Changing Attitudes from Home Deliveries to Delivering at Health Facilities

Khamis Abdalla Haji is a community health volunteer (CHV) serving the Kidazini community in Zanzibar. As a CHV in Zanzibar’s national community health program, called Jamii ni Afya, Khamis shares important health information with families in his community and helps connect them to primary health services so they can live safer and healthier lives.

Using a mobile phone and app, he goes from household to household to visit with clients, follow-up on outstanding health challenges, and answer questions they might have.

Recently, he visited Aisha Tajiri Abdalla, who was pregnant with her fifth child. She knew from others’ experiences that if she continued to have more children, then she would eventually be advised to go to the Mnazi Mmoja Referral Hospital to deliver.

But her four prior pregnancies had gone smoothly when she delivered at home and the hospital was far, so she planned to do the same this time.


During her fifth pregnancy, Aisha planned to deliver at home because her four prior home deliveries had gone smoothly. She changed her mind and decided to deliver at a health facility after counsel from Khamis, a CHV in the Jamii ni Afya program.
(Photo: Moh'd Abdalla Rashid/D-tree)

This immediately caught Khamis’ attention because the mobile app flagged that women with five or more pregnancies face a higher risk of possible complications and that supporting pregnant women to deliver in health facilities helps guarantee the health and safety of both mothers and newborns.


With supporting information from the Jamii ni Afya CHV app, Khamis counselled Aisha on the potential risks that can happen during a fifth pregnancy and encouraged her to attend a health facility for antenatal visits and deliver in a hospital. 

With a better understanding of the potential complications, Aisha decided to go to Mnazi Mmoja Referral Hospital for her delivery, and this proved to be an important decision when Aisha faced a premature delivery. Her baby was born underweight, but because she was at the hospital, her baby was able to receive special care for premature newborns.

After being hospitalized for one week, Aisha’s child was healthy enough to return home. Now that Aisha and her child have returned home, Khamis continues to check-in with them.

And, because the premature birth was documented, he uses the Jamii ni Afya app to share tailored information for premature newborns to best support Aisha with her newborn child.