MAQ Bulletin, East and Southern Africa

MAQ in East and Southern Africa

ESA MAQ Workshop Delegate Elected Member of Parliament

Dr. Manto Tshabalala, a family planning leader in South Africa, has been elected as a Member of Parliament in the new South African government. Dr. Tshabalala, National Coordinator of the Progressive Primary Health Care Network, was a member of the South African delegation at the February 1994 ESA MAQ workshop in Zimbabwe. She will play a leadership role in maximizing access to and quality of family planning services in the new South Africa.

MAQ in Other Regions

Turkish Clinicians Find Local Solutions

Clinicians in Turkey are working on a national standardization effort to reduce barriers to family planning services and training which involves the Ministry of Health and approximately half of the Turkish medical schools. Not only have constraints (that are commonly found in many clinical training sites) been identified, but some local solutions have been found. To compensate for the resource limitation of drapes, trays, and containers for sterilization, one trainer devised a cloth instrument pack (see photo), made of cotton material, with internal pockets that hold the IUD instruments, a flap that closes the pack, and a tie that fastens it for autoclaving and storage. When unfolded, this pack serves as a sterile drape on which to place the instruments, including a place for the speculum between insertions. To provide each client with an individual antiseptic container, clinical trainers are using readily available items such as disposable specimen containers, plastic yogurt cups and small metal Turkish tea saucers. This system of individualized local antiseptic containers eliminates possible cross-contamination among clients. Uterine sounds, which would have been considered unusable after only a few uses due to apparent corrosion, are now easily cleaned and reused. The black coating on these instruments (caused by a deposit of calcium carbonate, in areas of Turkey where the water has a high calcium content) can be completely removed by soaking them in a vinegar solution and gently wiping them with a smooth cloth.

These are a few examples of innovative solutions developed by clinicians in Turkey that are inexpensive, practical, adaptable and locally feasible ways to maximize contraceptive access and improve the quality of family planning services.

Nepali Birthing Kit Prevents Infection

Traditional birth attendants and midwives in Nepal are using a locally manufactured safe birthing kit that helps prevent the spread of infection during and after childbirth in home deliveries. The kit's contents, which are clean and sealed in plastic, include a small bar of soap, a coin-sized plastic disk on which to cut the umbilicus, a new razor blade, three pieces of string to tie the umbilicus, and a thin plastic sheet which can be spread under the mother during the delivery. In addition, the kit contains a set of step-by-step illustrated instructions that emphasize handwashing before and after the delivery and the wrapping of instruments and afterbirth in the plastic sheet for safe disposal. All of these are contained in a small cardboard box about the size of a deck of playing cards which is lightweight, easily carried in a pocket, inexpensive, and soon will be available in Nepali markets. Since the kit is modeled on traditional Nepali birthing practices (for example the plastic disk replaces a coin that would normally be used for cutting the umbilicus), it is readily accepted. This safe birthing kit is the product of an 18-month intensive social marketing research project by the Nepal Save the Children Alliance (funded by UNICEF and UNFPA, with technical assistance from PATH with USAID funding), which tested the kits in homes and in the marketplace. The first Nepali women's health micro-enterprise was organized to produce this kit. In its first few months, the group has produced over 30,000 kits to supply to local nongovernmental organizations (NGOs), and will soon be providing the kits to retailers in the market.

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