GUIDAN ROUMDJI, Niger, 5 November 2008 - Lying on a bed in the maternity ward of the UNICEF-supported Guidan Roumdji Hospital in eastern Niger, Tchima Abou knew she could have died. The 27-year-old woman had given birth to her sixth child, a girl, at home when she started bleeding and slipped into unconsciousness.
Fortunately, she was taken to the district hospital on time. The doctors and nurses there managed to save her life.
"I cannot believe I am still alive," said Ms. Abou.
Lowering the risk of maternal death
In Niger, a woman's lifetime risk of dying due to complications caused by pregnancy or childbirth is one in seven. Every year, 14,000 Nigerien mothers die from pregnancy-related causes - most of which are preventable - and thousands of other women experience injuries, infections, diseases or disabilities that can cause lifelong suffering.
"It is so important for women in Niger to access antenatal care visits, because Niger has one of the highest maternal mortality ratios in the world," said the head of UNICEF Niger's maternal health programme, Marie-Claire Mutanda.
Delivering at home is deeply rooted in the country's culture and traditions. Only 17 per cent of women in Niger give birth at health facilities.
Promoting antenatal care
A few metres away, in front of the entrance to the maternity ward, women waited for antenatal care visits to start. One of them, Ramatou Souley, 33, was pregnant for the fifth time. Two of her children from previous pregnancies had died.
"I come for antenatal care visits because I want to make sure that my child and I are in good health", said Ms. Souley. In Niger, less than 50 per cent of women receive antenatal care.
"During antenatal care consultations, the danger signs that lead to complications during pregnancy, delivery or post-partum, such as hypertension, can be detected," said Ms. Mutanda. "And other complications that can occur due to malaria or anaemia can be prevented. Women also get access to HIV testing and counselling during these visits."
In 2007, UNICEF supplied about 250,000 antenatal kits to over 400 health centres, maternity wards and hospitals throughout the country.
A continuum of care
A few kilometres from Guidan Roumdji, in the village of Kabawa, traditional birth attendant Rabi Omoro, 70, is on her way to visit a young mother.
Ms. Omoro, an extremely influential woman in her village, is part of a network of 630 traditional birth attendants that were trained by UNICEF across the country to provide assistance before and during pregnancy, as well as providing guidance on essential care for newborns.
"Since I was trained four years ago, I have been working a lot with health centres located in the area," said Ms. Omoro. "I refer complicated cases to these centres as soon as I identify danger signs, such as hypertension. I have also been promoting birth spacing among women in the village, and I explain them the importance of exclusively breastfeeding their babies during the first six months."
By guaranteeing a continuum of care before, during and after delivery, UNICEF is supporting the Government of Niger in ensuring that the country is on the right path to improve the health of mothers and their children.