‘YOUR Reproductive health Matters’ is back. Your weekly column that delves into the challenges that Zambia is still facing in the provision of primary healthcare owing to various factors that include health financing, infrastructure, health personnel, traditional and cultural beliefs, and legal barriers, among others.
This column will highlight success stories as well as areas that need to be improved in Sexual and Reproductive Health and Rights in Zambia with a clear focus on the marginalised groups. Join me as we set out on this interesting journey together.
Today, we look at the Maternal Mortality Rate (MMR) in Zambia
‘NO woman should die while giving life,’ is a global campaign that has given rise to well coordinated efforts by governments, cooperating partners, and non-governmental organisations among other players, to scale up programmes aimed at alleviating maternal mortality.
Despite recent advances, Zambia continues to experience high maternal mortality which currently stands at 252 against the national target of 100 per 100,000 live births by 2021.
Maternal deaths account for 10 per cent of all deaths among women aged 15-49 in Zambia.
According to the Zambia National Public Health Institute (ZNPHI), more than one-third of maternal deaths in Zambia are due to obstetric hemorrhage, and this is compounded by inadequate comprehensive surveillance for early detection of cases
when they occur in the community.
One of the pillars in safe motherhood is safe delivery, which requires women to deliver at health facilities, and under the care of qualified health professionals.
The campaign to accelerate the reduction of maternal mortality
in Africa (CARMMA) which was launched in 2010 identified three delays that make obstetric hemorrhage management challenging and significantly contribute to maternal deaths in Zambia.
They include delay in seeking care by individuals, delay in reaching care, and delay in receiving care.
To address these delays, the government through the Ministry of Health (MoH) has been raising community awareness, building mothers’ shelters and deploying staff in addition to treatments at the service delivery points to support the equitable provision of maternal child health (MCH) services.
Cooperating partners like UNICEF have also put in place various initiatives such as the establishment of Safe Motherhood Action Groups (SMAGs) that are trained, and equipped with basic supplies to reach out to the most disadvantaged women and the most in need.
The Planned Parenthood Association of Zambia (PPAZ) has also set up mothers’ waiting shelters in selected areas to promote safe delivery.
Despite all these efforts, about 53 per cent of births in Zambia occur in homes.
Hosea Foloko is a resident of Masaiti District in the rural part of the Copperbelt province, and she shares her experience.
“Mukolwe area (in Masaiti District) is one of the few places to have benefited from mothers’ waiting rooms but to be honest, I have had to bear my two children at home not because I don’t want to use the facility but it’s just the attitude.”
“I am very much aware of how risky it is to deliver at home because during my last pregnancy, I had to be rushed to the hospital due to excessive bleeding which we could not handle,” she says.
In contrast, Faith Fubisha of the same area says most women in Mukolwe have always yearned for the safest facility where they could deliver babies without facing the risk of losing their lives.
She says the construction of a mothers’ waiting shelter and training of SMAGs to make services available in her area, was an answer to their challenges of covering long distances to access healthcare facilities.
“The nearest health facility at Masaiti Boma is far from our homes and before this mothers’ shelter was constructed, many women would walk a long distance despite being pregnant to access the services resulting in most of them preferring to deliver at home. We are happy that most of us are now making use of this shelter for our safety,” she says.
Kitwe Teaching Hospital (KTH) senior medical superintendent Abidan Chansa has stressed the importance of giving birth at health facilities.
“Health facilities are fully equipped to deal with any complications that arise during and after giving birth. It is therefore, important for mothers to always seek to giving birth at health facilities to avoid the risks associated with childbirth.”
“During late pregnancy and early labour, women and families should act on danger signs, such as High Blood Pressure, swollen feet, bleeding of any sort by going to the clinic or health facility early,” Dr Chansa said.
Dr Chansa further explained that many of the deaths counted as maternal deaths occur in the hours and days right after delivery with severe bleeding (Hemorrhage) and infection (sepsis) as the worst complications.
“Such complications are common and can be managed easily in a clinic setting, but are likely to lead to death at home. The first examination of a woman after delivery is within six hours, therefore, women should stay in the clinic at least six hours after delivery to minimise the risk of bleeding and infection.”
“It is also critical for expecting families to make sure a complete birth plan is in place, and a health facility for delivery is decided in advance before the due date of the pregnancy,” he explained.
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Mon, 27 Mar 23 12:06:44 +0000