“It was three days of pain.” A young bride, Teresa Manuel was 16 when she delivered her first baby. “I gave birth at home. My mother was there…and some neighbors.” Teresa makes no mention of a nurse or doctor, because there wasn’t one.
She wants you to see her home, where it happened. Down a hot, sandy street in Naihava, a predominately Muslim village in rural Nampula, Mozambique, you pass a cashew tree and children playing shoeless in its shade. A woman prepares food for her family. With a baby on her back, she raises a large wooden pole—a 4-foot hand-carved pestle—then slams it down into a mortar, grinding rice flour.
“They used that pole during my delivery,” Teresa says. “They pushed it down on my stomach for three days…to push the baby out.”
“This is what happens when you give birth in our community,” says Teresa’s neighbor Rosalina remembering when she was 19, in labor at her grandmother’s home. “They took a piece of cloth and put it in my anus…and put a traditional medicine—some ground up leaves—in my vagina…For four days, they pushed the wooden pestle down on my stomach.”
Like Teresa, Rosalina’s delivery lasted for days. She struggled to recover. “I was lying in bed for a month,” she says. “I was never taken to the hospital…not once. My mother didn’t know the good of the health facility.”
No woman should have to go through this. But if her community expects early and frequent childbearing, and she doesn’t have access to quality health care, what choice does she have? How can women like Teresa and Rosalina pull their families out of poverty and keep their children healthy and fed, when each new pregnancy could kill them?
There’s a better way
For nearly 60 years, Pathfinder has improved sexual and reproductive health around the globe by partnering with communities most in need. We ensure they have the knowledge, skills, and tools they need to break through barriers, forging their own path to a brighter future.
“If you want to create meaningful, lasting change, you absolutely have to partner with communities,” says Rita Badiani, Country Representative, Pathfinder Mozambique. “You cannot change long-held beliefs about childbearing or break harmful myths about contraception working alone. Communities have to lead the charge. It’s the only way.” She smiles. “It’s also the Pathfinder way.”
In 2009, Pathfinder joined the government of Mozambique to launch one of our largest projects, Strengthening Communities through Integrated Programming (SCIP), supported by USAID. Over the last five years, we have reached over four million Mozambicans with sexual and reproductive health services.
“The best thing the project did was to involve community leaders,” says João Abílio Mutato, Vice President of Naihava’s Community Leadership Council.
Groups like João’s, composed of local religious leaders, farmers, teachers, and other influential individuals, have the power to create real change in their communities; they simply need support.
“When the project approached us,” says João, “I listened because I realized all their advice was good.” He had seen suffering in his community. “I saw women giving birth at home, women dying…malnutrition…couples having one baby after another…So all of us in the council discussed how we wanted to improve our community. Change started from here.”
Change starts with Rosa Manuel, a local outreach worker or “Animadora” trained by Pathfinder, who leads a women’s group for Teresa, Rosalina, and their friends, so they have knowledge about contraception, delivering at the facility, nutrition, and hygiene.
Change starts with Tina da Conceição Bandeira, a traditional birth attendant trained by Pathfinder, who ushers women to the facility for their prenatal care and safe delivery instead of having their babies at home using traditional medicine.
Change starts with Luisa Combi, a maternal and child nurse trained by Pathfinder, who provides safe, respectful sexual and reproductive health care in the health facility, saving lives.
All of us working together are making a difference
“I heard about the benefits of the health facility…through my group meetings and from my traditional birth attendant, Tina,” says Teresa, as her two young sons play beside her.
Rosalina lifts her youngest, 5-month-old Miro, onto her lap. “All these people—Rosa, Tina, our leaders—they taught us the best way of having a good pregnancy and healthy children.”
It’s been five years since Teresa and Rosalina delivered their babies at home. Thanks to your support and their community’s commitment to real, meaningful change, they will never be forced to suffer that way again. Armed with information and choices, the women of Naihava are starting a new tradition.
“Now, we deliver our babies at the health facility,” says Teresa.
“At the hospital, where I had my second and third babies…I didn’t suffer,” Rosalina says. “My husband and I were even told how to prevent HIV…how to feed our children. I got a mosquito net. While I was recovering after my delivery, the nurse actually gave me some tea!” A smile stretches across Rosalina’s face. “They took good care of me.”
“It’s really worth it to go to the hospital,” Teresa agrees strongly. “And to use family planning.”
Both women now plan their pregnancies. “At the health center, you get all the options,” Rosalina says. “If you want, you can choose pills, an injection, an implant, an IUD…It’s your choice.”
At 21, Teresa wants to have one more child and hopes for a girl. “I’ve learned family planning doesn’t mean you have to stop having children. I can rest for two years before I get pregnant again. I can wait until my youngest grows up a little.”
This is what progress looks like. In communities served by the project:
- The number of women choosing to give birth at the health facility with a skilled provider has increased from 63 to 75 percent in just five years.
- The number of women using a modern method of contraception has nearly tripled, from 7 to 18 percent. More women than ever are taking control of their health, and their futures.
“Today, I am happy because of what I have learned,” says Rosalina. “I want others to feel the same way. That’s why I follow all this advice…to be an example.”
“I just want my children to grow safe and healthy,” Teresa says. “Now they will.”