Maternal deaths are preventable

preventing or treating pregnancy and birth complications like emergency obstetric care, for example.
It has been established that women are dying in such large numbers mainly because they cannot afford requisite maternity services — a situation that has seen many resorting to unsafe means of delivery.

At the launch of the population census in August, President Mugabe called upon women to have more children, bemoaning the fact that the country’s population was stagnating because women feared dying.
About two months ago, there was talk of Government plans to scrap maternity fees in all public health institution. This was in direct response to the shocking death rate of mothers and the scrapping would be made possible through a Health Transition Fund — a temporary donor-funded financing mechanism to pool resources to help revitalise Zimbabwe’s health sector.

Following the directive to scrap maternity fees, there were unforeseen effects among which the case of congestion and women giving birth on hospital floors and benches at Harare Hospital made front page news.
Following these revelations, Health Minister Dr Henry Madzorera announced that he never sanctioned the move and maternity fees had in actual fact not yet been officially scrapped as resources for the HTF were still being pooled.

The Government had only done so as a pilot in selected health institutions to assess its feasibility.
Apart from the confusion, this experimentation has done much to demonstrate the dire situation relating to the maternal health in Zimbabwe.
On the other hand, following suggestions and wide calls to scrap maternity fees, there have been equally loud calls from various sections of society for the Government not to scrap maternity fees.

Among the most vocal voices against free maternity services has been Health Advisor in the President’s Office Dr Timothy Stamps who has reasonably cited sustainability concerns.

Dr Stamps and others put across very lucid arguments that scrapping user fees has never worked anywhere, and somebody still needs to pay for and cover the gap.

We are informed left and right that the Government has no funds, and to some degree this is understandable.
But the rate at which women are dying needlessly due to maternity complications remains unacceptably high and it is important to explore the corollary.
Maternal health as an entitlement is not just a development issue, but also a human rights one. The State remains the responsible authority as far as the welfare of citizens is concerned.

Merely stating lack of resources hardly takes away that obligation, but rather calls for the country’s fathers to explore other means and ways of dealing with these problems and also revisit how they prioritise national obligations.

It calls for accountability for maternal mortality, participation by stakeholders in policy and service development and demands actions that lead to a significant and sustained reduction in maternal mortality.

The 960 deaths per 100 000 live births is a national disaster that needs to be addressed with the level of seriousness it deserves.
Article 12.2 of the Convention on the Elimination of All Forms of Discrimination against Women to which Zimbabwe is signatory calls for the Government to “ensure women appropriate services in connection with pregnancy, confinement and the post-natal period, granting free services where necessary, as well as adequate nutrition during pregnancy and lactation”.

It follows that the State has an obligation to realise the right to health and take the necessary steps or actions that may include increasing resources to relevant services within the health sector, developing policies and addressing economic and socio-cultural reasons why women fail to access services.

In this very context, the Zimbabwe Women’s Resource Centre & Network in partnership with 12 civil society organisations working in the area of women’s rights has been advocating for improved maternal health services, particularly in rural areas where the situation for expecting mothers is even more dire.
Last week, ZWRCN scaled up its campaign dubbed “Ridza Mhere/Hlab’umhkosi” for improved maternal health services and took the advocacy message to grassroots women in the Midlands province.

The campaign seeks to raise awareness on high maternal mortality in Zimbabwe and influence the immediate and full commitment of the Government in addressing this challenge.

The goal of the campaign is to see improved accessibility of basic and comprehensive maternal health services at rural clinic and district level respectively by 2014 expected to markedly reduce maternal mortality by half by the year 2015.

This we believe will be accomplished through mobilisation of a critical mass of persons advocating for improved maternal health services as well as increased budget allocations and spending on public health in line with the Abuja Declaration.

The ongoing “Ridza Mhere/Hlab’umhkosi” campaign — which was initially launched early this year in Goromonzi, is being gradually rolled out to other provinces.
While remaining cognisant of the fact that wholesome scrapping off of maternity fees may be unsustainable in the long run, the bottom line remains that maternal deaths have become an emergency that has to be dealt with in one way or the other.

Perhaps as with the Aids levy, the Government can start exploring the idea of deducting a certain percentage from income tax to go towards addressing the maternal health problem. If that is not possible, for Zimbabwean women it’s about making some sort of a plan to improve maternal health services.
Reducing maternal mortality calls for concerted efforts in developing better policies that involve girls, women and children and more budget allocations to cater for their needs.

Educating about and increasing access to contraceptives caters for the lots of women that have unmet contraceptive needs to prevent unintended pregnancies leading to unsafe abortions and maternal deaths.

Addressing the delay models related to individual decision-making, access to affordable services and provision of skilled personnel are the other key factors.