Edwige Ratafindrafara, 19, four months pregnant visits the Ankadinandriana health centre, Madagascar

Edwige is four months pregnant. She is visiting the Ankadinandriana health centre, situated in the rural highlands of central Madagascar. Edwige is at the centre, which is the only health facility available to the 10,600 inhabitants in 14 rural villages over 40km east of the capital, Antananarivo, to receive her vaccine against Maternal and Newborn Tetanus, supported by the Pampers and UNICEF “1 pack + 1 vaccine” campaign.

Edwige, who works as a farmer, learned about the importance of vaccines from her mother-in-law who had been speaking with 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 diseases such as Maternal and Newborn Tetanus.

She has lived in a rural village, 30 minutes’ walk from the centre, her whole life, and 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, usually arriving by foot in labour and waiting 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.

Edwige feels safe in the knowledge that she can reach the health centre by foot and that there will always be a doctor, nurse or midwife.

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.