HealthMaternal Healthcare

HOW COVID-19 IS AFFECTING PREGNANT WOMEN AND THEIR CHOICE FOR DELIVERY OPTIONS IN KISMAYO.

Seynab attends her last ANC visit at Iskufilan MCH in Kismayo. SAF-UK midwife. Ardo Abdullahi is in charge of her case

28 May 2020– Seynab Abdulahi is preparing herself to welcome her third child. She is nine months pregnant and is anxious about bringing her child into a world ravaged by the COVID 19 pandemic and the rumors that she can transmit this deadly disease to her child during delivery.

This was her last ANC visit and she trudged slowly under the scorching sun to get to the SAF-UK health centre in Iskufilan village in Kismayo town. Seynab is one of the few pregnant women who, against the misconceptions and rumors on COVID 19 and advice on restriction of movement, has consistently sought routine services from the health facility.

SAF-UK midwife Ardo Abdullahi waits for Seynab to arrive.

SAF-UK midwife Ardo Abdullahi welcomed her warmly into the ANC/PNC designated room. She was careful to adhere to social distancing measures and she had her mask on. Unfortunately, Seynab was not wearing one since she could not afford to buy one.

For Seynab, who lives with her husband and two daughters in Iskufilan, a village in Fanole zone of Kismayo town, life has grown increasingly difficult as the COVID -19 pandemic restrictions drag on with severe economic effects. Being a Somali Bantu, a marginalized community, access to jobs in the town for her husband is even more challenging as opportunities fade due to government restrictions aimed at containing the virus.

Seynab has decided to have a home delivery to avoid infection at the health centre. She insists that’s her husband decision, otherwise she will have to opt for traditional birth which is not her personal preference. Ardo Abdullahi, the midwife in charge of her case, has been preparing her psychologically and ensuring that she has all the materials needed for a successful home delivery. She also encouraged Seynab to dismiss the rumors that she can transmit COVID-19 to her baby through physical closeness and breastfeeding. Thanks to the training given to health workers, Ardo is well equipped with the facts on the disease.

As Seynab headed home to prepare supper for her family, she was thankful for the advice and encouraging words from Ardo, who also gave her personal number to call  when labor pains begin.

There is however a cloud of anxiety that has enveloped the close knit community in  Iskufilan with a lot of rumors relating to COVID 19 and use of health facilities and services. Thanks to Seynab’s coming, Ardo the midwife and SAF UK, got to know of misconceptions on COVID 19 in Iskufilan village and are now planning the next community mobilization exercise with this issue in mind.

Somalia has one of the world’s most fragile health care systems burdened by millions of internally displaced people and a bureaucracy still recovering from state collapse and civil war. In the face of the COVID-19 pandemic, Somalia is facing a challenge to provide basic health services for vulnerable communities, especially women and children, with challenges on building strong capacity with timely consistent supply of all enabling factors for COVID 19 infection prevention and control at health facilities.

Beneficiaries desiring to use health facilities are either ignorant, careless or cannot afford basic PPE like masks increasing exposure to and infection of COVID-19.This can discourage use of health services causing a disruption in routine health services, such as ANC, PNC, delivery, immunizations, causing a rise in other common childhood illness and preventable deaths.

There is urgent need to provide health workers and also beneficiaries seeking critical services like delivery with sustainable source of necessary PPE. There is also need to invest in community mobilization for use of health services during this pandemic and strengthen that with community health education to demystify COVID 19 and assure the community, especially the most vulnerable like pregnant women, that it is still safe to seek lifesaving services like delivery from health facilities during this time. With support and commitment from UNICEF, SAF UK has set forth for this cause.