When Mariamo* arrived at her local health center in Mozambique on a Sunday night in April 2017, she found the maternity ward empty. Her labor pains were intense. A security guard ran to the staff living quarters to inform the nurse on night duty.
Without performing a physical exam, the nurse declared that Mariamo was not yet ready to deliver and returned home to sleep.
Four hours later, Mariamo gave birth to her son—with the assistance of the health center cleaner.
“The cleaner went to call the nurse, but she came back alone. My baby was left for a long time with his head stuck—a part was already outside. The cleaner saw that I was suffering and tried to help pull the baby out, but it was so difficult. My son was finally born at dawn. I had already given up hope of surviving. It was only in the morning, when they changed shifts, that I got help from a nurse. The other one left as if nothing had happened.”
Namati’s health advocate and several members of the village health committee conducted a routine visit to the maternity ward the following afternoon. Mariamo told them her story.
Several days later, the village health committee held a community education session focused on the rights of patients seeking maternal health services. Two women who had given birth on a weekend stood up and shared personal experiences similar to Mariamo’s. A number of women in the community said that they preferred to have their babies at home.
Soon after, the village health committee and health advocate met with the director of the health center to discuss these concerns. The director presented the nurse in question with a formal warning and called a meeting of the entire maternity ward staff to remind them of the potential health risks resulting from negligence and disrespectful treatment.
The situation improved significantly. The head labor and delivery nurse noted, “In our supervision routines, when we speak with postpartum mothers and family members, we hear reports of courteous, correct care … but we believe we can still do better.”
These improvements have also been felt by patients and community members. One young woman from a nearby village recalled,
“When I went to the hospital I was very fearful because I had heard that the cleaners were assisting with deliveries. I was surprised and happy to have been treated very well by the midwife there. My daughter and I are healthy.”
Zélia, a member of the local health committee, had a similar assessment: “The situation has gotten much better. The nurses are now assuming their responsibility with dedication. They attend deliveries with courtesy.” Both the hospital leadership and health committee members continue to monitor the ward to ensure everyone receives safe and humanized care.