A Midwife’s Commitment to Her Community
Advancing quality health services and maternal care in rural Mali
A Mother, A Midwife
It’s 5 a.m. in Selingué, Mali, and Mama Diancoumba is beginning her day. Child care comes first. Her husband lives far away in another town where there’s work, so she focuses on getting her three children, ranging in age from two to twelve, dressed, fed, and out the door to school.
But Mama’s responsibilities extend far beyond taking care of her own family. As the midwife in charge of maternity services at the local health center, she is key to the welfare of hundreds of mothers and children in her community.
Just 32 years old, Mama has been working at the Selingué Reference Health Center since 2013. In 2015, she became the midwife in charge of all maternity services, in recognition of her skills, her passion for the work, and her personal commitment to reducing maternal mortality.
With support from USAID’s Human Resources for Health in 2030 Program (HRH2030), she has continued to grow professionally, and is now the quality improvement coach for the maternity service providers at the Selingué Health Center as well as 11 affiliated community health centers.
A Focus on Quality Care
Once at the health center, Mama convenes a meeting with the technical staff. She is always looking for ways to provide better patient care.
“To improve the quality of maternity services and client satisfaction, I set up regular meetings with my team,” says Mama. “One of the gaps discussed during these meetings was the lack of systematic screening during prenatal consultations for preeclampsia and eclampsia. I proposed that we upgrade … routine screening of these conditions. The proposal was accepted and now the test is regularly available for all pregnant women.”
Though she oversees the implementation of all services — including prenatal and post-natal consultations, childbirth, and family planning — Mama makes time to tend to all of her patients. Following the day’s meeting, she visits all the women at the maternity center, to assess their health.
The patients look up to Mama, valuing her clinical expertise and her compassionate manner. Fatoumata Sidibe says, “I have known Mama for four years, and have had three successful deliveries with her. She knows how to do her job, she cares for a lot of clients, and speaks with them and reassures them.”
Says Mama, “When you love your job and cultivate a good relationship with your clients, the care becomes very easy because the clients easily adhere to all the advice given.”
Coaching Her Team for the (Health Care) Win
USAID has supported training to improve the quality of care and services of maternal, newborn and child health, family planning, and nutrition in Mali over the last several years. Mama has been able to apply her training in her day-to-day work to benefit not only her patients, but also her peers and colleagues.
“After my training, during the first performance evaluation conducted by the project, I scored 100 percent in my knowledge of delivery (childbirth) and 95 percent in prenatal consultation in accordance with Mali’s service standards,” says Mama. “With this high performance, I was appointed as quality improvement coach for the coaching and supervision of maternity service providers here and at eleven other community health centers.”
Her peers value her supervision and her coaching. “It’s fitting that Mama is in charge of the midwives, because she knows how to manage her staff, and is respectful and never angry with the staff or the patients,” says midwife Fatoumata Tougouna Coulibaly, who is responsible for emergency neonatal obstetric care. “She is a leader. I always pray to be as good as she is.”
Obstetric nurse Kanté Trena, who is also on Mama’s team, echoes this praise, noting, “I appreciate Mama’s commitment to the work.”
Mama’s coaching role has carried over outside the health center. On Monday and Friday afternoons, she teaches obstetrics and reproductive health classes at the local high school, Hypocrate School of Selingué. Here again, she focuses her students on quality care. “The quality of treatment is related to the quality of the provider,” she adds. “This quality must be instilled in future health workers from the time of their theoretical training.”
The Neighborhood Confidante
After work, Mama returns home to take over the housework and care for her children. However, her maternity expertise is still in demand.
“In my neighborhood, I am a counselor and the local women’s confidante,” says Mama. “My return from work is an opportunity for my neighbors to discuss the health issues that matter to them.”
Neighbor Aichatou Tounkara, who has recently given birth to twins, relies on Mama. “For this pregnancy, I was very anxious, as it was very close to my previous pregnancy and especially then it turned out I was carrying twins. Mama is a confidante for me, due to her professionalism and discretion. I approached her to share my concerns. She gave me advice and supported me until I finally felt secure. She followed and supported me right until the delivery.”
Mother. Midwife. Coach. Confidante. Mama Diancoumba lives up to her many names, nurturing and making a difference in the health and welfare of her community.
The USAID HRH2030 project is working in three target regions — Kayes, Koulikoro, and Sikasso — to implement a community-based strategy to improve maternity, family planning, and nutrition services, and reduce maternal, newborn, and child mortality. By institutionalizing interventions, including coaching and mentoring, the project is working toward sustained, significant improvements in access to, demand for, and quality of health services. Mama Diancoumba is one of 70 coaches trained by the USAID HRH2030 project in the Sikasso region. These coaches provide support to 500 health service providers. To date, 768,970 women of childbearing age and 2.6 million children under age 5 have benefited from the project.
About the Author
Ibrahima Kamaté is the Knowledge Management and Communication Officer for USAID’s Human Resources for Health in 2030 Program.