Guinea-Bissau has particularly alarming indicators of maternal and child health, with the highest maternal and child mortality rates in the world. Integrated Programme for the reduction of maternal and child mortality (PIMI) aims to contribute to reducing maternal, neonatal and child and juvenile mortality in Guinea-Bissau, and to ensure better access to quality health care for pregnant and postpartum women and children under 5.
Since 2013, the EU guarantees free maternal and child care through PIMI. A new phase started in 2017with an EU contribution of €20 million, and a co-financing from Entraide Médicale Internationale (EMI), Instituto Marquês Valle Flôr (IMVF) and UNICEF of € 2.7 million. PIMI-II is a nation-wide support programme which focuses on strengthening demand and supply of high-impact interventions for mother and childcare; improving free access to essential health services; and improving quality of health services and community health.
I started working with IMVF/PIMI II to make a contribution to reduce maternal and infant mortality rates namely in supportive supervision and training of health staff, our country does not have many resources and I feel my work is of utmost importance.
Doctor Omatt Piedade
Omatt Piedade, is a pediatrician working in one of the most remote regions in Guinea-Bissau under the 'Integrated Programme for the reduction of maternal and child mortality'. She supervises a health team of 4 people in 17 sanitary regions, where she promotes quality medical care to pregnant women and children under 5 years old. With access to health facilities, fostering partnerships with community health workers, with civil society organisations and with key players in the community such as 'Régulos' (traditional leaders) and religious leaders, Omatt helps to promote early and free access to care for pregnant women and children under 5 years old. She is also a fulfilled mother and wife, and she really feels that everyday, her work and her life lead to positive change in Guinea-Bissau.
A day at the Canchungo Regional Hospital in Cacheu, Guinea-Bissau
The Canchungo Regional Hospital in the Cacheu Region is one of Guinea-Bissau's 132 health facilities where PIMI II - Integrated Programme for the Reduction of Maternal and Child Mortality - is being instigated since June 2017. In the maternity ward, we see in the delivery room the weighing scale provided by the project - which contrasts with the old way of weighing babies - and in the postpartum room there are several mothers with their new-born children waiting for a free follow-up appointment.
PIMI directly benefits about 300,000 children under the age of 5, about 400,000 women of childbearing age, and more than 1,200 health professionals working in the country's 132 health facilities. The project indirectly benefits the entire population of Guinea-Bissau (over 1.8 million inhabitants).
PIMI is not just about distributing medicines and making consultations available for free. PIMI is a programme that goes beyond. It helps in the rehabilitation of health centres and the training of health technicians.
Vitório Mendes, a 26-year-old male nurse working at the Cacheu Health Center
In the first 2 years of the project, around 1,200 health professionals from all regions of the country benefited from PIMI in-room or on-the-job training in high impact interventions (basic training in maternal and child health), obstetric and neonatal emergency care, obstetric ultrasound, transfusion immunotherapy for laboratory technicians, caesarean section practice and obstetric anaesthesia.
Dr. Jess Rodrigues, who has been at Canchungo Hospital since 2011 and has participated in several training sessions promoted by PIMI II, namely, Obstetric and Neonatal Emergency Care (CONU) and Obstetric Ultrasound.
“PIMI II has done many things for my country, for my institution, and for me as a healthcare professional. I have improved a lot with the theoretical and on-the-job trainings that have participated in. I believe that we will continue to improve the country's indicators, subject of the utmost concern of PIMI and the National Government, especially as far as maternal and child health is concerned, to reduce the country’s appalling maternal and child mortality rates”, says Jesse Rodrigues.
In addition to clinical training, free distribution of medicines and medical consumables is one of the main pillars of the project. IMVF ensures permanent availability of 57 medicines drugs and 61 essential medical consumables in the health facilities covered by the project.
Some key results collected in September 2018
- in the first 3 trimesters of 2018, 2,943 pregnant women were attended and 1,798 children under 5 were diagnosed and treated for pneumonia in Catió sanitary areas (excluding regional hospital)
- 276 health professionals in the national health system were trained in an to promote a sustained improvement in maternal and child health care
- 6 health structures are now equipped with a total of 39 photovoltaic panels for lighting in maternity services, delivery rooms, paediatrics and abortion
- 11 health facilities are equipped with blood banks and respective solar panels
- 133 health facilities are equipped with various medical equipment and materials.
- PIMI II ensures the acquisition, storage and free availability of a total of 57 essential medicines and 61 medical consumables, as well as some medical equipment for 133 health units
- at Community health level, PIMI II supports coordination, training and supervision for 4,287 community health agents
- in the last year, 368 new community health agents were trained for 16 essential family practices
- in the field of nutrition, 1,173 new cases of malnutrition were admitted in the care centres.