Forty five years ago, Marie Hawoule watched her first child die a slow painful death.

“He started vomiting and swelling like a balloon,” she recalls.

Then, she was a teenager – newlywed and like most young women in her community, uneducated.

Now 60, she lives in the same cluster of cylindrical huts surrounded by wilting grass, roaming livestock and other similar compounds.

Memories of what happened have lingered on, trapped in her head for more than four decades.

“They smashed a clay port,” she remembers, “and used one piece to cut off my son’s umbilical cord.”

The boy died 20 days later.

A risky affair In Hawoule’s part of the country, childbirth is a risky affair that often takes away the life of the baby, and sometimes that of the mother.

Most women give birth at home, where untrained birth assistants use broken clay pots, kitchen knives and sometimes their teeth as surgical knives.

Infections and complications from poorly attended home deliveries add to several other factors causing children to die before they turn five.

Hawoule is part of a grassroots movement that is trying to bring change and give children in poor communities a better shot at life.

After community relay workers educated her about the benefits of antenatal visits and medically assisted deliveries, she says she has been taking every opportunity to talk other women out of having their babies at home.

Essential Family Practices Experts believe families that adopt essential family practices can eliminate up to 40% of the most common cause of deaths in infants and mothers.

In the Far North region, UNICEF is pushing for the adoption of several key EFPs, identified by communities themselves;

• Vaccination

• Exclusive breastfeeding for the first six months

• Antenatal visits

• Use of mosquito nets by the entire family

• Use of latrines

• Hand washing with water and soap

• Birth registration and child protection

According to a 2011 survey, the broader Far North is one of the worst places in Cameroon for a child to be born or for a woman to give birth.

In 2011, the under-five mortality rate in the region was believed to be 168 per thousand life births, well above the national average of 122.

Women like Hawoule often experience the deaths first-hand and endure the pain of losing a baby for the rest of their lives.

Yet, more than 45 years since she lost her first child in a sloppy home delivery procedure, things have not changed.

A few kilometres from Hawoule’s huts, in a community of farmers and cattle herdsmen like hers called Torok, the last birth in a health centre was reported in December 2013.

Indeed, nearly 80 percent of births in the entire region still take place at home. Aid workers and health officials say years of education have not produced the desired impact.

Community-driven change Now they hope women like Hawoule, community members themselves, will drive the needed change.

The United Nations Children’s Fund (UNICEF) is leading a grassroots-driven Communication for Development (C4D) campaign in the region.

The project, funded by the Japanese government, drafts community leaders, women representatives, young people and local administrators to help promote essential family practices – simple affordable things that families can do on their own to increase child survival.

Regional and district committees were trained in inter-personal communication skills but allowed to develop and implement their own strategies to reach communities.

“They are with the people everyday and understand their culture and how to cause behaviour change,” says Claire Soppo of the UNICEF country office in Yaounde.

“It is critical to involve local people in the process.”

In Novemeber, UNICEF also organised a mini football tournament dubbed sports for development (S4D) that included side-line activities like sketches and quizzes to promote public knowledge of essential family practices.

By adopting essential family practices, communities can increase child survival rates by up to 40%, says Claire.

“When you live in a place where health centers are far away, water is lacking and basic infrastructure lacking the best thing to do is to prevent falling ill through simple things like washing hands at critical moments like before eating or after using the latrine.”

Five districts of the Far North, with some of the country’s worst child survival and protection records, are involved in the C4D campaign.

“We wanted to set up a system that can be replicate anywhere else and with any funds,” says Serge Banyimbe, the C4D officer at the UNICEF country office in Yaounde.

“The broad ambition is to give children a good start in life.”

Even though Hawoule is past the childbearing age, she says she is now helping other women avoid the mistakes she made.

“When you give birth in the hospital, you have fewer problems,” she says.

“Children born at home are always sick, but those born in the hospital have fewer problems.”