Government hospitals and clinics have been hit by a serious shortage of midwives in a development that has seen health institutions fail to devote adequate attention to pregnant women.The country requires 8 000 midwives, but only 4 422 are available. The deficit became well pronounced after many of the healthcare providers migrated to greener pastures.
Fears now abound that the situation could lead to increased maternal mortality. Zimbabwe Nurses’ Association (ZNA) president Mrs Regina Smith said the country should immediately devise strategies to address the situation.
“Statistics from our sub-organisations show that the country requires a total of 8 000 midwives to attend deliveries in public health institutions and yet we only have 4 422.
“We have trained at least 6 500 midwives, but 2 078 are either in the private institutions or have left the country for greener pastures.” Mrs Smith said the ratio of midwives to expecting women was way below standard. As a result, she said, some of the patients are at times left unattended. The standard ratio of midwives to deliveries is 1:1 in the labour ward and 1:2 in the maternity ward. Mrs Smith said the present ratio stands at one midwife to 15 patients in the maternity ward and one midwife to five in the labour ward. “Ideally, midwives should only serve their main function; to improve accuracy and maintain quality care for pregnant women because no woman should die while giving birth,” she said.
Mrs Smith said most rural hospital and clinic maternity wards are being attended by primary care nurses and registered general nurses who are standing in for midwives.
Although Health and Child Care Minister Dr David Parirenyatwa could not be reached to comment on this particular matter, he recently revealed that the authorities were working to improve maternal healthcare.
A midwifery expert, who preferred anonymity, urged Government to recruit seasoned personnel to ease the situation.
The experts added that the authorities should investigate every maternal death to establish whether or not it was a result of a skills deficit.
The Zimbabwe Demographic Health Survey shows that the Maternal Mortality Rate (MMR) was at 283 deaths per 100 000 live births in 1994. In 2005 and 2006, it was estimated at 555 deaths per 100 000 live births.
In 2010 and 2011, the MMR shot to an estimated 960 deaths per 100 000 live births. The rate, however, slightly declined in 2012 and last year to 525 deaths per 100 000 live births.
“During my years of serving as a midwife, all midwives should have first served as general nurses for more than four years before taking any midwifery course,” said the expert.
“After training, they would practise as midwives under mentorship for two years before going into the field. This would help avoid situations where mothers die while giving birth due to unskilled maternal health personnel.
“Nowadays, a general nurse can be trained for midwifery and be employed as a midwife without mentorship”.