Clean care at birth: a mother’s basic human right?

For most families the birth of a baby is a time of great happiness and celebration, but every year in low income countries an estimated one million mothers and babies die owing to unhygienic environments and practices at the time of birth in health facilities.

By giving women access to simple, low cost, interventions during childbirth such as antiseptics, sterile equipment, antibiotics, and improving hand hygiene among health workers, almost 100% of these deaths could be prevented.  Clean delivery should be universally available and a basic human right and a massive effort to reduce deaths and ill-health from delivery-related infections is long overdue.  It’s unacceptable for this issue to be ignored any longer.

Although there are organisations working to improve the health and survival of women and children in low income countries, none are explicitly focused on cleanliness and hygiene.  The global movement “Every Women Every Child” launched by UN Secretary General Ban Ki-Moon in 2010 aims to save the lives of 16 million women and children by 2015 and is at the heart of a new charity whose purpose is to build on the valuable work of the research group Immpact, (Initiative for Maternal Mortality Programme Assessment) in infection related maternal deaths.

The Soapbox Collaborative is a new research based charity hosted by Immpact at the University of Aberdeen.  Its explicit focus is on improving cleanliness and hygiene around childbirth.  The charity is mobilising support and raising awareness of its work in low resource settings.   Its mission is simple, to make it possible for mothers and babies in low income countries to experience “clean care at birth” by improving the practices and behaviours of health care workers through on-site training programmes in infection prevention and control, (IPC) and by making improvements to the environments where women give birth, whether it’s in a large maternity hospital or a small birthing unit.

There are significant gaps in knowledge about the burden of life-threatening infections hence the charity’s equal focus on strengthening understanding of the benefits of “clean care at birth” through research studies on behavioural, technological and health systems challenges of providing “clean care at birth”.

The first Soapbox grant was awarded to the Rimuka Maternity Unit in Zimbabwe.  The clinic served 60,000 people and had a serious lack of even basic equipment. In 2011, 1000 women gave birth in the clinic which had just 12 beds.  Soapbox funds have supported an IPC training programme for health workers and made it possible for the clinic to purchase vital equipment which included a much needed baby resuscitaire, instrument trolleys and cleaning items such as a floor polisher, which were also in short supply.

The work of Soapbox has been made possible so far thanks to an initial award from the Burnland Trust and a research grant from SHARE/WSSCC to fund a research project in India and Bangladesh, “Wash and clean in the labour ward”, but more help is needed as additional funds will be essential to sustain the work of organisations like Soapbox so they can widen their scope and geographical coverage and as a result help save more lives.

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By Shelagh Barr, the Soapbox Collaborative and HEART Associate


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