By Chief K.Masimba Biriwasha
Harare, Zimbabwe – Between 1 300 and 2 800 women and girls die each year due to pregnancy-related complications in Zimbabwe. This translates to eight women dying every day of the year.
According to the Zimbabwe Maternal and Perinatal Mortality Survey (ZMPMS) conducted in 2007, 725 women die per every 100 000 live births, a figure which is far higher than the Millennium Development Goals (MDG) target of 75 per 100 000 live births.
Additionally, another 26 000 to 84 000 women and girls suffer from disabilities caused by complications during pregnancy and childbirth each year.
Given such shocking statistics, it is quite laudable that the government, in partnership with international donor agencies, the private sector, civil society and individuals, is making efforts to redress the unwarranted deaths of pregnant women in the country.
As in most countries in Africa, maternal and neo-natal health services in Zimbabwe face severe resource shortages from both the public and private sector that hamper the expansion of services.
This is despite the fact that the consequences of maternal mortality are felt not only by women but also by their families and communities.
Loss of women during their most productive years also means a loss of resources for the entire society.
Yet giving birth is such an important activity in our nation that every effort must be taken to guard against the loss of life.
In fact, 50% of the deaths are due to factors which can be prevented, such as delays in seeking care and lack of effective treatment.
Pregnancy-induced hypertension, commonly known as blood pressure, bleeding after birth, and puerperal sepsis (a serious medical condition that affects a woman during or shortly after childbirth, miscarriage or abortion) also contribute to the death of pregnant women.
Conditions such as anaemia, diabetes, malaria, sexually transmitted infections, and others can also increase a woman’s risk of complications during pregnancy and childbirth, and are thus indirect causes of maternal mortality and morbidity.
In addition, Aids accounts for 25% of the deaths among pregnant women.
According to the ZMPMS, 34% of pregnant women in the country tested positive for HIV in 2007, but only 1,8% were taking ARVs with dire consequences for their own lives and their unborn babies.
The survival chances of a baby whose mother dies or is HIV-infected and not on ARV treatment are severely reduced.
Undoubtedly, the political, economic and social crisis of the past decade has had a terrible impact on the public health delivery system, significantly reducing the quality of services provided to pregnant women.
Shortages in personnel, equipment and supplies continue to plague Zimbabwe’s healthcare infrastructure, putting the lives of pregnant women at risk.
Furthermore, many women, particularly in rural areas, cannot afford the transport costs required to make frequent travels to health centres during and after pregnancy.
Most women cannot raise the fees required to consult health personnel and hence go through a pregnancy ignorant of potential life-threatening complications.
Instead, they opt to deliver at home which significantly increases chances that a pregnant woman will die, especially when the delivery requires surgical intervention, or is carried out by non-skilled persons.
Other causal factors for high maternal mortality include gender inequality and lack of women’s rights and poor sexuality education.
Like Zimbabwe, many countries in Africa will not attain the MDGs unless urgent action, political will and commitment is strengthened.
Approximately one in every sixteen women in Africa faces the risk of dying in childbirth, while thousands more face delivery-related complications and illness.
In an effort to influence African states to act on maternal and child mortality, the African Union launched the Campaign on Accelerated Reduction of Maternal Mortality in Africa in 2009.
The purpose of the campaign is to mobilise political will and action that will save the lives of pregnant women and newborn babies.
As part of the campaign, the government of Zimbabwe is partnering with international donor agencies, private companies and individual to raise funding and awareness to reduce maternal mortality in the country.
What needs to happen immediately is a thorough revamp of the public health system otherwise efforts to reach women that die from pregnancy complications will remain in vain.
Healthcare programmes to improve maternal health must be supported by strong policies, adequate training of healthcare providers, and logistical services that facilitate the provision of those programmes.
Ensuring that all women and girls have equal access to the full range of services will be key to success.
More importantly, the government needs to implement policies that promote the liberation of women from traditional, economic, legal and cultural fetters.
Female education and empowerment are critical determinants of fertility, and providing girls with access to education is likely to increase their knowledge about how to prevent pregnancy complications.
Simply put, there must be a commitment to make access to services that improve the status of women as much a part of national life as breathing air.