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HEW IDI 4Birth NotificationQ. 1.1 How long have you been working as a HEW in this community?A. “It has been three years.”Q. Can you tell me what you have done within the past three years regarding maternal and newborn health?A. “I teach them. I teach by going door to door. I usually teach about balanced diet, exclusive breastfeeding for six months, and to bring babies to the health facility when they are sick. We give treatment using ORS.”Q. Where do you teach?A. “I teach in homes by going door to door, and at the community meeting that we have twice a month. We teach those people that attend our meeting. We teach the society through the Voluntary Community Health Workers (VCHWs).”Q. What else do you do?A. “We give vaccination services and treatment for sick babies.”Q. How do you identify newly pregnant women in the village?A. “We have VCHWs. They report to us whenever there is a newly pregnant woman in the village.”Q. Is there any other way that you can identify newly pregnant women?A. “No. I don’t have any other method. Some of them might hide their pregnancy from us because they are afraid of miscarriage.”Q. What do you do when you make home visits?A. “I visit mothers. I teach them about danger signs and vaccination.”Q. How do you do these things?A. “I do it by going to their house and teaching them. Some families come to the health post.”Q. What do you do during post natal care visits after birth?A. “I first wash my hands and check the baby’s health condition after that. I check to see if the baby has any of the danger signs. I teach about danger signs to the mother. I weigh the baby, take the temperature, and I will tell the mother to breastfeed her baby exclusively for six months.”Q. Why do you think it’s important to teach them?A. “For example, we used to give water to the baby immediately after birth, and we used to put blood on the baby’s body, and we used to give ‘amessa’.”Q. Why are the families giving these things to the baby?A. “They give water to the baby so the baby’s stomach can adapt to the water. They put blood to protect the baby from ‘budda’. They believe that if the baby has blood on the body, the ‘buddas’ cannot harm the baby. We used to give ‘amessa’, but it is no longer practiced.”Q. When do they start giving these things to the newborns?A. “They start giving it to the baby seven days after birth.”Q. 1.2 How do you hear about deliveries?A. “The VCHWs will tell me if there is a delivery. And we might find out when we do home visits.”Q. How soon after delivery do you hear?A. “I will hear within two or three days after the delivery, but that is the maximum.”Q. From whom to you hear about the babies?A. “I hear from the VCHWs. They will give me the report whenever they know there is a delivery. For mothers who gave birth on Saturdays and Sundays, the VCHW named Marta will give us the report on Monday because they give the report to Marta. Marta is a VCHW who lives near the health post.”Q. When was the most recent delivery that you heard of and who told you?A. “I heard from the VCHW. The birth date was July 18th, 2011, and I heard on July 19th. Marta was the one who told me.”Q. 1.3 In the past three months, how many post natal visits did you attend?A. “I visited eleven babies.”Q. Who told you about the most recent delivery?A. “The VCHW named Marta told me.”Q. How soon after delivery did you visit this mother?A. “She gave birth on Sunday, I heard about it on Monday when I opened the health post.”Q. When was the last visit you made?A. “July 19th.”Q. 1.4 From your experience, what are the main barriers that prevent you from making early Post Natal Care (PNC) visits?A. “There is no problem. But there are villages in our kebele that take two hours to get to. It is Meseret’s gasha.” (Note: Meseret is the VCHW in that gasha) “For the mother that gives birth in that gasha on weekends… it will take four days for us to hear about that delivery. The same is true for mothers who give birth on Friday afternoons. It is difficult for us to visit them immediately because we don’t have a place to stay overnight in the kebele.”Q. Is there any other problems that relate to a high workload?A. “We were three at the health post. But the third HEW did not do her work properly. She did not come to the health post as she was supposed to. So we had to split the work between two and the two of us are working as a team.”Q. How many gashas are far from the health post in this kebele?A. “There are only six gashas that are close to the health post. The others are so far away.”Q. For those gashas that are far, how do you hear about deliveries so soon?A. “We don’t hear so soon.”Q. In your opinion, how can these problems be solved?A. “We have meetings twice a month. We usually talk during those meetings. We tell them to be timely in bringing us the news. On the other hand, it’s difficult for the VCHW and for us to hear about deliveries that occur on Fridays, Saturdays and Sundays. But it is God’s will that they give birth on those days. We cannot postpone their deliveries. So this is one big problem we have. And I don’t know about the solution. If they are near to the health post, they would send the information to Marta’s house (VCHW) and Marta would give it to us and we would visit them as soon as possible.”Q. Who leaves messages of deliveries at Marta’s house (VCHW)?A. “The VCHWs will send the children in their neighborhood to give the message to Marta. We discussed this way of notifying before.” ................
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