KOMBIT: Mobilizing the Community for Safe Motherhood and Healthy Newborns

Haiti ranks 132 of 171 countries on maternal mortality. Neonatal mortality is 32/1000. Most (85%) of births in rural areas take place at home with assistance from a traditional birth attendant. The Haitian Health Foundation serves 200,000 rural people. It partnered with the Ministry of Public Health and Population and Sisters of the Good Shepherd in KOMBIT, a USAID Child Survival Program focused on improving maternal newborn health (MNH).

American College of Nurse Midwives Consultants trained 48 nurses and community health workers in Home Based Life Saving Skills (HBLSS). They trained 1074 community members from 27 villages spread HBLSS knowledge through mothers', fathers' and youth clubs, health fairs and TBA meetings. KOMBIT trained clinic and hospital staff in Life Saving Skills (LSS). 72 communities formed MN evacuation committees and emergency transport began in 2006. Maternal and newborn mortality reviews were conducted to increase community awareness and improve the quality of care from community to hospital.

HBLSS provided communities with the capacity to tackle maternal newborn deaths and take action. Trained community members supervised TBA deliveries to improve care. KOMBIT reduced delays in problem recognition, care-seeking and appropriate care. 587 women and newborns were evacuated (Aug 2006-Sept 2009), and women delivering with a trained professional doubled from 10-21%. In a sample of 147 emergency hospital deliveries, 21% were by cesarean-section and 28% by episiotomy; 10% of newborns were hospitalized.

Maternal-Newborn Mortality Review and HBLSS can be powerful tools in mobilizing communities to save the lives of mothers and babies.