State of the World’s Indigenous Peoples
Case Study: Maternal Shelters Save lives Case The maternal shelter is a waiting home where women who live far and those with highrisk pregnancies stay for monitoring and quick access to the provincial hospital, which saves the lives of both mothers and newborns. The facility was established with support of UNICEF to address maternal and newborn health in hard-to-reach areas. “Had my wife not come to the shelter to deliver at this hospital, she could have died”, said Mr. Mohamed“. The two previous deliveries were difficult and she almost died from excessive bleeding”. He was therefore happy to make the 800 km journey to the shelter where his wife stayed. She had a Caesarean section and required a transfusion, which saved her life.62
The use of maternal homes was also introduced in Eritrea in 2007 to reduce maternal mortality in remote areas. This led to a 56 per cent increase in facility deliveries and no maternal deaths in the 20 months since the introduction of the concept.63 The Kenya Ministry of Health also has a strategy to deliver services to the household through the Community Strategy.64 In this strategy community health workers are trained in various maternal, newborn and child health services and deployed in the community. It is envisaged that they will be able to provide integrated community case management of pneumonia, diarrhoea, malaria and malnutrition starting in hard-to-reach, underresourced areas. Another innovative way of delivering services is the concept of the tuberculosis (TB) Manyatta. This was devised by Dr. Tonelli,65 a Catholic nun working in a remote district in North-Eastern Kenya in 1976. The pastoralists living there had a high default rate for TB treatment. As a result, she urged them to construct small dwellings next to the health facility where the patient could receive observed treatment for four months, supported by a family member. As this concept was very successful, TB Manyattas were set up in remote areas for nomadic pastoralists.66 In Namibia, the treatment of TB for the San has been improved by educating family members on TB treatment.67 South Africa and Rwanda have also started health insurance for their populations, and it is hoped this will trickle down to indigenous peoples.
Addressing the data gaps Information on the health status of indigenous peoples in the African region is not adequate. Health systems in many African countries have challenges in collecting, collating and analysing data for their populations.
62
http://www.unicef.org/infobycountry/Kenya 62635.html.
63
http://www.unicef.org/esaro/5479_maternal_newborn_health.html.
64
Taking the Essential Package of Health to the Community: A Strategy for the Delivery of Level One Services: MOH, Kenya 2006.
65
http://annalenatrust.org/index.php?option=com_content&view=article&id=46&Itemid=53.
66
WHO: A Brief Hisory of Tuberculosis Control in Kenya: 2008 sourced from http://whqlibdoc.who.int/ publications/2009/9789241596923_eng.pdf.
67
State of the World’s Minorities and Indigenous Peoples 2013, Events of 2012, Minorities Rights Groups International.
026 ξ Chapter 1