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Paidamoyo Chipunza Senior Health Reporter
Pregnant women in Harare continue to defy the referral health system by shunning clinics and resorting to central hospitals, thereby exerting pressure on the limited human and other health-related resources, Mbuya Nehanda Maternity Hospital (MNMH) head of obstetrics and gynaecology Dr Tafadzwa Nhemachena, has said.
Addressing a press conference on the preliminary results of investigations into the death of a Harare woman, Ms Sharon Manyonho, who died on September 1 at MNMH, which is housed at Parirenyatwa Group of Hospitals, Dr Nhemachena said, ideally, the hospital was expected to be attending to high risk women who referred from local clinics.
He said women were shunning their local clinics, opting for central hospitals, thereby overwhelming the higher institutions of care and ultimately compromising service delivery.
High-risk women include those who are delivering their first babies and women with complications such as those needing theatre.
“We are having low-risk women, as well as high-risk women coming to Parirenyatwa Hospital, so that compromises and overwhelms the system, resulting in system failure, patients getting sub-standard care, complications and sometimes deaths,” said Dr Nhemachena.
He said because of the large numbers of women presenting themselves directly to central hospitals, one nurse from the labour ward was being forced to look after four pregnant women instead of two.
Similarly, Dr Nhemachena said in the general ward, instead of looking after five women, one nurse was being forced to look after at least 13 expecting mothers.
“We need to improve the referral system,” he said. “Probably because of the user fees (which have gone up) the low-risk women are shying away clinics for central hospitals and the effect for us is that it overloads the system and compromises the quality of care patients are supposed to be getting.”
Turning to the day Ms Manyonho died, chairperson of the committee set up to investigate circumstances leading to the death, Dr Maximilian Dzowa, said while the patient had been referred from Rujeko Clinic in Dzivarasekwa, she became the 17th patient waiting to get into the labour ward, which has a carrying capacity of only 10 women at any given time.
Dr Dzowa said the late Ms Manyonho had to wait on a bench, which already had six other expecting women, waiting for their chance to get into the labour ward.
“From 2am until 4am, no space could be found for the late Ms Munyonho,” he said. “Nurses were still busy with other deliveries. Two of the four doctors had to assist with deliveries as well.”
Ideally, doctors wait to attend to complications.
“The third doctor was attending to admissions who were coming in,” said Dr Dzowa. “The forth doctor was running around trying to organise blood for another life-threatening case, which had been referred from Mutare and needed to go into theatre.”
Dr Dzowa said it was only around 6am that a space for the late Ms Munyonho was found, but her condition had deteriorated and efforts to resuscitate her were futile, resulting in her death.
According to the Ministry of Health and Child Care, Harare and Bulawayo must have district hospitals to decongest central hospitals.
Ideally, patients should start seeking services at a local clinic from which they are referred to a district, then a provincial and eventually a central hospital.
Online Reporter