Improving health of pregnant mothers in South Sudan’s western region

Having appropriate health interventions and facilities helps save lives. This is true for pregnant mothers in Tambura County in South Sudan’s Western Equatoria State. Dr. Martin Nyajwok, World Vision South Sudan county coordinator for Tambura, shares the impact of World Vision and Health Pooled Fund’s efforts in improving antenatal and newborn care. 

Tambura Hospital is one of the two comprehensive emergency obstetric and newborn care centers in Lot 7, beside Ezo Hospital. The hospital is one of the 48 health facilities supported by the Health Pooled Fund (HPF). It is a referral point for all the peripheral health facilities in Tambura and Nagero Counties in Western Equatoria State. 

However, the two counties, like Ezo, depended on Yambio State Hospital for all the specialized services, including gynecological, obstetric, and surgical interventions. Referral to the Yambio hospital meant patients spent more money for upkeep while out of the counties, a resource only some families would afford. 

Despite referrals being the only option to save lives in emergencies, the service was greatly affected during the conflict and often during the rainy season due to road attacks and poor road networks. 

World Vision recruited a gynecologist and obstetric specialist for Tambura and Ezo County hospitals during quarters two and three of HPF's year four, respectively. The presence of the specialist significantly reduced referrals and their' associated costs and improved the timeliness of obstetric interventions for clients in the region. 

"By the 4th quarter, 593 pregnant women were motivated to attend antenatal care, 253 hospital deliveries, and 20 caesarian sections were conducted," shares Dr. Ezekiel.

Despite the progress recorded by the specialist, the lack of crucial equipment hindered the effectiveness and responsiveness of the healthcare workers toward the management of emergencies. One such piece of equipment was the ultrasound machine, which the project made available. 

Michelin, a 20-year-old pregnant mother of two children, having two previous scars following a caesarian section and the first beneficiary of the service, sang praise to World Vision and its partners for purchasing the equipment. Michelin narrates," I was referred to Yambio for a scan following unclear findings during my antenatal care visit to Tambura's Primary Health Care Center. However, I could not go due to a lack of funds for transport and upkeep. So I let God handle my situation."

"I did not know God would answer my prayers by bringing the machine closer to this hospital. This will surely help many vulnerable women like me to receive better treatment," she said. 

Michelin's scan showed the fetus alive, in a normal position and presentation but was a macrocosmic baby (sizable baby). Hence, she had to undergo an elective cesarean section. She delivered a baby girl that weighed 4.8 kg. She and her baby were in good health.

The machine enables easier diagnosis of uterus and ovary pelvic masses, which helps predict benign vs. malignant. Similarly, it assists in detecting miscarriage in early pregnancy, molar pregnancy, and ectopic pregnancy. Ultrasound also strengthens antenatal care follow-up by providing essential diagnostic information about a developing baby, including confirmation of the pregnancy and gestational age, checking for multiple pregnancies, congenital anomalies, problems with the placenta, monitoring fetal position and diagnosis of late pregnancy abnormalities (placenta Previa & abruption placentae).

World Vision procured the ultrasound machine with other equipment, such as a patient monitor, an operating table, and light and surgical sets, that enabled the transfer of surgical service from the cesarean section theater at the maternity wing to the main theatre. This equipment, in addition to the presence of the specialist, is expected to improve the timeliness of obstetric interventions and reduce mortality and suffering of mothers and newborns, hence, improving the quality of care.