In the southwest Couffo department, MSF teams work in four health centres and at the zone hospital in an area where pregnant women and newborn babies face exceptionally high risks of dying before, during, or soon after childbirth, in a country where maternal and neonatal mortality rates are already high.
Benin recorded 397 maternal deaths per 100,000 live-born children in 2020. This compares to a global average of 223 deaths, while this rate is just eight out of 100,000 live-born children in Europe. Newborn babies in Benin are similarly at risk; the country’s neonatal mortality rate is 30 deaths per 1,000 births, compared to a global average of 18 deaths per 1,000.
Many of MSF’s patients have experienced the loss of a child. Kèmy, aged 23, has already been bereaved twice. “I am the mother of three children, two of whom unfortunately died,” she says. “The first died at the age of 18 months and the causes of his death are unknown. He died at home where he received traditional treatment. My second child was stillborn at six months [of pregnancy]. My third child was born at home with the help of a traditional birth attendant."
Just 38 per cent of people in the Couffo department seek conventional medical care at the region’s health centres. Partly this is due to a shortage of qualified health staff in the area, but it also reflects a reliance on traditional medicine and its beliefs. In addition, most women choose to give birth at home, which can increase the risks for those who experience complications.
MSF teams in Couffo have been providing pregnant women and new mothers with antenatal and postnatal care and helping them to give birth safely, with the ultimate aim of boosting survival rates among both mothers and newborns. Teams will provide also soon care to survivors of sexual violence.
Mireille, a new mother, is one of those to have benefited from consistent medical care throughout her pregnancy and during childbirth. "When I got pregnant, I went to the health centre immediately,” she says. “The health workers in my village looked after me from the beginning of my pregnancy right through to giving birth. During my labour I had a complication, but because I was well taken care of, everything went well.”
Since MSF’s project opened in Couffo in October 2023, teams working in the four health centres of Toviklin, Tohou, Adjahonmé and Lokogba and in the Klouékanmè zone hospital have provided 8,044 antenatal and postnatal consultations and helped 2,677 women to give birth, including carrying out 797 emergency caesareans.
MSF has also provided the health centres with medical equipment, including oxygen concentrators, sterilisation equipment and hemoglobin analysers, and is funding additional health staff. At the same time, MSF has run training sessions for existing health staff to strengthen their technical skills. As a result of these initiatives, patient numbers at all four centres and at the hospital have gone up.
MSF teams are also working with the wider community and encouraging them to take responsibility for the health of community members. They have trained female volunteers in administering vaccinations and treating sexually transmitted infections, in providing antenatal and postnatal care and how to spot warning signs during pregnancy and after childbirth. These women are now equipped to provide healthcare and advice for mothers and newborns. Training in care for survivors of sexual violence, as well as safe-abortion and post-abortion care, will also be available to those who request it.
Working with and inside the community is key, says Ousmane Dakao, MSF project coordinator in Couffo. “We have used different ways to gain the confidence of women and improve the number of patients attending the facilities through supporting the volunteer community members, through providing free antenatal consultations, and through our health centre teams regularly travelling to outlying villages.”
MSF also plans to provide the community with tricycle ambulances in the coming months to facilitate the transport of pregnant women experiencing complications from their homes to health centres.
A deterioration of the security context
MSF’s work in Benin does not stop there. At the other end of the country, MSF opened a malaria and emergency response project in August 2023 in the Atakora department in northwest Benin, where a deteriorating security situation along its borders with Burkina Faso has led to increase of violence and large numbers of people being displaced from their homes.
MSF also supports the authorities in Benin in responding to any health and humanitarian emergency linked to conflicts, epidemics or natural disasters. MSF has set up a monitoring and early warning system and is supporting health facilities to put in place contingency plans for events such as large influxes of injured people.