Defined by the World Health Organisation (WHO) as the death of a woman while pregnant or within 42 days of termination of pregnancy, Zimbabwe’s high maternal mortality has become a major concern for Government and its partners in the field of sexual reproductive health.
Despite concerted efforts by both Government and its partners working in the field of sexual and reproductive health, Zimbabwe’s maternal mortality rate has continued to soar.
Last week, the Zimbabwe Women’s Resource Centre and Network (ZWRCN) and the Women’s Coalition joined the fray and in partnership with a coalition of 12 other local organisations working in this field, launched a campaign on accelerating maternal health service provision for women in rural areas of Zimbabwe.
The launch was witnessed by more than 10 Members of Parliament sitting in various portfolio committees dealing with sexual and reproductive health, senior Government and traditional leaders as well as civil society organisations.
There was a heavy presence of House of Assembly members through portfolio committees on Health, HIV and Aids, (represented and chaired by Mrs Maina Mandava), budget (represented by chairperson Mr Paddy Zhanda,) and public accounts (Mr Kudakwashe Bhasikiti).
Dubbed the Ridza Mhere/Hlab’umkhosi Campaign for Improved Maternal Health Services in Rural Areas — the campaign was launched initially in Mashonaland East at
Munyawiri School in Domboshawa and will soon be rolled out to other provinces.
ZWRCN executive director Mrs Naomi Chimbetete told The Sunday Mail In-Depth that the campaign sought to complement efforts of the Ministry of Health and Child Welfare’s Campaign on Accelerated Reduction of Maternal Mortality in Africa (CARMMA) launched in June 2010.
“The focus of the Ridza Mhere/Hlab’umkhosi Campaign for Improved Maternal Health Services in Rural Areas is to strengthen extensive advocacy in raising awareness on the issue of high maternal mortality in Zimbabwe.
“The campaign also seeks to influence the immediate and full commitment of the Government in addressing this challenge,” said Mrs Chimbetete.
The goal of the campaign is to see improved accessibility of basic and comprehensive maternal health services at rural clinic and district levels by 2014.
The mobilisation of a critical mass of organisations advocating for improved maternal health services and increased budget allocation and spending in line with the Abuja Declaration is expected to help accomplish this goal, Mrs Chimbetete said.
Sexual and reproductive health services are declining in the country with the maternal mortality rate (MMR) rising to 960 deaths per 100 000 live births, according to the recently released Zimbabwe Demographic and Health Survey (ZDHS) 2010-2011, from 555 deaths per 100 000 in the 2005/2006 ZDHS.
UNFPA sexual and reproductive health specialist programme officer Dr Mpeta told The Sunday Mail In-Depth in an interview last week that the current ZDHS noted the difficulty in measuring an accurate maternal mortality because of the huge numbers.
“This is evidenced by the fact that the maternal mortality is expressed per 100 000 live births, demonstrating that it is a relatively rare event. It is also important to note that the results for the 2010/11 ZDHS covers seven years before the undertaking of the survey,” said Dr Mpeta.
He said results from the current ZDHS clearly indicated that Zimbabwe was way behind in realising its target of 70 maternal deaths per 100 000 live births by 2015.
Sexual reproductive health experts have advanced several reasons for the upsurge of Zimbabwe’s maternal mortality rate.
According to the Zimbabwe Maternal and Perinatal Study of 2007, HIV and Aids is the leading indirect cause of maternal mortality contributing about 25 percent.
Pregnancy-induced hypertension/eclampsia, post-partum haemorrhage and puerperal sepsis are the top direct causes of maternal deaths.
There has been a decline in skilled attendance at birth from 73 percent in 1999; 69 percent in 2006 and 66 percent in 2010/11 ZDHS.
“There is therefore need for the country to continue investing in human resources for health. It is sad to note that according to the ZDHS 13 percent are assisted by a traditional birth attendant; another 13 percent by an untrained relative and 3 percent are unassisted.
“The high user fees continue to be a deterrent factor for women to access health services,” said Dr Edwin Mpeta.
Mrs Chimbetete told hundreds of people gathered at the launch who included pregnant mothers that adequate and timeous allocation of and transparency in spending of resources directed at maternal health could significantly reverse the high death rate.
The Ridza Mhere/Hlab’umkhosi Campaign for Improved Maternal Health Services in Rural Areas forms part of a regional campaign on “Accelerating the Right to Sexual and
Reproductive Health Services for Women and Girls”, which is being conducted in Zimbabwe, Zambia, Mozambique, Nigeria, South Africa and Uganda. The campaign will run from 2011 to 2014.
The regional campaign was necessitated by the realisation that despite the signing and ratification by African governments of regional and international instruments, high-level committees and commitments, such as the Millennium Development Goals (MDGs), Convention on the Elimination of all forms of Discrimination Against Women (CEDAW), the
Maputo Plan of Action (MPoA), the Sadc Protocol on Gender and Development, women continue to have limited access to SRHR services, and women’s health rights are not given the priority they deserve.
The following organisations form the coalition spearheading the campaign:
(ZWRCN), Women’s Action Group (WAG), Students and Youth Working on Reproductive Health Action Team (SAYWHAT), Gweru Women’s AIDS Prevention Association (GWAPA),
Zimbabwe Women Writers (ZWW), Women and AIDS Support Network (WASN), Katswe Sistahood (YOWLI), Zimbabwe Association of Doctors for Human Rights (ZADHR), Community Working Group on Health (CWGH), Padare/Enkundleni Men’s Forum on Gender, and the Disabled Women’s Support Organisation (DWSO).
In his keynote address at the launch, Deputy Minister of Health and Child Welfare Dr Douglas Mombeshora told the gathering that reducing maternal mortality has been a stated goal for at least 30 years under various regional and international agreements signed and ratified by African governments.
“Despite these proclamations, the maternal mortality ratio continues to rise and women continue to have limited access to maternal and other reproductive health services.
“More recently and more alarmingly, the 2010-11 Zimbabwe Demographic and Health Survey (ZDHS) recorded a maternal mortality ratio of 960 deaths per 100 000 live births, that is, for every 1 000 births in Zimbabwe, there are about 10 maternal deaths,” said Dr Mombeshora.
He said in response to this tragedy, Zimbabwe had successfully launched the African Union Campaign on Accelerated Reduction of Maternal Mortality (CARMMA). The campaign was launched from a background of high maternal and perinatal mortality rates, which are far away from the 2015 MDG targets.
“The ministry has prioritised a number of interventions, in order to improve maternal and newborn health, in line with the three delays model and life cycle approach.
“It will strengthen information, education and communication (IEC) on danger signs of pregnancy, birth preparedness, and mobilisation for skilled attendance at delivery by all women regardless of religious beliefs, age, residence and socio-economic status,” said Dr Mombeshora.
He paid tribute to international partners like UN Women, the European Union, OXFAM Novib and Amanitare, for their continued support towards maternal and newborn health. Dr Mpeta said current programmes expected to reduce the maternal mortality rate included integration sexual and reproductive health and HIV services aimed at reducing costs and providing services within the same locality.
The Health Transition Fund, a multi-donor pooled fund meant to support the Ministry of Health to achieve progress towards achieving the highest possible level of health and quality of life, has been established. Revitalisation of maternity waiting homes that would promote access to services and the repair of ambulances has become key for the