As part of safe motherhood practices, expectant mothers in Zambia are urged to deliver at a health facility so that they will benefit from medical care. But during the night in rural areas without electricity, midwives may have to struggle with a small flashlight torch or improvised kerosene lamp to provide the light they need to monitor labour progress or document clinical procedures.
But this is no longer a problem for Mandombe clinic, a typical poor rural health facility located in the heart of Luangwa District serving over 2000 people. The CIDRZ Better Health Outcomes through Mentoring and Assessment (BHOMA) study funded by the Doris Duke Charitable Foundation, has been implementing structured primary health care improvements in 42 rural centres in Lusaka Province. Mandombe clinic was one of the sites chosen for a 6-month long pilot. BHOMA installed solar panels so that the protocol-directed outpatient care could be implemented and clinical information captured on data servers for assessment and evaluation; part of BHOMA’s aim to improve rural clinical care.
However, after the successful 6-month pilot, the BHOMA study was required to shift out of Mandombe to focus on the other clinics. This presented a moral challenge to the CIDRZ BHOMA team: after assisting with bringing necessary light how could they pull out leaving the health facility, and its laboring patients, in the dark again?
The solution was to reroute the installed solar panels so that they fed into light bulb circuits that would continue to provide some basic lighting. Now laboring women who come to Mandombe clinic in the night find a brightly lit Out Patient Department and maternity room, and a happy midwife able to see what she is doing when she provides necessary care.