Tsildvina Rafaratsilavina, (18) mother to baby girl, Safidtiniaina (two days old) at the Ankadinandriana health centre, Madagascar

Eighteen year old Tsildvina gave birth to her baby girl, Safidtiniaina, two days ago at the Ankadinandriana health centre, situated in the rural highlands of central Madagascar. Tsildvina is at the centre, which is the only health facility available to the 10,600 inhabitants living across 14 rural villages over 40km east of the capital, recovering from the birth of her first child.

Tsildvina is more than familiar with the Ankadinandriana health centre as she went there throughout her pregnancy for check-ups with the midwife and to receive her vaccines against Maternal and Newborn Tetanus, supported by the Pampers and UNICEF “1 pack + 1 vaccine” campaign.

Tsildvina, went to a nearby village where her mother lives when she found out she was pregnant, a Malagasy tradition. It was there she learned about the importance of vaccines from the community health worker in her village. The community health workers play an integral role in saving the lives of women and children by running vaccination campaign awareness programmes and walking door-to-door to advise and remind women that they must be vaccinated to protect themselves and their unborn babies from fatal diseases such as Maternal and Newborn Tetanus.

She has lived in rural villages her whole life, near to Ankadinandriana with her mother, and a rural village on the west side of the capital Antananarivo with her husband, who sadly missed the birth as the distance was so far for him to travel in time. Having experience rural life, Tsildvina has seen and experienced the challenges that women face including the long distances along uneven terrain to the nearest health facility, which can force women to give birth at home in unsanitary conditions with only a traditional birthing attendant present.

The Ankadinandriana health centre is a community hub where mothers-to-be go to get check-ups with the midwife; babies and pregnant women are vaccinated; and meetings with the community health workers take place. Women go to the centre to give birth, often arriving on foot. They stay in a house in the centre complex, which was built by the community. The house is just a shell with four rooms, the mother-to-be and her family are responsible for bringing bedding, cooking materials, coal for the fire and anything else they might need with them. Following the birth they spend up to three days in the ward until they are well enough to make their long walk back home. There is also a dentist and walk-in health facility on site.

Tsildvina felt safe in the knowledge that she could access the health centre by foot and that there are always health professionals in the area to support her throughout her pregnancy and with the health and birth of her newborn child.

The Pampers and UNICEF “1 pack + 1 vaccine” campaign has funded vaccination programmes in Madagascar helping to eliminate the disease across the country. Despite helping to eliminate Maternal and Newborn Tetanus in a total of 15 countries, including Madagascar, there are still an estimated 100 million women and their newborns in 24 countries who are still at risk from the fatal disease.