Decreasing the mortality rate among adolescent mothers in Liberia

The first time Finda Tamba gave birth, she was 16 and was forced to give birth in the bush behind her house. She was in labor for two days and almost died. “To be honest, I was scared,” said Finda. “Two of my good friends had died when giving birth and I didn’t want that to happen to me.” More than half of Liberia’s pregnant mothers give birth without the benefit of a professionally trained health worker by their side.

According to a new UN report, pregnancy is the leading cause of death among women ages 15-19. With 42% of Liberia’s rural adolescent girls giving birth before the age of 19, one can begin to understand why this small West African country has one of the highest maternal mortality rates in the world. Having women give birth at a health facility has been shown to go a long way toward saving their lives.

Finda lives in a rural community in Liberia’s Lofa County, about a 10-hour drive from the capital, Monrovia, and a 6-hour walk away from the nearest health clinic. A JSI-implemented, USAID-funded initiative called Rebuilding Basic Health Services (RBHS) is using an approach to involve communities in solving problems related to maternal health – particularly for transporting women to health facilities when it is time for them to give birth. The approach involves organizing community meetings (and regular follow-ups) to inform residents about the country’s urgent maternal mortality problem and find solutions to it.

When one of these meetings was organized in Finda’s community, it was well attended. Participants included political leaders, traditional leaders, members of civil society organizations (including women’s groups), members of the local transport and motorcycle unions, and health workers, including trained traditional midwives. The meeting facilitators began by highlighting the high rates of maternal and newborn mortality in Liberia and sharing evidence-based practices to reduce them. Members of Finda’s community were then asked to identify realistic ways they could try to curb the problem.

The community decided they would work together to:
  • Ensure trained traditional midwives register all pregnant women in their catchment communities on a monthly basis so that they are tracked and receive the antenatal care they need.
  • Work with chiefs to propose that families pay a small amount of money to trained traditional midwives who take care of pregnant women and accompany them to health facilities to deliver their babies.
  • Build “maternity waiting homes” in towns with health facilities, where late-stage pregnant women and girls (who live far away) can stay until it is time for them to deliver their babies at a facility.
  • Work with the motorcycle and transport unions to provide transport of pregnant women to health clinics, carry messages from clinics to families and vice versa, retrieve ambulances as needed, and bring midwives from health facilities to pregnant women as needed.
As part of the approach, the facilitators from RBHS returned to Finda’s community in Lofa three months later to follow up and support their progress. What they found was encouraging:
  • Trained traditional midwives share a list of all pregnant women from each village and town with all area health clinic staff.
  • Motorcycle and transport unions have provided their contact numbers to communities for use in transport emergencies.
  • Members of the motorcycle union are passing on referral information to nearby clinics.

Learn more about JSI's work in Liberia.