Mchinji Birthing Project

Mchinji Birthing Project

Organization type: 
nonprofit/ngo/citizen sector
$50,000 - $100,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

In order to increase the number of women who deliver at the district clinic and to involve the Traditional Birth Attendants (TBAs)who are still conducting the majority of the deliveries, the Birthing Project will use the TBAs as "SisterFriends" to pregnant women with the intention of rewarding them for providing local, village centered guidance and support and referring the pregnant women to prenatal care and delivery. SisterFriends provide one on one support to pregnant and postpartum mothers. This keeps the TBA involved in their work as birth caretakers while introducing and stresing the concept of prenatal care in the village and gives the pregnant woman a local support person. The women and stakeholders in the 7 villages served by the district clinic have been meeting, making plans and now beginning to implement this project for one year. This model began successfully in Honduras but has been interrupted by the military coup.

About Project

Problem: What problem is this project trying to address?

Malawi has one of the highest infant mortality/maternal morbidity rates in the world. It also has a 95% vacancy rates for physicians, three hspitals and a shortage of trained nurses. The majority of women are delivered by TBAs because of the long distance they have to walk to get to a clinic, the time it takes for them to be away from their families when they are at sucha place and their collective sense of not being treated well by the overworked staff at the clinic. There are not enough beds and the mothers often run out of food during the 3-4 weeks they may spend there before the birth of their child. The bigger problem is that the international maternal and child health community has decided that because every woman deserves a professional birth...TBAs will no longer be allowed to deliver except in an emergency...nor will they be offered skill building education, medicine or supplies, such as gloves. Since the majority of women do not deliver at the clinics, the TBAs are the primary birth attendants without the education or materials they need to properly deliver the women. In an effort to abolish the TBAs, their role has been redefined without any input from them.
About You
Birthing Project USA
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Section 1: About You
First Name


Last Name



Birthing Project USA


, NM

Are you an individual between the ages of 18 and 35 who would like to apply for a nine month Young Champions Program mentored by an Ashoka Fellow?


Section 2: About Your Organization
Organization Name

Birthing Project USA

Organization Phone


Organization Address

2270-D Wyoming Blvd. NE #331, Albuquerque, NM 87112

Organization Country

, NM

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Your idea
Country your work focuses on


What makes your idea unique?

It creates an inclusive and culturally competent model for the limited number of physicians/midwives and TBAs to work together to assure that pregnant women are encouraged to attend prenatal care and to deliver when possible at the district clinic. It gives the TBA an active role, brings her out of the closet and rewards her for participating in the health care system as well as providing the pregnant women a trusted friend and advisor in her village.

Do you have a patent for this idea?

What impact have you had?

To date, 12 TBAs are involved and are having historic meetings with the limited health care staff that exist in this remote area of Malawi. These meetings are historiacal because it is the first time the TBAs have been invited in to the clinic to see what happens there and they are introducing and practicing the concept of prenatal care rather than just providing birthing care. Most importantly, the women in there feel they are connected to alarger community of women who are addressing the same issues.


A community meeting was held comprisedf of all the stakeholders: chief, district health officer, nursing staff, TBAs, pregnant women and those waiting to deliber to discuss what the mothers said they need to make a system of care that would work for them. As a result of the meeting, a local woman was chosen to manage the project and the professional sstaff and TBAs have agreed to work together with clearly defined roles. The US Birthing Project will provide training for the TBAs and side by side support to the nursing staff and medicine and supplies, eg beds, gloves, pitocin


There is a sense of hope that while the world is working to assure that all women are delivered by what the international organizations define as the appropriate professional the meantime...women in Mchinji will be provided support to access prenatal care and the safest delivery possible provided by a trained TBA or nurse. The measurable objectives are: the number of prenatal visits will increase and the number of women who deliver at the clinic will also increase and the TBAs will create/embrace a role for themselves that works in collaboration with the health care system and the pregnant women will have meet their stated need of having someone to provide social support.

What will it take for your project to be successful over the next three years? Please address each year separately, if possible.

Year 1: Planning, implementing the project and assessing/evaluating for improvement, meeting the program objectives.The project has identified money for travel, basic staff, medicine and supplies and limited documentation.

Year 2:Opportunity for the project participants to continue to meet and discuss the the project outcomes and to address the sytemic issues that prevent them from having healthy babies,, such as limited life options for girls/women and to use the project to determine what else needs to be integrated into their project design.

Year 3: The project will be ready to be replicated in other communities based on their success in establishing protocol for creating a conmprehensive system to address a global issue. Ata time when the world needs thousands of new health care providers, the Mchinji project is demonstrating how to integrate/educate/support TBAs who have the calling to be with women during their reproductive years as a friend/advisor and supporter to access whatever care is available.

What would prevent your project from being a success?

Nothing. These women are going to make this happen!

How many people will your project serve annually?


What is the average monthly household income in your target community, in US Dollars?

Less than $50

Does your project seek to have an impact on public policy?


What stage is your project in?

Operating for less than a year

Is your initiative connected to an established organization?


If yes, provide organization name.

Birthing Project USA and Raising Malawi

How long has this organization been operating?

More than 5 years

Does your organization have a Board of Directors or an Advisory Board?


Does your organization have a non-monetary partnerships with NGOs?


Does your organization have a non-monetary partnerships with businesses?

Does your organization have a non-monetary partnerships with government?


Please tell us more about how these partnerships are critical to the success of your innovation.

The Malawi Ministry of Health is involved and supports the project because it has the potential to improve birth outcomes by encouraging women to access the government clinic. Raising Malawi is paying for the Malawi based expenses. An ethnic hair care company is funding the US costs. We are also partnering with Black Midwives and Healers toprovide Cerified/Mastered midwives to provide training and support.

What are the three most important actions needed to grow your initiative or organization?

Successful outcomes during the first year based on building trust between all the stakeholders and the courage for all of us to do what works for this community.

The Story
What was the defining moment that you led to this innovation?

My defining moment occured when I visited an orphanage in Malawi and realized of the 36 babies there...all of whom had lost their mothers in childbirth...half had been during the care of a TBA and the other half had died at the government hospital. It was clear to me that both sectors have to be supported in order to save the lives of women. During the first health care meeting that included the TBAs, these womenmade it crystal clear that they cared about what happens to women during birth and that they consider these babies as theirs and that they were hurt that they had been dismissed and discounted. I also was aware that the professional staff put on their traditional wraps and were respectful to the TBAs in a way that is not their normal behavior in the hospital and clinic. I could see that the missing piece was a mechanism to bring them all together on one team.

Tell us about the social innovator behind this idea.

The social innovation is adding the concept of "sisterfreind". The pregnant/parenting women said they wanted/needed a trusted non-family member to confide in early on in pregnancy that they could trust for guidance/direction /support. The TBAs embraced this new role and the incentive to refer/accompany their mothers to government health services. Perhaps the biggest social innovation is the opportunity for Birthing Project USA, an organization of women of African descent to be of service to African women and the healing that comes from recognizing each other as sisters.

How did you first hear about Changemakers?

Newsletter from Changemakers

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