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CHIMANIMANI — Chipo Maraidze, pregnant with her first child, has just arrived at Mutambara Mission Hospital and is battling for her life.
She has been in labour since the day before but because of transport problems, has only managed to reach the hospital more than 24 hours later.
It’s too late because she has already developed complications. She is very weak and staff at the hospital try to save her and the child using all methods in the book. A few hours later they are able to save the mother, but she loses her baby.
Maraidze has been luckier than many other women who die every day in childbirth in Zimbabwe.
According to the United Nations Population Fund (UNFPA) at least eight women die every day countrywide while giving birth, the majority of them in rural areas where health facilities are not within easy reach.
The Zimbabwe Maternal and Perinatal Mortality Study published recently has estimated that the maternal mortality ratio in Zimbabwe is at 725 deaths per 100 000 live births. This mortality ratio is one of the highest in the region.
According to the World Health Organisation the maternal mortality ratio is one of the important indicators for a country’s health status, quality and access to health care and service delivery.
Secretary for Health and Child Welfare Gerald Gwinji recently said Zimbabwe’s maternal mortality ratio is one of the highest in the region and the situation was unacceptable.
But Maraidze’s story is the sad reality that many rural communities live with on a daily basis; many women continue to arrive at health facilities too late to save their babies and themselves.
But there is some light at the end of the tunnel.
The UNFPA together with the Japanese government is supporting the Maternity Waiting Homes (MWH) programme around the country. A MWH is a facility within easy reach of a hospital or health centre where a pregnant woman can stay towards the end of her pregnancy and await labour.
Once labour starts, the woman is transferred to the health facility so that labour and childbirth are assisted by a skilled birth attendant.
At some hospitals the programme had been abandoned over the years as a result of the economic crisis and the lack of donor support leaving many women at risk.
Speaking at the commissioning of the MWH programmes at Mutambara Mission Hospital UNFPA representative in Zimbabwe Basile Tambashe said although the maternity shelters are important the MWH programme cannot be a stand-alone intervention.
“Our level of success in reducing maternal mortality will depend on the availability of health workers skilled in obstetric and neonatal care services and their capacity to handle obstetric and neonatal emergencies,” said Tambashe.
“There is also need for the continued availability of the necessary tools of the trade and commodities for use by these skilled staff.”
Also contributing to high maternal deaths is the fact that as a result of the high maternity fees, the poor state of the health delivery system and for religious reasons many women were opting to deliver at home.
Recent statistics from the Central Statistics Office showed that at least 40% of women — even those in urban areas — are giving birth “outside a health institution”
To support the MWH programme the Ministry of Health and Child Welfare and UNFPA have come up with operational guidelines for the hospitals offering waiting services for expecting mothers.
The UNFPA recognises that there are “three delays” that contribute to the high rate of maternal deaths.
These are the delay in deciding to seek care, the delay in reaching a health facility and the delay in receiving appropriate care.
“In a bid to strengthen efforts directed towards addressing the second delay the ministry developed MWHs guidelines through a participatory and consultative approach, to facilitate their revitalisation and standardisation,” said Gwinji launching the guidelines at Mutambara hospital.
“The overall objective of the guidelines is to provide service providers at all levels of care with the key information on standard operational guideline procedures for the maternity waiting homes to facilitate their revitalisation and standardisation.”
While at the shelters expecting mothers are supported by the UNFPA and its partners to get at least three solid meals, blankets and bedding at no cost to them. Chipo Mudzokora already a beneficiary of the new look waiting shelter said she was very excited about the benefits of the programme for women.
“I stay very far away from the hospital in Rusitu (about 30km away) and when I heard about the shelter I felt relieved because I had no idea how I would get to hospital in time when I went into labour,” said Mudzokora.
“I want to tell many other people about it when I go back to the village. The hospital provides all our meals and all we do is sit and rest everyday. I think this is good because we save our energy for the big day.”
But for women like Maraidze the knowledge about this shelter may have come too late.
BY BERTHA SHOKO
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