Hesperian Health Guides

Hesperian Health Guides

Work to improve women’s health

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HealthWiki > A Book for Midwives > Chapter 1: Word to Midwives > Work to improve women’s health


Midwifery is not just about treating health problems as they arise. Health problems have many causes. Some are physical, some are social, economic, or political. By treating social, economic, and political causes, you can prevent many health problems — and protect more women in the community.

Working to treat social causes and to improve women’s health is not something one midwife can do alone. She must work with the whole community. Understanding causes and finding solutions is more possible when people work together. See ideas about working with others to make change .

People who affect a woman's health

A woman's health is affected by many people. To care for a woman, you must work with those people too.

Some of the people that affect a woman's health are:

  • her husband, children, parents, and other family members.
  • the people she works with, or works for.
  • her neighbors and friends.
  • community leaders — including spiritual leaders, government officials, and village heads.
  • other health workers — like traditional healers, doctors, and community health workers.
a circle of men and women standing around a woman.
A woman's health can be protected — or hurt — by the whole community.

Anyone who influences the way a woman works, eats, has sex (or does not have it), or cares for her daily needs has an effect on a woman’s health. Sometimes the effect is good — it protects or improves the woman’s health. Sometimes it is bad — the woman’s health and well-being are endangered.

For example, it may not help to tell a pregnant woman to eat more if her husband always eats first and there is not enough left for her. She herself may believe her husband’s and children’s hunger is more important than her own. Who else could you involve to try to improve a woman’s nutrition, when she does not have enough to eat?

  • the woman's husband, who is eating first. Perhaps you could talk to him about how much food a pregnant woman needs.
  • the men of the community, who all expect to eat first. The woman's husband may be more likely to change if other men do too. You could have a meeting of men and women and discuss why pregnant women must eat more to be healthy. If one man in the community agrees that women must have as much or more healthy food as men, this opens the door for others.
  • children, who will soon grow up to be mothers and fathers. Each time a man eats first and most, and a woman eats last and least, their children see and learn that a man's hunger is more important than a woman's. By talking to groups of schoolchildren or by changing the way your own family eats, the next generation may grow up to value men and women more equally.


Who could you involve to make sure there is enough food for everyone?

Working together to save lives

When midwives work with the whole community, they can find solutions to help the women they care for — or to help everyone in the community. Here is a true story:

A creative solution

In the small villages of West Africa, when a woman has a problem in labor, it is very hard for her to get to a hospital. Few villagers have cars, and most taxi drivers refuse to take women in labor. When a woman is in danger, there is little her midwife can do.


Some midwives and villagers talked about this problem, and discovered a creative solution. Even though no villagers had cars, they were near a large road. All day and night, trucks drove down the road bringing products to the city. Someone suggested that if a woman needed help in labor, she could ride with a truck driver to the hospital.

For this plan to work, the villagers needed to be sure that truck drivers would agree to stop if they were needed. They talked to someone from the union of truck drivers. The union members were happy to help, and now they have a system that is simple and effective.


When a woman needs to go to the hospital, the midwife puts a yellow flag out near the road. When a passing truck driver sees the flag, he stops and picks up the woman and the midwife, and takes them to the city hospital.

By working together with each other, other villagers, the truck drivers, and their union, these midwives helped save lives.


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