EVERY year across the world more than 300 000 women die from complications during pregnancy and childbirth. The figure translates to at least one woman dying every 90 seconds.
And for every woman that dies, another 20 women suffer from chronic ill-health or disability.
In Zimbabwe, between 1 500 and 2 800 women and girls die each year due to pregnancy-related complications, tra-nslating to 10 women dying every day.
Another 26 000 to 84 000 women and girls suffer from disabilities caused by complications during pregnancy and childbirth.
The prevailing maternal mortality rate stands at 960 deaths per 100 000 live births up from 725 deaths per 100 000 in 2009/2010 while child mortality rate is at 86 per 1 000 lives.
Given such shocking statistics, the country is far from achieving Goal V of the Mille-nnium Development Goals, which aims at reducing the maternal mortality ratio by 75 percent and achieve universal access to reproductive health for all women by 2015.
The confrontation between the Deputy Prime Minister Thokozani Khupe (pictured) and Harare Mayor Muchadeyi Masunda after the mayor dismissed Khupe's push to scrap maternity fees at council clinics, with Masunda describing the move as "unsustainable", will not stop the increase in the number of women who die providing a necessary service to their nation.
Khupe is advocating for the scrapping of maternity user fees for pregnant women at government hospitals and council clinics and says she has sourced US$40 million to subsidise maternity costs under the Health Transition Fund (HTF).
As a result, government in June 2012 scrapped maternity user fees in at least 36 rural district hospitals under the auspices of HTF. However, the free maternity service has been suspended following advice that the move was premature and risked worsening the situation in poorly funded hospitals and clinics.
"The high rate of maternal mortality found in the 2011 Demographic and Health Survey Report is a matter of concern. While there may be statistical queries to this, it needs to come down. The Health Transition Fund should complement the US$10 million allocation for maternal health from the Ministry of Finance to allow the Ministry of Health and Child Welfare to provide a comprehensive maternal hea-lth services without user charges," Community Working Group on Health, executive director, Itai Rusike, said.
Nearly one in three maternal deliveries are done outside the district of residence, as people search areas that offer better services or more affordable care.
Clinics need resources to provide adequate quality mat-ernity services for normal deliveries without charge, backed by improved referral and waiting mother facilities at hospitals.
"Reduced access to or use of skilled midwives within districts adds to cost burden or barrier to service uptake for women, indicating the need in these areas, largely rural, to improve the quality of maternity services within districts," said Rusike.
"Further, when facilities do not have waiting mother shelters, as is often the case; mothers may be discouraged from attending services by the costs of staying in the facility while they wait for the delivery, or the absence of a place for them to stay," Rusike added.
Despite the provision of free maternity services not being practical for a developing nation like Zimbabwe, the increase in maternal deaths still needs to be addressed.
Every minute wasted, another woman dies in childbirth.
Maternal and neo-natal health services in Zimbabwe face severe resource constraints from both the public and private sector, hampering the expansion of maternal delivery services. The consequences of maternal mortality are felt not only by women but also by their families and communities.
The high death rate among women due to childbearing is considered unacceptable bec-ause most of the deaths can be avoided. Failure to invest in maternal health has been described as not only irresponsible and immoral; it is also deeply counterproductive, undermining national growth and development.
"Central government finan-cing obligations to local government need to be clarified and reliably honoured so that services are not compelled to unfairly charge poor communities in contradiction to national policy. Fee barriers at primary care services need to be removed.
"There should be a particular focus in primary health care on health of women and children, due to their vulnerability and to the fact that their ill health affects the wider community. Apart from the general inputs all people need for health, women also need services to support safe reproductive health, pregnancy, prevention of mother to child transition of infections such as HIV, child delivery and care, including their nutrition during pregnancy," Rusike said.
The World Health Organisa-tion (WHO) Maternal Mortality Report shows that the majority of these deaths occur during and immediately following birth: 25 percent are caused by severe bleeding, 15 percent by infection, 12 percent by eclampsia (a seizure disorder), and eight percent by obstructed labour.
The remaining deaths are due to unsafe abortion (13 percent), other direct causes (eight percent), and indirect causes such as HIV and malaria which may be aggravated by pregnancy.
Despite the progress made so far in increasing the availability of maternal healthcare facilities, the majority of women across the country remain without full access to this service. The country is facing a number of challenges impeding improved maternal health, while costs and other access issues prevent women from accessing the available resources.
International advocate for women's and children's rights, Graca Machel, described the current situation in maternity hospitals as a horrifying experience for women despite the fact that investing in maternal health is a wise health and economic policy decision.
"Pregnancy and childbirth are all too often a cruel and harsh lived experience for Africa's women, particularly the poor and women in rural areas. Almost 75 percent of women who die in childbirth would have been alive if they had access to the interventions for preventing pregnancy and birth complications", Machel said.
According to the 2010 Africa Progress Panel Policy Report, Maternal health is not a "women's issue". It is about the integrity of communities, societies and nations, and the well-being of all the men, women, boys and girls whose own prospects in life depend upon healthy women and mothers.
"Even when cost is not a primary obstacle, women are often unable to access quality maternal healthcare when they need it.
"Africa faces a health-worker crisis: on average, there are only 13,8 nursing and midwifery personnel for every 10 000 people. In the poorest countries, this ratio is less than 1 per 100 000 people," the report said.
In Zimbabwe, 80 percent of midwifery posts in the public sector are vacant. While maternal care interventions from WHO are proving to be effective in reducing maternal deaths, a lot needs to be done to inrease their accessibility.
Source: http://allafrica.com/stories/201210041297.html
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