Morocco Family Planning and Maternal & Child Health Project: Phase V
Safe Motherhood

• Background
• Goal
• Objectives
• Audiences
• Communication Highlights
• Safe Motherhood Main Messages
• Phase II

Background

Due to high rates of maternal deaths in Morocco, Phase V (1994-2000) included a maternal mortality reduction program to improve the survival of women of childbearing age. The program focused on improving maternal health services and communicating the appropriate information to audiences that could effect change.

To raise awareness about mortality and convey the message that women need not die in childbirth, a national communication strategy was developed and implemented by the Information, Education and Communication (IEC) Division of the MOH, with assistance from Johns Hopkins University Center for Communication Programs.

Goal

To improve health of women of childbearing age and of children under the age of five.

Objectives

To enhance the quality and ensure the sustainability of family planning and maternal/child health services with consolidation of institutional capabilities.

Audiences

• Phase 1 main audience: policy makers
• women of childbearing ages and their families

Communication Highlights

• "Khlat Eddar"
• play, Aide-Toi, le Ciel t'Aideras, toured major urban and rural areas with safe motherhood messages and dramatic videos,
• Bent Ettajer, was shown by mobile health units
• Outreach national television and the country's major long-distance bus lines and "Point of Sale"

The Safe Motherhood Main Messages

Phase 1 concentrated on heightening policy makers' awareness of the high level of maternal mortality in Morocco and enjoining their commitment to reduce maternal deaths. Key to this advocacy effort was a widely disseminated documentary video, Khlat Eddar, calling for mobilization of resources and improvements in emergency obstetric care. At the same time, materials designed for health professionals urged them to take responsibility for preventing maternal deaths by emphasizing emergency obstetric care skills appropriate for each level of the health system. The documentary and the press kit were so well received that there was a marked increase in media coverage on maternal deaths, resulting in the endorsement from the late King Hassan II to address this vital health issue.

Phase II

The focus of this phase was on helping women and their families recognize signs of complications during pregnancy and childbirth so they can better make timely decisions to seek care. An Enter-Educate (entertainment education) approach was used with this audience wherein a play, Aide-Toi, le Ciel t'Aideras, toured major urban and rural areas with safe motherhood messages and dramatic videos, Bent Ettajer, was shown by mobile health units. Showing these materials on national television and the country's major long-distance bus lines increased their reach.

The communication strategy was based on the Three Delays model, which delineates non-medical factors contributing to maternal deaths:

• Cultural and socioeconomic factors that delay the decision to seek care,
• Access and distance factors that delay arrival at an adequate facility, and
• Health system inadequacies that delay the provision of appropriate care.

The model gives priorities to inadequacies in health services because they affect all the delays. For women to decide to seek care, they must know that they can get appropriate care from skilled providers at a health facility that has adequate resources and is accessible. However, the communication strategy is equally important in informing various audiences about what each can do in case of emergency obstetrics situation to reduce the unnecessarily high maternal mortality rate.

The communication strategy has been successful in placing maternal mortality reduction high on the national agenda, resulting in mobilization of resources and improvements in emergency obstetrics care. Outreach efforts through the Enter-Educate approach have helped women and their families learn that an obstetric complication does not ordain death. With such encouraging results, including praise from visiting US First Lady Hilary Rodham Clinton for the Moroccan government's commitment to reducing maternal mortality, the MOH is planning to replicate Safe Motherhood activities with varied donor support.