Before Doctors Without Borders/Médecins Sans Frontières (MSF) arrived in the southern department of Couffo, Benin, only a small percentage of pregnant women and women of reproductive age were visiting a health center on a regular basis. Most women were not getting medical check-ups during their pregnancies, and often gave birth at home.
There was also significant demand for contraception, but around half of women of reproductive age did not have access to it. Maternal and infant mortality rates were high, and some of these deaths could have been prevented with regular medical monitoring.
Since 2022, MSF teams and partners from the Ministry of Health have been working to ensure long-term and sustainable changes in health care access for communities in Couffo. Today, outreach and health promotion activities in Couffo’s villages are carried out mainly by women trained by MSF. These women have connected health centers in the area with local communities, focusing on women, who are now being monitored on a more regular basis.
Léonie is the mother of five children. She is one of the women in her village who have been made aware of the good practices to adopt when pregnant to stay healthy. During her last pregnancy, Léonie suffered from fluid retention and swelling in her feet that made it difficult for her to sleep. The herbal infusions she was given had no effect.
Once she was informed of the importance of medical care during pregnancy, Léonie went to a health center where staff listened to her needs. Because her last pregnancy was particularly difficult, without this medical assistance and a safe delivery of her baby, Léonie could have died. Today, her 7-month-old son, Précieux Magloire, is doing well and also receiving care at the health center.
Minds are slowly changing about a long-held taboo
Hippolite supervises health promotion activities in the villages of KTL health zone, which is named after its three communes, Klouékanmè, Toviklin, and Lalo. Part of his job is to train and support women leaders, who are active ambassadors for other people in their villages. The involvement of these women is essential to help inform the community and support them in making decisions to improve their reproductive health.
“If women don't know why they need to go to the health center, they won't go,” said Hippolite. “Medical staff can save lives, but we are also fighting ignorance, which can lead to some people dying.”
prenatal consultations
consultations for access to family planning methods
deliveries, including 4,153 in the hospital, 3,659 in health centers, and 2,108 cesarean sections
To bring sustainable change within the community, MSF is focusing on providing adequate information about different methods of family planning methods to enable couples to choose if and when they will have their next child.
“The question of contraception has been a taboo subject in Beninese society for a long time,” said Hippolite. “Some people thought that a woman who controlled her pregnancies would become sterile. I’ve noticed that people’s minds are slowly changing, when a couple understands that a woman will be in good health if she avoids a pregnancy too soon after the last one.”
Community coordination ensures access to health centers
Lucienne is one of the 465 leaders trained by MSF. Since she started, she has seen the results in the community, particularly among men. In her village, a tricycle referral system has been set up to take people to the nearest health center. It is mainly the men who manage this system for the women.
“Before I became involved, I also thought that contraception made people sick and sterile,” said Lucienne. “I understood the reluctance of husbands and their wives. Today, I realize that when contraception is accepted in a household, it avoids many problems between partners.”
“I was also afraid that women who suffered complications during pregnancy would die,” she continued. “Today, many things have changed for the better.”
These women leaders play a vital role in reducing maternal mortality, complementing MSF’s awareness-raising activities with their knowledge of the challenges and conditions the communities face and how best to communicate with their peers.
Contraception contributes families’ well-being
Felix is the father of six children, the eldest of whom is 15. He and his wife lost two children who were in their early childhood. As one of the 160,000 people reached by MSF teams since the project began, he is now aware of the various methods of contraception. Before, he used to believe that the withdrawal method was enough to prevent pregnancy. Now he understands the importance of spacing births for the well-being of his whole family, and that contraceptive methods are a safe way of achieving this.
“Denise gave birth five months ago to a baby girl whom we have named Naomie,” said Noutchedehou. “Now we’re going to take good care of the children we already have, and we won’t have any more children. I, in turn, will pass the message on to my children so that this suffering never happens again.”
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Our work in Couffo
MSF teams have been working in the Couffo department since 2022. In addition to health promotion activities, six health centers have received the support of MSF in the recruitment and training of health staff, rehabilitation, and medical supplies. MSF teams also work in Couffo’s hospital, which receives the most severe cases in the area and we assist a blood bank to ensure that adequate blood supplies are available for anyone in need. MSF supports pre- and postnatal consultations, safe deliveries, safe abortion care, family planning counseling, and assistance for victims of sexual violence.
