Health Exchange

Five midwives and a doctor in Tanzania made a film in 2006 called ‘Play Your Part’. They documented the appalling conditions in which women have to give birth. Showing the film to policymakers had remarkable effects. The Government doubled the number of new midwives trained each year and placed more midwives in rural areas.

Brigid McConville, Director (UK) of White Ribbon Alliance Global Secretariat tells what happened.

Tanzania has by no means the highest maternal mortality rate in sub-Saharan Africa, yet it is still over 10 times higher than the rate in low-fertility countries in Europe. The ‘Play Your Part’ story began in Tanzania in 2006 when five midwives and a doctor – all members of the White Ribbon Alliance – were trained in participatory film making. In the space of two weeks they had made a 10 minute film which was screened to a major national audience, including the Minister of Health. The team then encouraged the Minister to participate himself. They filmed him and included him in the next cut. Since then, the team has continued to film and edit half a dozen different versions in English and Swahili, for national TV, for international audiences, and for the communities who shared their own personal stories.

In every version of the film, we see the struggles faced by people at grassroots level as they try to reach health facilities, as well as the heroic attempts of health care workers to provide mothers, babies and children with the services they need. In Babati, Tanzania where part of the film is based, the clinic is forced to make a list of supplies for a prospective mother to bring in, as they are so very short on various essentials such as gauze and gloves. As the film makes clear, overcrowding is a huge problem with only 10 beds for 60 mothers in one particular clinic.

We see families in their home settings and hear from men who have helped their labouring wives make the long trip to the health facility by wheeling them on bicycles through the night. We see the crowds of women waiting for health care – antenatal, postnatal, immunisation, family planning – from a handful of hardworking midwives at rural outreach clinics. We hear from the minority of women who have given birth at a health facility how skilled care has kept them – and their babies and children – safe.

We will not crack these deep-rooted problems until and unless everybody sits up, takes notice and plays their part.

The film has had a powerful impact. When the film was aired on Tanzanian television on the night before a budget debate, White Ribbon Alliance Tanzania (WRATZ) activists called members of Parliament and urged them to watch it – leading to uproar in Parliament the next day as MPs demanded better services for the mothers of Tanzania.

The Government has responded by doubling the numbers of skilled birth attendants trained year on year, and by immediately employing new midwifery graduates, especially in rural areas. Furthermore, President Kikwete is now a strong supporter of maternal health issues – his leadership very much evident at recent UN meetings in New York and in his role as President of the African Union.

But there was early concern about whether the film would have any impact at all. Rose Mllay of WRATZ said they were worried “whether it would be acceptable and owned by Tanzania, let alone the international world. We overcame that by seeking a permit from the Ministry of Information and requested that the Health Minister put his voice in it. In the film he discusses the problem of maternal and newborn mortality being related to inadequate skilled workers, and that it is felt from the grassroots level right up to the policy makers.”

The film also received high profile support from the pop star Stara Thomas, a mother and a household name in Tanzania. Stara contributed the title song for the film and performed it for the Prime Minister of Tanzania and other dignitaries at the public launch of the film in Tanzania.

‘Play Your Part’ is unique in bringing the authentic experiences of the people of Tanzania – midwives, mothers and other members of the community – to the ears of national and international policy makers and donors. For the first time, the film gives voice to Tanzania’s frontline health providers in their struggle to provide quality services for mothers and children. It also reveals the wide range of difficulties faced by families in getting access to those services. Above all, the film is a positive call from the grassroots to all of us – from members of the community, to governments, to international organisations – to play our own part in working together for mothers, babies and children.

The film has become a global model with the World Bank, which is now funding a similar project in Burkina Faso. This will hopefully yield the same community wide and political support as it has in Tanzania, resulting in everyone playing their part to help more mothers live to see their child grow up.

Brigid McConville
Director (UK) of White Ribbon Alliance Global Secretariat
Contact details: bmcconville@whiteribbonalliance.org
www.whiteribbonalliance.org

Watch the ‘Play Your Part’ film
http://www.whiteribbonalliance.org/resources.cfm?a0=video&play=PLAYYOURPART

Million Mums – The White Ribbon Alliance’s exciting new public campaign.
The aim of the Million Mums Campaign is to demonstrate the collective power of women by finding at least a million mums willing to say NO to maternal mortality.

Million Mums – Play Your Part – Pass it On
www.millionmums.org

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