Community overcomes birthing taboos in remote district

By Louisa Gibbs and Sian Rolls, Pacific Women.

Strict taboos were once forcing women in the remote Lufa District of Papua New Guinea to give birth in their outdoor gardens rather than the nearby health facility. This has changed, with women now birthing in the safe conditions of the local health facility, thanks to community-led action through CARE’s Mamayo project.

Women waiting for their appointment at a health centre. Photo credit: CARE.

It had been a customary practice for women not to give birth at or near locations occupied by men, in the communities that surround the Ubaigubi Sub-Health Centre in Lufa District. The local health facility was one such restricted area – women were not giving birth there because the health worker was a man. As a consequence, women were not receiving proper medical support during or after delivery.

‘Because of the customs… pregnant women did not go to the clinic,’ explained Kua Sam, a youth leader from Agibu Village. ‘They remain in the community and deliver.’

The Mamayo project is a maternal and reproductive health initiative led by CARE International in Papua New Guinea in partnership with the Government of Papua New Guinea and supported by Australia through its Pacific Women and Gender Equality Fund initiatives.

Mamayo uses proven community leadership methodologies that reduce the social and cultural barriers to women’s access to health services. It builds family and community support for women’s access to reproductive and maternal health. It also seeks to ensure community decision making about health services considers the needs and interests of women and girls.

The Lufa community selected 31 community leaders (13 women and 18 men) to complete Mamayo’s three-module community workshop series. The workshops are participatory and help communities challenge negative gender norms and behaviours related to poor health. The module topics are: leadership; sexual, reproductive and maternal health; and action.

The community leaders explored how local customs and gender norms can be harmful to women’s health. They identified norms and practices they could change within their communities and developed action plans. One action plan was to adopt community by-laws to repudiate cultural norms that had prevented women giving birth at the health centre.

The community leaders implemented their action plans by engaging with people in their communities through one-on-one and community discussions. These discussions brought together the custodians of culture, the eldest people in the community. Using the skills and information they learned in the workshops, the community leaders talked to the elders about the custom not being appropriate.

With the elders’ support and through a process that reflected the needs and interests of women, the community has removed the taboo. As a result, the women of Lufa District can now access the health facility to give birth.

‘[S]ince CARE arrived and taught us through their trainings we have passed what we had learned with our community and young men along with all other men are bringing their wives to the clinic,’ said Mr Sam. ‘I now think clearly. I set my custom and embarrassment aside and I continuously accompanied my pregnant wife…to and from the clinic.’

This story has been developed for the Pacific Women Annual Progress Report 2019. It features a Pacific Women-funded initiative and partner. For more information about Pacific Women’s support for initiatives across the region, refer to the interactive map:

Through a 10-year commitment, Pacific Women connects more than 170 gender equality initiatives funded by the Australian Government and implemented by over 160 partners across 14 Pacific Island countries. Providing technical, knowledge sharing and convening support to the portfolio of partners is Pacific Women’s Support Unit, working to improve the long-term impact of gender equality projects in the Pacific.