The Sunday Mail
Pregnancy is an experience women cherish dearly despite the labour pains associated with it. Sadly, many times expecting mothers die while giving birth. This is an epitome of a health delivery system gone wrong. A total of 232 cases of maternal deaths have been recorded since the beginning of the year and six cases were recorded last week alone. Although the country’s maternal mortality ratio dropped from over 900 deaths per every 100 000 live births to 614, the rate is still unacceptable.
For those living in the rural areas, far away from health facilities, this high rate of maternal mortality brings anxiety for pregnant women.
The Ministry of Health and Child Welfare is concerned about the maternal deaths.
“Though we are not delighted by the high numbers of women dying giving birth, it’s a relief because the numbers are coming down as compared to the previous years,” said the Ministry’s director for family health, Dr Bernard Madzima.
“Around this time last year, the country had already recorded more than 400 maternal deaths. We are aiming to curb preventable or avoidable maternal deaths which are mainly caused by reporting late to a facility.”
The maternal mortality rate is the annual number of female deaths per 100 000 live births from any cause related to or caused by pregnancy or its management. The major causes of maternal mortality are pregnancy induced hypertension, post partum haemorrhage, malaria, puerperal sepsis, obstructed labour, lack of information and unsafe cultural practices.
Factors associated with maternal deaths also include the delay in deciding to seek medical attention, delay in reaching a health care facility and receiving appropriate care. The absence of skilled personnel during child birth, lack of services to provide emergency obstetric care, reproductive health commodities shortages and weak referral systems also contribute to maternal mortality.
Studies have revealed that over 30 percent of mothers in the country do not deliver in health institutions and over 57 percent of mothers do not go for post-natal checkup.
Unicef Zimbabwe country representative, Reza Hossaini has commended the country’s efforts in reducing maternal mortality.
“Maternal mortality in Zimbabwe is actually going down. After 20 years of rising, for the first time between 2010 and 2014, the curve is bending downwards,” he said.
“In Zimbabwe, health facilities are available and utilised, good ante- and post-natal care services are available, mothers are educated and early treatment of conditions which aggravate complications in pregnancy – all these have helped in reducing the deaths even further.”
However, some countries in sub-Saharan Africa have managed to bring down the numbers even lower than Zimbabwe. Maternal mortality ratio for South Africa stands at 300 per 100 000 live births, Mozambique 490, Malawi 460, Tanzania 460, Zambia 440, Kenya 360, Swaziland 320, Namibia 200 and Botswana 160. The Government of Zimbabwe aims to reduce the deaths to 174 per 100 000 live births by end of 2015.
There is need for concerted efforts to ensure that no woman dies while giving birth, the current statistics are still worrying. All stakeholders must play their roles in reducing these figures.
The Zimbabwe Agenda for Sustainable Socio-Economic Transformation (Zim Asset) set social services and poverty eradication under one of its clusters. The cluster seeks to help reduce morbidity, maternal and infant mortality rates.
At least 90 percent of all pregnant women are expected to make at least four ante-natal care visits while fully functional maternity waiting homes should be available in all districts.
The Government and its partners have come up with various measures aimed at reducing maternal mortality in the country.
The prevention of mother to child transmission (PMTCT) programme in Zimbabwe which began in 2009 by using World Health Organisation (WHO) guidelines of single dose nevirapine or Option A which was later upgraded to Option B+ has seen a reduction in maternal deaths in the country.
In 2012, the UNFPA received a grant from EU to support the Ministry of Health and Child Care in revitalising maternity waiting homes and related services for the period 2012 to 2015.
In Zimbabwe, maternity waiting homes were attached to rural district hospitals from the early 1980s. This provides a safe place for high risk pregnant women during the final weeks of their pregnancy as emergency obstetric and neo-natal care services are readily available.
Maternity waiting homes also provide an opportunity for pregnant women to receive integrated health promotion on safe pregnancy, family planning, nutrition, hygiene and new-born care.
Moreover, the Government through the Health Transition Fund which was introduced in 2012, scrapped user fees for pregnant women in vulnerable communities as a measure to reduce the country’s alarming maternal mortality. Some traditional leaders have also become involved in the reduction of maternal mortality rate by fining expectant mothers who give birth at home.
Pregnant women who give birth in the homes are fined US$25 by the chief and US$5 by the herdman. In cases where cash is not available, they use goats as payment.
Gokwe’s Chief Nemangwe said: “Introducing a fine for home deliveries is the only way we can encourage pregnant women to visit health facilities. However, since the introduction of the fines, no new cases of home deliveries have been brought before our courts.”
