women should not be rewarded for attending antenatal care

IntraHealth/Twubakane, an NGO operating in different districts of the country, recently rewarded mothers for attending standard pre-natal care. Several mothers in Rwamagana and Muhanga districts have received the rewards after attending the compulsory check ups before birth. Understandably, the rewards follow reports that many pregnant women are not keen on attending antenatal care and delivering under medical watch; facts that are responsible for the high child and maternal mortality rates, statistics that the NGO and government is eager to reverse. It is hoped that by rewarding them, Intrahealth will encourage more women to act responsibly instead of relying on old women, known as traditional birth attendants, to deliver. I commend this goal. It is a good gesture in as far as improving lives is concerned. However, with regards to rewarding mothers for attending antenatal care, I beg to differ. Only when parents take this as a personal responsibility, will the numbers of women seeking antenatal care increase. Naturally, a person would not wish to avoid using a proper health facility. For one to do so there must be a strong reason. In the interactions I have had with women, they tell me that only a few pregnant women go to health centres because of the kind of reception given to them at the health units. They argue that the mistreatment subjected to pregnant women by nurses and midwives is what drives them away from health centres. The health facility becomes meaningless when a woman waits for hours unattended; especially after one has travelled several kilometres to reach there. As pregnant women cry with pain, they, say, they are laughed at, and accused of being weak by the hospital staff. With this situation in mind, the only way to prevent this bad situation is through massive sensitisation, instead of rewarding mothers for fulfilling their obligation. I believe that the rewards may be counter productive and drive parents to have more babies at a time when the government is spearheading family planning campaigns. Believe me, if there is a link between attending prenatal care and getting prizes, it has the danger of motivating women to make more babies in order to get more rewards. If we want to make more responsible mothers, who mind about the health of their children, the best way is to develop a strict policy. With strict policies in place, all parties, men included, will not fail to ensure that an expectant mother visits a health facility- as long as there are mechanisms to monitor absentees. Seen in another way, the rewards mean you tolerate those with I don’t care attitude- who violate the rights of the unborn baby yet producing a healthy baby is a woman’s duty. I contend that rewarding is not the best way to encourage compliance. Improve the relationship between midwives and pregnant women and equip the health facilities so that when the women visit, they will realise the difference between producing in villages and health centres. Lastly, empower women economically such that those who lack the means to reach health facilities can afford to do so, without necessarily relying on their husbands. jtasamba@gmail.comThe Author works in The New Times