Ahead of the international day of social justice, we spoke with Tausi Suedi, the co-founder of Childbirth Survival International (CSI), a global humanitarian and grassroots non-profit organisation committed to reaching the unreached with health services and information. In this interview, Ms. Tausi, who also serves as an adjunct professor at Towson University in Maryland (USA) teaching Global Health at the undergraduate level, explains how CSI is impacting lives with low-cost low-tech interventions and its mission to end child and maternal mortality in African countries.

What inspired you to establish Childbirth Survival International [CSI]?

From my childhood years, I was always concerned about the well-being of people particularly women, children, youth, and the elderly, especially in marginalized settings. For a long time that guided the academic choices I made through college, university, and places I worked to get experience in global health and development. Around March/April 2013, Mrs. Stella Mpanda, a veteran nurse midwife in Tanzania and I were having an interesting conversation and it led to the establishment of CSI. Through CSI, we are impacting lives with low-cost low-tech interventions and giving people hope.

CSI runs reproductive, maternal, newborn, child and youth-related programmes in Africa. Can you shed more light on your activities in these areas and some of the achievements you’ve accomplished over the years?

CSI’s work directly impacts pregnant women, newborns, children under five years old, frontline health workers (midwives and nurses), and adolescents/youth in marginalized communities. We specifically focus on these populations because when you look at key indicators such as maternal mortality, infant mortality, neonatal mortality, and the causes of death and disability, it is clear huge gaps remain unmet moreso in the rural areas. Currently, CSI has an established presence in five countries across sub-Saharan Africa –Tanzania, Uganda, Nigeria, South Africa, and Somalia–with significant results coming out of Tanzania and Uganda. CSI has five top priorities: Maternal, Newborn & Child Health; Reproductive Health & Family Planning; Training of Frontline Health Workers; Adolescent Reproductive Care; and Community Education and Empowerment. Through these five priorities and in collaboration with local partners and communities, some of the achievements include:

1. More than 350 pregnant women have received childbirth kits (mama kits) for free to ensure they deliver in a health facility with a skilled birth attendant.
2. More than 2,500 adolescent girls have benefited from CSI’s Girl Talk, Girl Power program, averting teenage pregnancies, HIV infections, staying in school.
3. At least 30-50 licensed midwives have been trained on quality and respectful maternity care to provide pregnant women with necessary care to avoid death or disability due to a preventable/manageable complication.
4. About 70-100 orphans and vulnerable children in poor communities are on track to get an education through CSI’s Safina (Noah’s Ark) program that puts emphasis on no child left behind.

   

In the last five years since you established CSI – what are the lessons have you learned, especially in providing healthcare services to rural and underserved communities?

Any opportunity to work in a community at the grassroots level, one is bound to learn a lot from their shared experiences and enrich their understanding to design quality and culturally-acceptable interventions. From listening and learning, you quickly pick up on the grief and frustrations due to inadequate health systems in the communities. The distribution of healthcare services across sub-Saharan Africa is fairly uniform in the sense, of disproportionate allocation of resources and skilled healthcare workers, more services are in the urban areas compared to the rural areas, where there’s more need. Besides the existing challenges in healthcare access and delivery, we recognize culture and low literacy levels play a critical role in how families and communities in rural areas perceive modern medicine and the strong gender views that limit women and girls from accessing health services. In addressing health challenges and gaps in rural and underserved communities, a big picture approach is necessary for larger impact for example the intentional involvement of men–spouses, domestic partners, village elders, religious leaders, government leaders at the grassroots level–to champion health and well-being of women, children, and adolescents/youth and be a voice in advocating for quality healthcare services in their communities.

A 2017 report by UNICEF says ‘at current trends, 60 million children will die before their fifth birthday between 2017 and 2030, half of them new-borns’. What are you recommending on how to boost maternal and child healthcare in Africa, especially in underserved communities?

Increasing health literacy is a big step. CSI routinely facilitates community education sessions on various health topics on reproductive, maternal, newborn, child, and adolescents/youth health. We do see the demand for these health literacy sessions in underserved communities. For example, mothers want to know how to provide quality care for their children and more couples become interested in family planning. If you look at the causes of death in children under five years old, they are preventable and treatable. Illnesses like diarrhea shouldn’t be the leading cause of death. Educating and empowering mothers to recognize danger signs and seek care early can significantly improve child survival. Educating mothers on how to prepare oral rehydration therapy at home is a low-cost low-tech intervention that saves lives. A mother’s health affects the quality of care she can give her child. If a mother is strong, healthy, and has a supportive spouse/family, chances are her newborn will grow to be healthy through breastfeeding and proper nutrition. The reverse is equally true–when a mother is weak and has no social support in her home or community, chances are her newborn will not thrive. Increasing access to family planning/birth spacing is necessary to give a woman’s body time to heal and recover from previous pregnancy and birth.

What role can traditional birth attendants play in rural areas in eradicating child and maternal mortality in Africa?

We must first understand that traditional birth attendants are the trusted “skilled healthcare providers” in rural areas. Grasping that helps in designing an intervention that will be embraced. TBAs as they call them are key partners in eradicating child and maternal mortality in Africa. By creating a space that links them with the formal health sector and recognizing the role they play especially in communities where there’re no skilled healthcare providers or adequate health facilities, TBAs can be regarded as assets to strengthen the movement to end maternal and child deaths. For example, if a TBA receives minimum required training on basic safe childbirth practices and has access to a nurse/midwife via mobile phone at a health facility that is 10 miles away, she’s likely to save life of mother and baby. In the event a pregnant woman has serious complications that the TBA cannot manage, the TBA can now easily contact the skilled nurse/midwife and necessary steps are then taken to save the life of the mother—eliminating delaying at home and increasing chances of saving lives of mother and baby. Until stronger and functional health facilities are established throughout the healthcare system continuum in Africa, it is important to understand that TBAs are the primary “skilled” healthcare providers for women in rural areas.

Looking first towards 2020 and then beyond that, what challenges do you foresee in the next few years, when it comes to raising money, implementing money and continuing to lower maternal, newborn and under-5 deaths?

Funding, Funding, Funding! CSI has a strong and multidisciplinary team and we continue to recruit unique talent to advance the organization’s mission and vision. Since 2013, hundreds and thousands of lives have been impacted mostly by individual contributions. CSI’s grassroots efforts have been recognized by community and government leaders, who ask whether we can scale up to other underserved communities. With limited funding, scaling up to impact more lives and transform communities, cannot be achieved.

Millions of dollars are invested in ensuring child and maternal health in Africa. In what ways do you see the money that has been dispensed actually taking form on the ground and in what ways can these funds be better disbursed especially when targeting organisations working in underserved communities?

There has been some progress on investments already made to improve maternal and child health in Africa BUT more work remains. To channel funds is not enough and is neither the solution formula for speeding up efforts to significantly reduce preventable maternal and child deaths across sub-Saharan Africa. Prioritizing of funds, increased political will, and strategic partnerships with trusted nonprofits working in underserved communities, for example, CSI are some of the ways to accelerate change in rural areas.

CSI 5th anniversary is around the corner. Basically, what message do you want to deliver to the world, especially Africa?

CSI’s 5th-anniversary theme is “One Mother, All Mothers Count: Save Mothers of Africa” from preventable deaths and disabilities (fistula). The message CSI is delivering is: The time is now to end needless deaths of mothers in Africa. For every mother that dies, it’s a loss not only for her family but the community and country. Mothers of Africa are dying every single day and that is unacceptable. Midwives need to be supported to provide quality maternal care and reproductive health services.

Adolescents and youth, especially the girl child should have access to equal opportunities in education, sports, leadership, and live to their full potential–healthy, educated, informed, and economically empowered–in order to give back to their families and communities and contribute to the growth and development of their countries. The time is now for leaders of Africa to take a united stand on increasing investment in health and integrating health in all policies.

How can individuals, organizations, and the private sector in Africa and around the world support CSI?

Childbirth Survival International (CSI) can be supported through financial donations securely on the CSI website and through time (using one’s skills to volunteer as much time as they can give) and treasures (non-financial donations e.g. children’s clothes, school supplies, sanitary pads). CSI constantly seeks to partner and collaborate with reliable organizations and businesses in the private sector who share similar core values and prioritize well-being of people before profit. We have online campaigns such as childbirth kits for pregnant women https://www.gofundme.com/7dollars, school supplies for orphans and vulnerable children, so they too can go to school and learn https://www.gofundme.com/csi2018schoolsupplies.

What should we expect from you and CSI in the future?

A wonderful last question! I have lived my life giving back and touching lives, I can only see myself doing more of that. For CSI, we expect the organization will continue to expand and go as far as Asia and South America-regions that have similar statistics like sub-Saharan Africa essentially unfolding the vision of reaching the unreached with health services and information. You can expect to be hearing lots more about CSI in reaching the unreached and impacting lives.