UNFPA is on the frontline of efforts to realize high-impact maternal and newborn health interventions in Lao PDR. To achieve this, it supports the nation’s health sector and local partners with investments in quality education to ensure all health professionals have the knowledge and skills they need to deliver life-saving support in remote and hard-to-reach communities that need it most.
Thanks to the generous support of development partners such as KOFIH, Luxembourg and the Maternal Health Trust Fund to the family planning and sexual reproductive health programs as well as UNFPA deployed technical and financial resources, the systems strengthening programs are already delivering results, with Lao PDR becoming Asia and the Pacific’s first internationally accredited midwifery schools. To see this work in action, UNFPA meets two beneficiaries from one of the schools located in northeast Xieng Khouang province, home to a number of ethnic communities and one of the highest for family planning uptake in the country.
Xieng Khouang province, Lao PDR: Vongchanch and Lar Inthavong go to work each day knowing their specialist skills can make life-saving differences to the communities they serve.
“I have been a midwife for nine years now. I know it is really important work and it makes a difference. It makes me passionate about my job, especially seeing the interest of the community in [adopting] healthy behaviors,” said Lar, a 28-year-old midwife from Long Hang village, in Phoukout district.
She has joined 36-year-old Vongchanch, a doctor based in Khoun district’s Longsan village – 32 kilometers from the nearest town, to attend a Basic Emergency Obstetric Care (BEmOC) training for health workers. The four-day course is being held at the College of Health Sciences, one of three midwifery schools in Lao PDR internationally-accredited with UNFPA support.
The BEmOC course builds the capacity of midwives, nurses, general practice physicians, obstetricians and gynecologists who commonly attend births at the acute phase of an emergency response.
“We, as health providers, are glad to attend the BEmOC training. We have expressed interest in capacity building and this training was very practical and informative” said Dr Vongchanch.
This training reflects the broader commitment of the Ministry of Health, with UNFPA support, towards building the capacity of midwives under the Reproductive Maternal Neonatal Child Adolescent Health Strategy 2021-2025. This was emphasized at the high-profile 7th Asian and Pacific Population Conference in Bangkok in late 2023, with the Government of Lao PDR reiterating its International Conference on Population and Development commitment to achieve zero preventable maternal deaths. This will be realized through increased investments in midwifery through a national midwifery strategy to ensure midwives are well-trained and deployed to health facilities, especially in remote and hard-to-reach areas, such as Lar and Vongchanch’s villages.
For Vongchanch, supported by five volunteers in this village, this transfer of knowledge is critical as the remote location, lack of information and cultural beliefs combine to expose pregnant women to multiple risks during pregnancy, delivery and postpartum.
“I cover three villages. The majority of my clients are ethnic Hmong. Despite all efforts to raise their awareness, they always wait for the last minute to come to the health facility for delivery. The young mothers often feel unwell after the delivery. We are doubling efforts to raise awareness on the risks of early pregnancies as well as child marriage,” said Vongchanch.
Basic emergency obstetric and newborn care, provided by skilled staff such as Lar and Vongchanch in health centers, plays a critical role in reducing maternal and neonatal deaths.
Timing is critical in preventing maternal death and disability: postpartum hemorrhages can kill a woman in less than two hours. For most other complications, a woman has between six and 12 hours to get life-saving emergency care. Similarly, most perinatal deaths occur around delivery or in the first 48 hours.
To manage obstetric complications, this means facilities must have multiple skilled attendants, such as Lar, ready to deliver assistance around the clock.
“In my village, I met with an adolescent girl aged 14 years old who became pregnant. Immediately, I knew this was a case at risk of health complications. I asked her to go to the village hospital, but she refused to be monitored because the nurse was a male practitioner,” said Lar.
The girl spent three days in labor before Lar convinced her to go to the hospital.
One day after delivery, the patient started bleeding intensively for more than three hours. Lar contacted other health colleagues using the established telehealth support system to seek advice on immediate actions to save the mother’s life.
“We were successful, but after I faced this situation, I decided to join the BEmOC training to gain more skills and also confidence in my practice,” said Lar, who is now encouraging other colleagues to attend the training.
The pair said the training also offered an opportunity to share experiences, gain mentorship and highlighted health providers’ thirst for knowledge and skills to realize favorable maternal and newborn health outcomes and achieve zero preventable maternal deaths.
“We have a very rewarding, yet challenging job. Receiving this type of training can literally be the difference between life and another outcome,” said Lar.
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UNFPA, the UN's sexual and reproductive health agency, works in over 150 countries, including Lao PDR, to achieve zero maternal deaths, zero unmet need for family planning and zero gender-based violence.
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