The Sunday Mail
Sunday Mail Reporter
The breakdown of Zimbabwe’s health referral system is negatively impacting efforts to reduce the country’s Maternal Mortality Rate (MMR), it has been established.
MMR refers to the death of a woman while pregnant or within 42 days of termination of pregnancy.
It is measured per every 100 000 live births.
The referral system requires one to first seek treatment at their nearest health centre.
However, statistics availed by the Ministry of Health and Child Care disclose that most women are bypassing their nearest health centres to flood the referral hospitals such as Chitungwiza, Parirenyatwa and Harare hospitals.
With their resources stretched to the limit the referral hospitals are recording more maternal deaths.
Of the 92 maternal deaths recorded across the country during the first 14 weeks of this year more than half of them occurred at Chitungwiza, Parirenyatwa and Harare hospitals, the weekly report on Epidemic-Prone Diseases, Deaths and Public Health Events ending 6 April reveals.
Harare Central Hospital had the highest number (27), Parirenyatwa recorded 12 deaths while Chitungwiza had 11.
Officials at the three health institutions argue that the breakdown of the country’s health referral system has given rise to this worrying trend.
Harare Central Hospital clinical director Mr George Vera disclosed that the institution’s maternity unit is struggling to cope with demand for its services.
“Ideally, a referral system is meant for complicated conditions but it seems the hospital is being overwhelmed by pregnant mothers who just come to deliver without being referred to Harare Hospital,” said Mr Vera.
“Our capacity is to assist at least 20 mothers per day but, we are currently assisting 30 or more mothers to deliver per day, which is a challenge for the hospital.”
Last year Harare Hospital recorded 14 605 deliveries and 77 deaths while 3 697 births and 27 have been recorded so far this year.
At Parirenyatwa and Chitungwiza hospitals officials disclosed that an increasing number of patients are coming without the referral letters as is required.
“Some of the cases can be handled at district hospitals but there appears to be belief that one is best served at a hospital in Harare or Chitungwiza hence the increasing number of patients who are coming directly to us.
“As a result of that belief we are also under pressure,” said an official at Parirenyatwa Hospital.
The Permanent Secretary in the Ministry of Health and Child Care, Brigadier-General Gerald Gwinji, revealed that Government is crafting measures aimed at ensuring that the referral system becomes functional again.
“A fully functional referral system is crucial in addressing the high maternal mortality rate,” he said.
“As a ministry we have been conducting meetings with health workers to educate them on the importance of the referral system because they also have a role to play in making it work.
“On the other hand, we are also having community-based programmes to alert the public about the system because it seems the majority is ignorant.”
Dr Gwinji, however, conceded that most women opt to bypass their nearest health centres because they lack resources.
“That is a challenge we are working hard to address.
“Our ministry, together with our partners and stakeholders, has trained 1 800 midwives to date as we seek to address the shortage of manpower at some sites.
“We are also going to continue crafting ways of ensuring that resources are available so that pregnant women can safely deliver at their nearest hospitals.”
Statistics show that the country’s MMR was at 283 per every 100 000 live births in 1994 and increased to 555 in 2006.
In 2011 it was estimated to be at 960.
