Optimistic Voices
Vital voices in the fields of global health, global child welfare reform and family separation, and those intent on conducting ethical missions in low resource communities and developing nations. Join our hosts as they engage in conversations with diverse guests from across the globe, sharing optimistic views, experiences, and suggestions for better and best practices as they discuss these difficult topics.
Optimistic Voices
Empowering Midwives: The Key to Saving Lives
Welcome to a transformative episode that dives deep into saving lives through improved maternal health in Sierra Leone. We share inspiring stories from a recent training conference in Kenema, focusing on the critical role midwives play in reducing maternal and infant mortality rates. You'll hear from Matron Mary Augusta Fuller, Chief Nursing and Midwifery Officer, who shares insights on the vital need for comprehensive training programs for midwives, addressing both essential newborn care and postpartum hemorrhage management.
In our conversation, we explore the significance of mental health awareness among healthcare providers, highlighting how integrated training can create better support systems for mothers and their newborns. Additionally, we tackle cultural barriers women face in rural settings, often inhibiting their access to crucial medical care. The episode emphasizes the importance of empowering midwives with both knowledge and practical training to advance community health outcomes.
Through dialogue about new initiatives and the ambitious strategic plans laid out by the Ministry of Health and Sanitation, we present a hopeful vision for the future of maternal health in Sierra Leone. Join us in understanding how these efforts can pave the way for a healthier tomorrow for mothers and their children. Stay tuned as we inspire meaningful change in local healthcare communities.
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This is Optimistic Voices. I'm your host, yasmin Vaughn. Normally I host all of our episodes on global health, but this week we have a really unique episode of Optimistic Voices for you. In January, helping Children Worldwide collaborated with members of the Together for Global Health Network to hold another maternal and child health training conference. You may recall our two-part episode last year on the training we did in Bow, where we trained almost 100 midwives and nurses. This year we were asked by the Ministry of Health and Sanitation to do the training again in Kenema and we had 43 participants from Kenema, kailaun and the surrounding hospitals and clinics. The training is focused on two main curricula essential newborn care and helping mothers survive bleeding after birth. These two curricula are focused on tackling the top causes of maternal and infant mortality in Sierra Leone, namely postpartum hemorrhage, which is bleeding after birth, and infant resuscitation, which is a helping babies breathe curriculum. But it also included morning lectures on burnout, maternal mental health and respectful maternal care, helping to build up some of those soft skills that are so important within the nursing practice. All of this was held at the new Kenema School of Midwifery, which just opened in December of last year and is now training the first class of midwives in the region. Today's episode of OV was recorded with the Chief Nursing and Midwifery Officer, matron Mary Augusta Fuller live from the training we were doing in Kenema. Interviewing her is one of the Together for Global Health partners and a very dear friend, josephine Garnham, who is the Executive Director of the Healy International Relief Foundation, who is an instrumental part of our Together for Global Health network and the training that we're doing. In this interview she talks with Matron Augusta about the Ministry of Health's priorities for maternal and child health over the next few years, the challenges that they've had and the successes that they're celebrating within maternal and child health in Sierra Leone. Before we get into the interview, I want to share a little bit about the importance of training for midwives and nurses.
Speaker 2:The WHO states that skilled midwives could avert more than 80% of all maternal stillbirth and neonatal deaths In Sierra Leone. Things like limited equipment, inadequate mentorship and education constraints mean that midwives sometimes don't have the chance to receive hands-on training. In fact, the Kedema School of Midwifery was the first school of midwifery built in the country with a skills lab, and it's a really fantastic lab allowing the students to get hands-on training using simulators to practice their experience. Midwives need practical experience and support to improve their skills and to boost their confidence, because, in addition to knowledge, midwives have to be confident. They have to be prepared to act decisively and effectively in life-saving situations, which is why often, high pressure and resource-limited situations mean that they lack their confidence. So it's essential not only to equip midwives with the necessary knowledge, but to foster their confidence in performing those skills in challenging circumstances.
Speaker 2:So our Together for Global Health Network members in Sierra Leone have been working together to address the challenge of maternal and neonatal mortality by increasing the competence and the confidence of midwives to perform life-saving procedures.
Speaker 2:As a part of the conference and the training, we also offer ongoing mentorship and refresher courses, and we provide supplies and equipment for what they call low-dose, high-frequency training, which is where you have nurses take the supplies and equipment back to their facility and do little mini training sessions with other people at their facility the other nurses and midwives that are working there so that they can continue to refine their skills and build them, with the ultimate goal, of course, of contributing to a reduction in maternal and infant mortality rates.
Speaker 2:This collaborative effort is conducted completely in partnership with the Ministry of Health and Sanitation, both at their invitation and at their discretion, to ensure that everything that we're doing is in alignment with national priorities and avoids the duplication of efforts, because there are a lot of organizations that are engaged in working in maternal and child health in Sierra Leone, so we want to make sure that everything is filtered through the Ministry of Health. Now, with that introduction, you can hear from Chief Nursing and Midwifery Officer, matron Fuller, as she shares more about the ministry's plans for Sierra Leone's future in maternal and child health.
Speaker 3:My name is Josephine Garnham and I'm sitting in for Yasmin Vaughn for today's episode. We're interviewing Matron Mary A M Fuller, who serves as the Chief Nursing and Midwifery Officer at the Ministry of Health in Sierra Leone, leading and providing oversight to over 12,000 nurses and midwives nationwide site to over 12,000 nurses and midwives nationwide. She played a pivotal role during the Ebola epidemic, working in the reproductive health and family planning program at Princess Christian Maternity Hospital. In her current capacity, matron Fuller has been instrumental in initiatives such as the introduction of the Maternal and Child Health Handbook aimed at strengthening the continuum of care for pregnancy through early childhood.
Speaker 3:A dedicated public health specialist, she has over 37 years of experience in the civil service sector. She has been a strong advocate for the development of midwifery schools across Sierra Leone and a key convener bringing together subject matter experts to develop context-specific and up-to-date curricula. Her passion for capacity building among nurses and midwives is driven by her commitment to reducing maternal and child health mortality rates in the country. To reducing maternal and child health mortality rates in the country. Mitra Nkfula, tell me a little bit about yourself where?
Speaker 4:you're from and how you got to where you are now. Hello everyone, I hail from the south of Sierra Leone, to be specific Puget District, and I went to the Holy Rosary School in Puget. I also proceeded after my O-level exams at that time, so the National School of Nursing in Freetown. After my three-year studies I went for two years course well midwifery within the same western area of Freetown. At the end of my training as midwife I was posted to various areas, one to Pugetong Government Hospital. After some years I was posted to various areas, one to Pugetong Government Hospital. After some years I was transferred.
Speaker 4:That was during the war, and during the war we were then sent to the camp at Gundama. We spent some time there and there I developed the passion for midwifery and public health together. To me those two are the two careers that should match together. So we developed a lot of. We developed a lot of booths at that time, not hospitals but small, small booths within chiefdoms. We divided the camp into chiefdoms and we developed booths for them where we do ORT, where we do some deliveries and so forth. So I developed passion also for public health and I went to do my public health in Furabe College. I did the diploma in public health and was then transferred back to a longer government hospital to practice and I practiced at the clinical site for a few years, about five years there. I know the relationship between clinical and public health.
Speaker 4:From there I was transferred to Pujo as the district health sister. I spent some time in Pujo and proceeded to Kambia in the north and then to Bombali district. From Bombali district I was then transferred to Western area. At that time Western area was one not OBA and rural. So I was there as the district health sister, one there at the district health system one. At the end of five years I was transferred to the reproductive health and family planning program. At that time we were at Presence Christian Mentality Hospital. There I worked with the midwives within that facility to develop SOP standards for delivery standards for the use of MSOB store standards for the use of Maxsoft. That was at that time. That was what we used. So trainings and so forth. We do trainings for our facility workers, for the DHMT workers, for the peripheral health unit workers. So I was finally transferred there.
Speaker 4:We had Ebola Then. I was then transferred to the Directorate of Nursing as deputy and I was in charge of the training that we are going on with Ebola. So we trained before the foreigners came in to assist us. At the end of Ebola I went and did my master's in public health and then I came back. I was now appointed as the chief nursing and midwifery officer in the Ministry of Health.
Speaker 4:I have worked with so many partners and we decided to develop the maternal and child health handbook.
Speaker 4:I went to Japan where I learned about the handbook and we, as serial unions, decided to develop our own in our own context. So now we are trying to roll out this handbook to all the facilities if we can get help from other people, because what we have learned is a routine book is not a one-off printing book, so we need everybody all hands on deck. I've enjoyed working in the Ministry of Health and Sanitation with all my partners and I hope we will continue to work hard to reduce the death of our mothers and babies and infants. I have also contributed a lot to the development of additional midwifery schools, because from years ago we had only one midwifery school within the country. Now we are boasting of three of them one in the north, one in the south and one in the east as additional to freedom and one in the east as additional to freedom. So we thank God and we are going to continue working on this line so that our mothers can have quality care delivery. Wherever they are, they can access quality of care. Thank you.
Speaker 3:Thank you, Matron. I understand that the Nursing and Midwifery Office has just finished the 2025 version of the National Nursing and Midwifery Office has just finished the 2025 version of the National Nursing and Midwifery Strategic Plan. What are some of the main accomplishments that have been reached since the last strategic plan and what are some priorities outlined in this plan?
Speaker 4:The Midwifery Nursing Strategic Plan was developed with support from UNFPA and there are so many things outlined in that. Midwives we have to focus on the development of the faculty itself so that we don't have diploma tutors or nursing tutors that teach diploma. So we are working on that. Most of them are now masters holders, so that is one of the achievements from the last strategic plan. Also in the strategic plan we are talking about service delivery. We want to ensure that the nurses give quality service delivery to their patients. So we are now looking at the tools to encourage them for documentation. So we have developed this handbook to ensure that there is continuum of care from pregnancy right down to up to five years. We are even envisaging that we can bring in the HPV within that handbook so that by 10 years, if you are a female, you can now have your HPV within the book. We also, apart from service delivery, the associations is also a pillar. On that. We have now reviewed all the associations they have. What do we call it? The associations we have? So we have helped the two associations the nursing and midwifery associations to develop their constitutions. So we have also done that, which is a plus from the old strategic plan and now we have done our elections as well, the two. They have got new executive coming up. In fact, what we did the last time we had interim so that we developed their standards and so forth, all the policies and so forth within those associations, but now we have elected the executive for both associations. So that is a plus from the old one. Now we want the associations to develop their own plans and to see how they can write their own projects so that they can finance themselves Under the strategic plan. We also have the regulatory body. We have worked on the act. It was last 2023 that it was enacted in parliament and now we have a council instead of a board. We are now trying to have the physical space for the board. So we have acquired a land space where they are working on the BOQ so that we can source funding for the construction of the secretariat for nurses and midwives. So that is a plus from the old strategic plan, plus from the old strategic plan.
Speaker 4:We also worked on the education. We are now working with the universities to train specialist nurses instead of just RNs, rns. So we are doing specialist nursing training. We are doing presently the university commerce. We are doing presently the university commerce. They are doing specialty training on medical surgical critical care, perioperative care, nurses and massanga. We are doing tutorial for nurses. We are doing also mental health. They are doing physiotherapy for nurses. We are doing also a mental health. They are doing physiotherapy for nurses. So all those specialty areas have been identified and we have started the trainings For the mental health. It's going to be next year because we are now developing the curriculum for mental health.
Speaker 4:So we had a lot of achievements from the previous strategic plan, but we have already completed this one and we hope, with the challenges from the last time, we will be able to overcome them. The first challenge was like really getting finance to implement all this strategic plan that we developed. But what happened? We had limited partnership. So now we are working with partners, like for the maternal and child health handbook. We have few partners now with us. Jica is one who is really championing the implementation of this handbook. We have World Bank working with us also. We have Seed Global, and Seed Global is not just working with us on the handbook, they are working with us in our training institutions. They bring in international experts to work with us Presently international experts to work with us. Presently we have six of them working, two in the north the North Midwifery School in the north two in the south and two in the east. So we are waiting to see how we can bring the National School of Midwifery on board this year. Thank, you.
Speaker 3:Thank you, mitran. As we talk about this strategic plan, we also would like to talk about maternal and child mortality For our listeners that are new to this topic. What are the leading causes of maternal and child mortality in Sierra Leone?
Speaker 4:The leading causes of maternal mortality are hemorrhage it's at the top of our list for maternal death simply because there are underlining causes. Some women are anemic when they come into labor, some women cannot get access easily to comprehensive care and some people even fail to come until the last moment. The second is obstetric emergencies is eclampsia. Emergencies is eclampsia. Eclampsia occurs normally with high blood pressure during pregnancy and we have noticed that this is linked to mental health disorders, stress in the home, stress in their workplaces, stress with their husbands and so forth, and it's an underlining cause to develop the preeclampsia. And when they develop the eclampsia, if they don't access the facility earlier, definitely we will lose them. So that is another cause.
Speaker 4:Sepsis is another cause for maternal death in Sierra Leone, though on a lower scale. But what we are seeing is that especially when women deliver not in the facilities they come in with sepsis because after delivery you have to have, you have to use, definitely have to use baths and so forth. So normally, what we have found out, the hygiene aspect of maternal care is lacking, especially where you don't have these women accessing the facilities earlier. So what we have said is that we now are going to embark on educating the women in their communities to prepare for delivery, so that if you have to use your pad then you have to have a clean cloth. If you cannot afford to buy, then you can have your clean cloth, iron it up and then you can reduce the possibility of sepsis.
Speaker 4:And then sometimes these women, they also go for delivery definitely at the facilities, the facilities, some facilities at the lower level. They don't even have sterilizers to sterilize. You know their instrument, the instrument that they work with. They are now used to chlorine washing. So when the chlorine are not available, what happens? We don't know. But sometimes they come up now with sepsis and they are treated in the hospitals. But sometimes and they are treated in the hospitals, but sometimes even when you have CICs done in some areas, you have sepsis, resorting to sepsis, whether they cannot afford to buy their dressings and so forth. So people will end up with sepsis. Or sometimes they are already malnourished before they come in, so they don't have that much resistance. So for sepsis. And then we have. I think those are the three leading causes of maternal deaths in Sierra Leone in Sierra Leone.
Speaker 3:Thank you so much and you've also highlighted with that the challenges in addressing these issues, which is access, hygiene, lack of the resources, lack of integrating mental health into this, for the stressors that usually will cause hypertension and other things in women that are of bearing age. So also we're looking at what are the specific cultural and social factors that contribute to maternal and child mortality in Sierra Leone.
Speaker 4:For the cultural in the first place in Sierra Leone when women, especially those living in the rural areas, when they are pregnant, they don't want people to know about it. In the rural areas, when they are pregnant, they don't want people to know about it. So if you have ectopic and you don't want people to know that you are pregnant, so in the end when the ectopic rupture, you will definitely lose your life. So that culture of hiding pregnancies before 12 weeks is contributing also to the death of young women within our facilities. Then the polygamy also contributes largely to the death of women within the communities, simply because when you have a polygamous home, the head wife is always the decision maker and if you are not in good terms with that head wife, what happens to you you will even be afraid to complete when you have problems. So in the end, when the problem escalates, then that's the time you find it even difficult for them to make the decisions. What can we do with this woman? Sometimes they even feel you have something to say or you are promiscuous. That's why you're having those problems. You are promiscuous, that's why you're having those problems. So we have that type of culture within our country. Then the older culture is even the nutrition aspect of women, especially when they are pregnant. There's no laid down rule that you can get extra. You continue to get whatever is available. Sometimes you can even go hungry for the whole day, until evening when the final meal is ready. So we also have to look at that. That's why we have developed this handbook with Victoria where we have the nutritional page telling you what a pregnant woman can eat during pregnancy fruits and so forth and a page for even the children. So that also can interfere. When the woman is anemic, what happens? When you come out for delivery, no matter what happens, you will lose blood and an anemic woman losing blood will lead to death if we are not careful, did not notice it before time.
Speaker 4:Another cultural behavior is the male decision. Most men, they will not take it from you. Let me say you are having bleeding before delivery, antepatient hemorrhage and the husband is not there. He goes out somewhere for two, three days. You have to sit down there and wait, especially where you cannot get coverage to that man. Then that woman be at risk of losing her life. So we have a lot of things there. The women are not given the opportunity to make the decision on their own when it comes to pregnancy and delivery, so we also have to work on that. That's why we are pleading on the involvement of male in maternal and child health using the handbook.
Speaker 3:Thank you so much, mitron. So, as you highlight these challenges, what are the current strategies and policies in place to reduce maternal and child mortality rates?
Speaker 4:The ministry wants to improve on access so that, wherever you are, you can access the facility when there is need or when you are pregnant. And, coupled with that, we want to also improve on the quality of care. That's why the ministry have developed Coupled with that, we want to also improve on the quality of care. That's why the ministry has developed a quality of care directory that goes out into the facilities to ensure that they deliver quality of care and they have the instruments and the materials, the consumables, to do that. And we also we are working on this maternal and child health book to reach the men as well. That's why we are talking about mama and papa class, so that the antenatal clinic can now offer mama and papa class for men and women to attend, so that we know more about the health of the mother and the health of the child. The ministry also is working on building quality hospitals. They are now working on tertiary hospitals within the country itself, at strategic points. Presently they are constructing one big hospital for Kudon District, moyambadi Street and Falaba District. Then they are working on a big hospital between Kenema and Bo, so that those two districts can access tertiary hospitals. They are also working on the personnel, now the comers. They are training specialist doctors and they are also training specialist nurses. The government is supporting these trainings. That's why they have also they have the Postgraduate College of Nursing not only nursing Postgraduate College of Health Specialties, where we have also a department for nursing and midwifery. So they are working on all this. It's already established. So it's now. They have developed their work plan for the next five years and they have started working. So with the postgraduate college, you now have nurses and midwives going in there to develop their career.
Speaker 4:The government is also working on partnership. There are so many partners coming in to Sierra Leone. So many donors want to do something For the partners. Now the Saudi Arabia they want to build us a 300-bed hospital in Longe. We are working with the Chinese and we are working with AIDB. Aidb is building the three hospitals in the three districts. So we are working on partnership and we are working with our donors to build on the. It's not only building the hospitals but the already existing hospitals to have light and sanitation. So the solar light project is on for 60 facilities. We already have or not we have done this. Pcmh Boer Government Hospital was launched recently the solar energy. So we are working on all these things to ensure that we improve on the quality of care that we give our women and our children.
Speaker 3:Thank you so much. So you talk about education. We're sitting in an office at the new midwifery school in Kenema, which is absolutely beautiful, and we have trainings going on around. Tell me a little about how this school came to be and why there was a need for it.
Speaker 4:For years by now, we have been training in one school that is the National School of Midwifery, with two classrooms, and we have been recycling nurses. You do your three years, you come out, work for two years and then you are enrolled into the midwifery and at the end of the day, we don't have the midwives where they are supposed to be, because when you come out, you are a nurse and you are a midwife. We will send nurses to come out and you will be among them as a midwife. Then you will lose your skills. So we saw that we are not gaining anything. Who said we should have over 3,000 midwives before 2030. And at that time we are not even up to 900. And most of them were in administrative work. So we decided to have another midwifery school in the north, sponsored by IMC at that time. So with the school in the north, we are now doing training midwives SECHNs. These are state-enrolled community health nurses that were established with the primary health care. We now decided to train them as midwives so that they can go into the communities further than the hospitals. But we saw that again, it was slow. We are still recycling our nurses now.
Speaker 4:We said what about the south? Let's have one in the south. So we partnered with Caritas and Action Mondial in Germany to establish the school in the south. Again we decided are we just going to be establish the school in the south? Again, we decided, are we just going to be training SHNs? Let's have what we call direct entry into midwifery. So we started the direct entry into midwifery last year but we saw that we are still training a small number.
Speaker 4:What about having one in the east? And this project came about with negotiation with ISDB. They decided to put up a structure for us and we came down to the community here, the mayor and the elders, the chiefs. We talked with them and they gave us a 10-ton acre to build that school. We informed ISDB, they did their assessment and they agreed with us.
Speaker 4:It is a special school. For over four years now we have been working on this school. It is a very special school In fact to me. I call it a college of midwifery in Sierra Leone. We are starting as a school but we want to develop into a college. It has special features. This is the first school with its own administrative building, school with its own administrative building, the first school which has a skills lab well equipped and a library plus a radio station, just for the school to communicate with the community. And it goes beyond the Kenema district into the Kailan district and you can also focus it in Bull district. So we are.
Speaker 4:It is a superb. It has it, has it? What does? It has hostels for male and female, so it's unique. So we are hoping. Presently we are sitting in the school, we are doing trainings, we are even going to use it as a hub for the training of midwives, those who are already qualified for their CPDs. We are going to use the school as a hub because it's spacious, it's free, it's just ideal for training of midwives. Thank you, thank you.
Speaker 3:Thank you so much, mitron. I can hear the sense of pride you have in how this birthing process of this I'll call it a center for excellence that you have created here. It's absolutely beautiful and we see how you know you have created kind of a high standard here. That is incredible for us. We've really loved being here and we're very impressed with this midwifery school. So what are the specific interventions that the Ministry of Health has been doing that have shown most promise in reducing maternal and child mortality rates in Sierra Leone?
Speaker 4:One. I think there are four key things, four or five key things. One, the trainings they have invested in training heavily. Two, they have invested in infrastructure. Three, they have invested in drugs and management. Four, in partnership we are now doing the PPP In partnership for the provision of drugs so that we can minimize the stockout of drugs for our mothers and children. So these are the four key things that the ministry is investing in, and supervision has come up as key. Now the ministry is planning to be doing hard-hook supervision to facilitate to district not just facilitate to district to see the functionality of the district and see how they can come in and survey some situations that are predominant in each district because we take them as they are all quite unique in their own operations.
Speaker 3:Thank you so much. Thank you so much. So we've been working on the training of skilled healthcare workers. We also are always, constantly asked about the challenges in retaining doing in terms of strategy, especially in these rural areas that need them most, and now you're bringing up some of the best trained and skilled health care providers.
Speaker 4:In the first place the ministry. A year ago they developed the rural retention strategy. A year ago they developed the rural retention strategy. Our problem now is the implementation of that strategy, ensuring that when you go to the provinces you will be considered, because people are afraid when you're in the provinces you will not have opportunities for scholarship, for even further your education and so forth. So we have worked on that. We are just waiting for the implementation from the HRH.
Speaker 4:And the problems with most of these rural areas is accommodation. Most facilities. They have only perhaps one or two accommodation, that is, for the in-charge, which is the community health worker and the community health officer please, not a community health worker, community health officer and the midwife perhaps. So we have limited space in these rural areas. And then the other amenities internet facilities, better schools for the children. So we are looking at all this and sometimes most of our midwives are women. They complain about home breaking, so they have problems with their relationships when they go out into those districts. So what this retention plan is to provide these small, small amenities for the EHUs, plus making it rotational so that at least you go there at least two years and you are allowed to return back to Freetown or whatever big town where you want to be. So those are the things that we are planning to do. We are just waiting for HR to source funds to implement this particular action.
Speaker 3:Thank you so much. We're wrapping up now. So how can we strengthen the referral system to ensure timely access to specialized care, and what are the data, gaps and challenges in monitoring and evaluating maternal and child health programs?
Speaker 4:We start with the referrer. There's a referrer system set up within the Ministry of Health, but they had challenges. So now there's an interim referral system going on and they are working really on rules and regulations. They are working on how to allocate these ambulances to districts and how to operationalizeize them, because most of the time there is no fear, there is no this. So now they are working on that to see how much fear an ambulance can use for, let me say, one quarter of half every six monthly. So the new interim team is working with partners and the ministry to ensure that they put together some literature. And there's another big thing that is a problem with the referral the maintenance of the vehicles. So it involves huge money. The ministry also. They gave money to NEMS but thank God for the new body that is honored. They can now plan really how to utilize this money properly. For the For monitoring and evaluation. Every district will have monitoring and evaluation team.
Speaker 4:We are now saying that the data collection is also very important. We have to train our nurses and these are the people who collect our data so you can evaluate your data, provided you have the correct data. So we need to train our nurses and midwives on data collection. Apart from data collection, the digitalization of the data. This is going to be a huge change and if we succeed it's going to be a plus, a feather in our cap in the Ministry of Health. In fact, most of the nurses they don't even have computers. Most of the healthcare workers in the district they don't have computers. Most of the facilities themselves. To have one computer for the facility is also a challenge. So we have to work step by step to see how we can get our nurses and midwives to know more about computer and how to digitalize all their data before they can set up to the data managers.
Speaker 3:Thank you so much. So our final question that we ask all guests is what are you most optimistic about? Guess?
Speaker 4:is what are you most optimistic about? That in the next one to two years, cereal Young will post off more than 3,000 nurses, midwives. If all these four schools together train, we hope to get more than the 3,000 working in the field, not only those working in the offices, and I hope that at the end of the day, at the end, we will reduce drastically, we will bend, the curve of maternal death right down to international standard. Thank, you.
Speaker 3:Thank you so much to our listeners. We say thank you to Matron Mary Fuller, our Chief Nursing and Midwifery Officer, who is most beloved. You should see when she comes into the room how the midwives sing and are so happy because of the immense change and that she's doing nationwide and her passion for reducing maternal and child mortality rates. Thank you so much, Mitra Unfula, for coming and speaking to our audience today and sharing your wisdom and for all that you are and all that you do. Thank you.
Speaker 1:Thanks for listening. If you enjoyed this episode, please subscribe, share it with others, post about it on social media or leave a rating and review. To catch all the latest from us, you can find us at Helping Children Worldwide on Instagram, linkedin, twitter and Facebook Hashtag Optimistic Voices Podcast.
