By Brenda Zulu
Too
many women are suffering and dying from complications of pregnancy and
childbirth in Zambia. These women are in
the reproductive age group of 15 to 49 years.
Most of these deaths occur amongst the poorest in our society.
According
to the 2007 Zambia Demographic Health Survey (ZDHS) maternal deaths are a
subset of all female deaths and are associated with pregnancy and childbearing.
Maternal death are defined as any death that was reported as occurring during
pregnancy, childbirth, or within two months after birth or termination of a
pregnancy. Estimates of maternal death are solely on the timing of the death in
relationship to the pregnancy.
A
specialist in Maternal Health at the University Teaching Hospital (UTH) Dr
Swebby Macha says that the major causes of maternal deaths in Zambia were excessive
bleeding, infection, unsafe abortion, high blood pressure and obstructed labour.
“Pregnant
women who suffer from malaria, HIV/AIDs, TB, anemia and poor Nutrition are more
likely to die. Poverty, low levels of
education, low status of women and violence against women in our society also
increases the risk of women dying in pregnancy and child birth,” said Dr Macha. He
also observed that Zambia’s Maternal Mortality Ratio (MMR) which currently
stands at 591 deaths per 100, 000 live
births were unacceptably high.
“There has been only a marginal decrease from
the MMR of 729 deaths per 100, 000 live births (2003),” said Dr Macha.
He
also observed that many women in the developing world and most women in the
world’s least developed countries give birth at home without skilled attendants
and when they seek help for complications at local health facilities; basic
equipment, medicines, blood transfusion services are lacking.
Zambia
officially launched the Campaign for Accelerated Reduction of Maternal
Mortality in Zambia (CARMMA-Z) in June 2010 aimed at successfully tacking the
major issues behind Maternal Mortality.
The theme for this campaign is “Zambia
Cares: No woman should die while giving
life”.
Under
CARMMA there is hope that every pregnant Zambian woman will have access to the
availability and use of universally accessible quality health services
including those related to reproductive and sexual health which are critical
for reducing maternal mortality.
A
main challenge to women’s maternal health arises from inequitable distribution
of health care services, particularly in rural areas. Service delivery in
Zambia is characterized by many challenges, not limited to lack of availability
of emergency obstetric care.
A
visit to Haabulile Rural Health Center in Chief Chikanta’s area revealed that
the health centers are not staffed. The nurse in charge had gone to church and there
was a pregnant girl and a woman who had just given birth.
In
an environment that respects women, pregnancy, birth and motherhood could
powerfully affirm women’s rights and social status without risking their
health. The enabling environment for
safe motherhood and child birth depends on the care and attention provided to
pregnant women and newborns by communities and families, availability of
skilled health personnel at delivery and the availability of adequate health care
facilities, equipment, and medicines and emergency care when needed.
Globally
according to Dr Macha, 530, 000 women die of pregnancy related complications
during child birth of which 99% occur in developing countries. For every woman who dies from causes related
to pregnancy or childbirth, it is estimated that there are 20 others who suffer
from pregnancy related injuries, infections, diseases and disabilities, often
with lifelong consequences. The truth is
that most of these maternal deaths are preventable. Research has shown that
approximately 80% of maternal deaths could be averted if women had access to
essential maternity and basic health- care services.
High
fertility, close pregnancies and large families are still the norm in rural
areas, partly because of lack of reproductive health services and the lack of
choice of women in the matter. These factors contribute significantly to the
high levels of maternal mortality. Current mortality trends are linked to among
others poor nutrition, a lack of education, ill health and a lack of access to
appropriate health services, factors that impend human and social development.
The main
causes of the high maternal mortality in Zambia include lack of national
commitment; limited financial support; weak coordination and partnership;
increasing poverty; the low status of women on the continent; weak health systems;
the adverse effects of HIV/AIDS, tuberculosis and malaria and the exodus of
medical personnel to overseas destinations. Experience has shown that safe
motherhood can be achieved if every birth is attended to by a trained health
worker with midwifery skills, if transport is available for referral services
and if quality basic emergency obstetric care is available. Without such
interventions Zambia might not achieve the fifth Millennium Development Goal
(MDG 5) to improve maternal health by 2015.
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