High maternal mortality cause for concern

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Shortly after Zimbabwe attained independence in 1980, the Government constructed maternity wings at all major hospitals, provided the necessary drugs and recruited well-trained midwives.

Shortly after Zimbabwe attained independence in 1980, the Government constructed maternity wings at all major hospitals, provided the necessary drugs and recruited well-trained midwives.

Gender Lens with Moses Mugugunyeki

At one time, the government even abolished maternity fees at all health institutions, except central hospitals.

But over the past decade the health standards in the country have fallen as experienced health personnel left the country. There has also been a marked reduction in fiscal allocation to the health sector.

The cheapest maternity health services in the country are offered by local authorities.

Maternal mortality continues to be a major challenge in Zimbabwe with most women dying due to pregnancy-related complications because of limited access to antenatal, delivery and post natal care.

Maternal mortality is the death of a woman during pregnancy or shortly after pregnancy. It is also referred to as “obstetrical death”. The death rate is less than one percent in the developed world. The treatment to avoid maternal deaths has been available since the 1950s.

There is direct maternal death and indirect maternal death. A direct maternal death is the result of a complication of the pregnancy or delivery. An indirect death occurs when a patient with a pre-existing or newly developed health problem dies during pregnancy. The death is considered incidental to the pregnancy.

The major causes of maternal mortality are bacterial infection, uterine rupture (scar from a previous caesarean section tearing during an attempt at birth), renal and cardiac failure as well as hyperemesis gravidarum (condition characterised by severe nausea, vomiting and weight loss during pregnancy).

Around the 1980s when all was rosy in the health sector, the country had a low maternal mortality rate of just 90 per 100 000 live births. However, in 1994 the gains in the health sector plummeted to 253 per 100 000 live births. As if this was not enough, a more frightening situation was still to come.

Statistics from the Ministry of Health and Child Care show that maternal deaths in the country increased from 555 in 2005 to 725 per every 100 000 births in 2009.

According to the 2012 National Census Report, the maternal mortality ratio in 2012 was 525 per 100 000 live births. Health experts say Zimbabwe is losing eight women a day due to death caused by pregnancy complications.

However, if drastic action is taken to revive the collapsing health sector; the government can at least get closer to attaining Millennium Development Goal (MDG) Five — Improve maternal health.

Goal 5 A, targets the reduction of maternal mortality ratio by three quarters, while 5B is about achieving universal access to reproductive health.

The United Nations says maternal mortality has nearly halved since 1990. An estimated 287 000 maternal deaths occurred in 2010 worldwide, a decline of 47% from 1990. All regions have made progress but accelerated interventions are required in order to meet the target.

More women are receiving antenatal care. In developing regions, antenatal care increased from 63% in 1990 to 81% in 2011. Only half of women in developing regions receive the recommended amount of health care they need.

The health sector has to get its act together and avail more funds for other projects other than HIV and Aids. Maternal health is not being given the attention it deserves, but even if this happens, Zimbabwe is far away from achieving the 2015 target. But at least we can get closer to the target.

More maternal deaths are looming and if a road map for the resuscitation of the health delivery system is not crafted soon, more mothers are likely to succumb to pregnancy complications.

One way of averting death or serious morbidity when complications arise is through increasing access to skilled attendants during pregnancy, childbirth and postpartum.

Zimbabwe, with a population of about 13 million, 52% of whom are women, is facing the same fate as most of its African counterparts.

In Africa high maternal mortality rates have been largely attributed to inadequate financing of maternity programmes, illiteracy among women and tradition and culture, usually enforced by men to disadvantage the women.

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