adminWalter Mswazie
AT least 20 women die per week from pregnancy-related complications in Zimbabwe.
This is worrying as it militates against efforts to achieve Millennium Development Goals (MDGs).
Zimbabwe’s quest to reduce maternal and pre-natal deaths to manageable levels by 2015 might not bear any fruits given that we are less than 1 000 days away from the deadline.
It has been realised that pregnant women continue to die while giving birth yet the country has a deliberate policy meant to curb such eventualities.
Community Working Group on Health director, Mr Itai Rusike said Zimbabwe and most of the Sub-Saharan Africa is off track in achieving most of MDGs by 2015.“Our biggest challenge is in goal number five which is reducing maternal-related deaths by three quarters by 2015. We have done fairly well on goal number six of halting and reversing the spread of HIV and Aids and combating malaria and other diseases,” he said.
In September 2000 leaders of UN member states signed up to eight social development goals, now called MDGs. They committed themselves to combating poverty, hunger, HIV, TB and malaria, illiteracy, environmental degradation and discrimination against women by 2015. Many of the targets relate directly to health.
The Health Transition Fund (HTF) launched in 2011 was supposed to provide funding to hospitals so that they scrap user fees for pregnant mothers but that has not happened. This has therefore left us with the same challenge of high maternal mortality. Scrapping of user fees for pregnant women would be a welcome development in the country’s quest to meet MDGs.
The million dollar question is, where is the country and the rest of the continent failing? Is it the lack of political will, poor funding or what?
While, in Zimbabwe, there seems to be a considerable headway in the area of HIV and Aids with the prevalence rate reduced to about 13 percent from 23 percent in the 1990s, there seem to be some grey areas when it comes to malaria and maternal deaths.
According to World health Organisation (WHO) globally, the number of deaths of children under five years of age fell from 12 million in 1990 to 6, 9 million in 2011. In developing countries, the percentage of underweight children under five years old dropped from 28 percent in 1990 to 17 percent in 2011.
Between 1990 and 2011, under-five mortality declined by 41percent from an estimated rate of 87 deaths per 1000 live births to 51. The global rate of decline has also accelerated in recent years – from 1, 8percent per annum during 1990 – 2000 to 3, 2 percent during 2000–2011.
Despite this improvement, many countries, including Zimbabwe are unlikely to achieve the MDG target of a two-thirds reduction in 1990 mortality levels by the year 2015.
Although there is a marked increase in the number of deliveries attended by trained health workers in Africa the proportion is still far below 50 percent and it remains a grave concern for many countries under WHO.
Zimbabwe like many countries has also achieved the MDG target on access to safe drinking water but there is still more to be done on other areas such as sanitation.
In Zimbabwe, maternal deaths are caused by poverty, shortage of primary health care centres especially in marginalised areas and lack of transport. Cases of women giving birth on their way to the clinic have been told with those in newly resettled areas the worst affected. The shortage of critical staff and poor remuneration are other challenges adversely affecting the country’s quest to meet MDGs. While the Global Fund to fight HIV, Aids,
TB and Malaria has gone a long way in filling the huge gap in the area of HIV and Aids and TB, more sustainable funding is needed.
Mr Rusike’s organisation is carrying out community consultations on MDGs in the context of the Post 2015 Dialogue.
He said the aim for the dialogue is to find out what people want for health in the post 2015 era and what has been achieved or not achieved.
“While some countries have made impressive gains in achieving health-related targets, others are falling behind. Often the countries making the least progress are those affected by high levels of HIV and Aids, economic hardship or conflict.
“While we have done well on HIV and Aids as a country there is a challenge on the sustainability of the programmes we have began due to scarcity of resources. We solely depend on partners that in the case of serious economic recession, they can fail to help us. What we should look at is the alternative health funding from our own means as a country in the post 2015 era and not to depend on the Global Fund whose life span can be shortened,” he said.
Masvingo provincial medical director, Dr Robert Mudyiradima said while the country has done much in critical areas, more still needs to be done.
“We failed to achieve health for all by the year 2000. We could not achieve the target due to the economic hardships that kept on bedeviling our nation. However, let us not forget that Zimbabwe is a success story in Africa if not in the world. We are the only country with a comprehensive HIV and Aids policy which has seen us reducing the pandemic from about 23 percent to 13 percent in 10 years. The interesting part of it is that before the Global Fund, we have been using our own home grown solution, the Aids levy. This has gone a long way in helping us coordinate activities as well as buy antiretroviral drugs for those on treatment,” he said.
Dr Mudyiradima said the fact that Zimbabwe has been under illegal economic sanctions but managed to perform better than other countries confirms that its people work hard.
“Our resilience in the face of HIV and Aids has seen us succeeding where others have failed. We have been under sanctions but we continued to do better than other countries not under sanctions. By and large we have done extremely well in our quest to achieve MDGs especially on health,” said Dr Mudyiradima.
Batanai Health Service Organisation advocacy manager Mr Joshua Mavhundu said Zimbabwe deserves praise.
“While there are some grey areas that need to be attended to, I feel we have done much better under the circumstances. What we need as a nation is to jealously guard the gains we have made so far. Our people should appreciate the strides the country has made on combating HIV and Aids, tuberculosis and provision of safe drinking water. The Government has been making sure that no one starves by providing food where people have not harvested any. However, the issue of improved access to treatment remains a challenge and that is an area which still calls for attention,” he said.
Online Reporter
derick.khumalo