) carried out by Talk Pregnancy with Dr Noella (TPWDN) 2023
All the participants received certificates as trained healthcare workers in the fight
against maternal and neonatal mortality. These ambassadors were thrilled and
ready to combat maternal mortality in their community like never before.
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Aviva Women in Science Fund Project (Open Dreams) carried out by Talk Pregnancy with Dr Noella (TPWDN) 2023
PHASE 2: CAMPAIGN IN WUM TO SCREEN 200 PREGNANT WOMEN
We screened 166 pregnant women, and out of that 79 women had not started ANC
(47.6%). That’s almost 50%. It ranged from 2 months to 9months. From this we
recorded cases of malaria with one severe form that was admitted and placed on
medications. The others were managed as outpatients. Secondly, some identified
with mild to moderated hypertension in pregnancy and were given a follow up visit
to do a control.
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Aviva Women in Science Fund Project (Open Dreams) carried out by Talk Pregnancy with Dr Noella (TPWDN) 2023
30 pregnant women benefited from free ultrasound scans. From which some
complications like breech in pregnancy was identified. A woman, who came
coming of decreased fetal kicks, was evaluated and reassured of the good fetal
wellbeing of her baby.
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Aviva Women in Science Fund Project (Open Dreams) carried out by Talk Pregnancy with Dr Noella (TPWDN) 2023
A common complication that occur during pregnancy is anemia induced by
pregnancy, Thanks to the Northwest Regional Delegation of Public Health for the
folic acid they provided. This was given to all pregnant women some for one
month and others for 2 months depending on their gestational age.
At the end, women who had not started antenatal consultations were all linked to a
community health worker and to nearby health centers in their respective locations
to ensure continuation of care.
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Aviva Women in Science Fund Project (Open Dreams) carried out by Talk Pregnancy with Dr Noella (TPWDN) 2023
CHALLENGES
1) The bad roads and fear of uncertainty reaching to an area highly affected by
conflicts.
2) Few healthcare personnel trained compared to the capacity needed during the
campaign
3) Short period of sensitization for the campaign given that it was approaching the
festive period and also had to evaluate to know how safe the road was.
RECOMMENDATIONS
1) Increase time from training to the campaign
2) Increase number personnel trained per District
3) Involve the other 19 health district to improve uptake of ANC in the whole
region.
APPRECIATION -To the founders of Open Dreams: Cristina Bernardo Kullberg, Hans Kullberg, Blaise Buma and James
Akaba through the Aviva Women in Science Fund –Community Project. - Thanks to Dr Ambe Lionel NW Focal Point person for Sexual and Reproductive Health, Dr Nsame
Denis Director Regional Hospital Bamenda, Dr. Ombaku Kingsley Obstetrician/ Gynecologist Regional
Hospital Bamenda, Mr Azang Livingstone Head of Labor Unit Regional Hospital Bamenda, Dr Elome,
District Medical Officer of Wum Health District, Dr Nkeh Edmond, Director of Wum District Hospital,
Dr Beri Bella, Doctor at Wum District Hospital, Nurses and community health workers of the Wum
District Hospital (Ayoni Elizabeth, Chifu Elizabeth, Loveline Tangang, Wani Caroline, Wandji Charles,
Rukayatu DanAsabe, Muun Berinyuy,Hadija Ibrahim). -Team leaders of Talk Pregnancy with Dr Noella ( Mr Gamnje Standly secretary TPWDN, Mr Mukoh
Walters Community Mobilizer TPWDN, Sama Nestor Project coordinator, Angyiembe Edna and
Ndanjong Christelle Coordinators of TPWDN) and all other volunteers. - Open Dream volunteers and Aviva Scholar ( Niegem Mbwame, Nji Tima, And Kelei Pauline
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Aviva Women in Science Fund Project (Open Dreams) carried out by Talk Pregnancy with Dr Noella (TPWDN) 2023 --
