Health facilities in Manicaland have considerably improved maternal health service delivery due to targeted interventions that sought to strengthen emergency obstetric and neonatal care over the past year.
The interventions were rolled out in areas hit by Cyclone Idai and were implemented by the United Nations Population Fund (UNFPA) and the Ministry of Health and Child Care with US$1,24 million support from the Government of China.
Reproductive health medical equipment and medicines were procured and distributed to health facilities in cyclone-hit districts to enhance their capacity to provide emergency care services for pregnant women and new-borns.
Maternity waiting homes were rehabilitated at Chipinge district hospital, Mutambara Mission hospital and Birchenough Bridge district hospital to ensure pregnant women who live far from hospitals and those with high risk pregnancies could be accommodated comfortably close to these facilities towards due date.
Health workers at all the facilities in the districts were trained in various lifesaving techniques which has contributed to a decline in maternal mortality and morbidity.
Acting provincial maternal, neo-natal and child health officer Dr Tendai Nyafesa said maternal deaths in the province had declined by 23 percent between 2021 and October 2022.
“We have seen a general decrease in terms of maternal and child mortalities as compared to the previous years but we feel the figures are still high and a lot more needs to be done in terms of reducing the deaths. In 2021 we recorded 70 maternal deaths and this year as of October we are at around 54 and we believe and try to make sure that we don’t surpass the previous year’s figure,” he said.
He said the province was trying to improve antenatal care coverage to ensure that women book early so that problems are identified and solved early.
He said the province was also trying to strengthen the uptake of family planning, especially the long acting contraceptives which communities could access to help them plan their pregnancies and reduce maternal and child mortalities.
A tour of Birchenough Bridge hospital, Chipinge District hospital and Mutambara Mission hospital this week revealed how the interventions by China Aid had contributed to improved access to maternal services, hence contributing to a decline in maternal deaths at district level.
Mutambara Mission Hospital matron Mr Nhamo Mirato said the institution used to record up to seven maternal deaths per year but that had declined to between two and three deaths per year.
“This programme has gone a long way in helping usreduce maternal mortality and morbidity. We used to receive complicated cases of obstructed labour, some of them would be referred from Muchadziya clinic which also receives pregnant mothers from Mozambique. It takes three hours for a mother to be transferred here with complicated labour, so the waiting mothers’ home has ensured that pregnant women can be monitored at the hospital and assisted as soon as an emergency arises,” he said.
The waiting mothers’ shelter at the hospital was extended and now has the capacity to accommodate 80 pregnant women.
Mr Mirato said all midwives, nurses and doctors at Mutambara Mission Hospital, as well as other health facilities in Chimanimani district had been trained in the use of anti-shock garments, a device which helps reduce post-partum haemorrhage — the excessive bleeding that can occur after delivery.
Excessive bleeding is one of the leading causes of maternal deaths along with eclampsia — high blood pressure that can occur during pregnancy.
At Birchenough Bridge Hospital in Buhera district, an average of 200 deliveries are done every month, highlighting the need for maternal health services.
The institution’s matron Mr Nicholas Sithole said by virtue of the hospital being situated on the border of three districts (Chimanimani, Chipinge and Bikita), patients catered for would go beyond the official catchment area of 18 000.
“Our mothers can now come and wait for delivery at the shelter and this helps us to identify complications earlier and intervene. We used to have three or four neonatal deaths but because these mothers now come early, we now record about two deaths in two months. Also because of the skills our staff received, there has been a marked decline in maternal deaths,” he said.
Chipinge district pharmacy manager Ms Mellita Chimhowa said the medical equipment and supplies received from the programme had ensured that the district hospital and other health centres were well stocked to offer emergency obstetric services.
“We received commodities to help us improve maternal and child health care; these include equipment and medicines required by pregnant mothers during and after delivery as well as oral contraceptives. This ensured that we had enough medicines needed in all forms of emergencies that might arise during child birth and it increased our stock levels to about 95 percent.
“All 52 clinics and two satellite clinics in the district also received these medicines so it strengthened emergency maternity service provision across the district,” she said.
The women accessing maternal services from the hospitals expressed their appreciation at the improved facilities that were allowing them to access services easily.
Ms Rufaro Kadzutu from Chayamiti village in Chimanimani said the waiting mothers’ shelter was an important facility which could save the lives of many women.
“The roads in Chimanimani sometimes are not passable when it rains so some women give birth on the road and do not make it to the hospital. But if you book early, health workers can quickly identify any problems that might affect you and your baby and they can attend to you while you wait for delivery here at the shelter,” she said.
Another pregnant mother from Bocha, Marange, in Mutare district Mrs Rutendo Chemvumi, who has been suffering from low blood pressure has been at the shelter at Birchenough Bridge since November 1.
“My blood pressure sometimes drops below normal but the nurses and doctors have helped to manage it and make sure that my baby and I are safe until I deliver.
Coming here early meant I could be attended to by the doctor whenever I had a problem instead of waiting to see the doctor the next day. They told me that this condition could affect my baby so I had to make sure that we remain safe,” she said.
Ms Ratidzo Rugwinhi from Chapanduka village in Buhera said with her first baby, the local clinic delayed transferring her to Birchenough Bridge Hospital after a difficult labour.
Unfortunately, her baby died and she also suffered severe bleeding which almost killed her after the birth. Her next two births were through Caesarean section, so she had been admitted into the shelter early to avoid complications.
“We are losing many women in the communities because they are not coming to hospital on time and usually they only come when there has been a complication. I want to encourage women to visit the hospital early and not deliver at home,” she added. – The Herald
