Training Community Midwives in Angola to Prevent Obstetric Fistula

2 hours ago

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Votoka strongly believes that we must PREVENT obstetric fistula as well as TREAT the women who suffer from it. We are so proud that in 2025 we began to train community midwives/traditional birth attendants (TBAs), first in Huambo province and then in Bie province.

In early 2026 we continued the Community Midwife/Traditional Birth Attendant training in Bie province, where 403 TBAs received a one-day training on obstetric fistula prevention and the promotion of healthy pregnancies. These trainings occured across 5 different municipalities, namely Andulo, Belo Horizonte, Camacupa, Catabola and Nhareia. All trainings were delivered bilingually, in both Portuguese and Umbundu, to best transmit the content to our audience. This brings our TBA training in Bie to a close, with a total of 9 municipalities reached and 662 TBAs receiving training between October 2025 and February 2026.

Votoka (in green vests) with the traditional midwives from Camacupa, Bie, Angola. The midwives holding coloured folders have received a set of laminated images to use when teaching their communities about obstetric fistula and how to prevent it.

With less than 50% of the Angolan population giving birth in institutions (health posts, hospitals etc), that means half the population give birth at home without help or with the help of TBAs. This percentage skyrockets in rural communities, where over 80% of women are likely to give birth at home. Reaching these women is essential in order to prevent obstetric fistula from occurring.

Of the 403 midwives trained in 2026, we provided 150 of them with IEC kits (packs of laminated photos to be used to conduct awareness sessions in their local communities).

We hope that they will act as mobilisers - to identify women who live with obstetric fistula and connect them to treatment, and to prevent more women from suffering this devastating birth injury, and to prevent more babies from dying during childbirth. Whilst global efforts focus upon healing the physical wound of the women who suffer from obstetric fistula, sadly there is no way to save the babies who have died. So we must invest in prevention - for the women, and for their unborn children. We must also care for emotional health of the women who have suffered the trauma of a stillborn birth.

We try to encourage our TBAs to promote better mother and infant nutrition, participation in pre-natal care (when available), having at least 1 ultrasound to identify the position of the baby and the placenta (if available in their region), spacing out births to give each child better early nutrition and to allow the woman's body to recover, delaying marriage and birth till after 18 years of age (or later if possible), and encouraging women to give birth in hospitals that offer emergency cesarian care (if possible). In some provinces there is only one hospital for more than 1 million people that offers emergency obstetric care!

So far the midwives have shown great engagement with our training. They want healthy babies and healthy women too!