“Before practicing as a midwife, I was a nurse and had some obstetrics skills. It must be said that as a nurse I was already practicing the profession of midwife since I gave birth in a health center where we were only 2. I did them regularly for 4 years. Women confide in me without embarrassment. Dialogue is easy. I have no judgment of them, and give them all the attention I can. They must feel it.

In underserved areas, the health worker should have minimal conditions to survive. The example of housing is essential. In addition, managers must be able to visit regularly to assess and motivate the teams. When I was a nurse, I practiced 103 km from the county seat. I remember a difficult time especially for the evacuations, because of the inaccessible roads. There was no ambulance either. I lived like this for 4 years, away from my family, who I visited once a month.

As for the behavior of midwives, I admit having witnessed verbal violence and agree that the reception of patients remains to be improved. The midwife is often alone when it comes to childbirth. Lack of skills, lack of confidence and mastery of actions can lead to loss of self-control and emotions. Teamwork can overcome these situations. Over the past few years, I have noticed changes in behavior, among the staff and the population. Women are attending health centers more and more, thanks to sensitization through radios and health workers and free access. I also notice a little change from husbands who accompany their wives.

Since April 2016, childbirth has been free, including the cesarean. Before, it took 900 FCFA and 11,000 FCFA for a caesarean section with the state subsidy. Free education should help reduce maternal and child deaths. In fact, attendance at health centers has become more important since the introduction of free access. But the fact remains that today we must overcome the overcrowded maternity hospitals, the lack of qualified personnel, the lack of equipment, of facilities, the lack of medicines … We need a concrete commitment from the authorities.“

©Sophie Garcia / UNICEF