The challenge of delivering for rural women is a critical issue for UNFPA as it works to ensure that every pregnancy is wanted and every childbirth is safe.
Accessing basic health care, including quality family planning services and supplies, is problematic for many women in rural areas, leaving them with little control over the timing and spacing of births. Once pregnant, these women often face limited transportation options to reach skilled assistance during labour or to get emergency care should complications arise.
Roads and transportation are often rudimentary, and hospitals and health centres are spread over wide distances. In many rural villages, the only ‘ambulance’ available is a donkey cart or group of men who carry the woman for hours over rough terrain to get to a road or a hospital.
“From some rural villages, it can literally take days for a woman to get to a hospital that can perform an emergency Caesarean section, and by then it is often too late to save the baby or prevent a serious birth injury such as obstetric fistula. Tragically, all too often, the mother dies as well,” explains Gillian Slinger, coordinator of the global Campaign to End Fistula.
Women and girls living in rural areas are not only the most difficult to reach, but they are also often disenfranchised in other ways. “They are usually the least educated and have less decisional power,” said Ms. Slinger. “Even in countries where national legislation guarantees women’s rights, those are more difficult to be enforced the farther you go from the capital. It is also not easy to challenge cultural traditions which can further perpetuate inequities and gender issues."
But innovative approaches and new technologies are offering new possibilities for extending quality care to even the most remote areas.
Promising approaches include using mobile phone technologies such as ‘telemedicine’, which UNFPA Executive Director Babatunde Osotimehin has called a 'game-changer' in Africa, and providing a range of training and incentives to encourage midwives and health workers to serve in the hinterlands of Afghanistan.
UNFPA also supports mobile clinics in underserved areas to deliver health care to remote areas. In some situations, maternity ‘waiting homes’ care for women in the last weeks of their pregnancy to ensure that skilled care will be available during labour. UNFPA has also set up surgical camps to treat injuries of childbearing (including obstetric fistula and uterine prolapse) that disproportionately affect women in rural areas. The Fund has reached out to rural women in Niger through by educating their husbands.
Here are 13 different approaches from 13 different countries to overcoming obstacles to providing care for rural women, the subject of this year’s Commission on the Status of Women.
1. Using Mobile Phones to Tackle Fistula in Tanzania
2. Dial 555 for Fistula Treatment in Sierra Leone
3. Monitoring Expectant Women Using Cell Phones in Rwanda
4. Rewarding the Heroic Work of Midwives in Afghanistan
5. Reaching Out to Minorities in Viet Nam with Midwives who Speak their Language
6. Saving Lives in Ethiopia by Task-Shifting Medical Procedures to Trained Clinicians
7. Community Midwifery Takes Hold in Laos (video)
8. Deploying Mobile Clinics in Central America After Severe Flooding
9. Waiting Home Makes Deliveries Safer in Cambodia
10. Training Midwives to Care for the Mothers of South Sudan
11. Responding to the Scourge of Uterine Prolapse in Nepal
12. 564 Women Operated on During Fistula Fortnight
13. Educating Husbands about Reproductive Health in Niger