Chronicle Editor
Andile Tshuma, Sunday News Correspondent
MS Musa Ncube knows exactly what happens each time there is a medical emergency in her rural community outside of Plumtree Town in Matabeleland South Province.
People look for a car and if one cannot be found, which is quite common, they load the ill person onto a donkey-drawn cart and make the jolting 25-kilometre journey to the hospital.
Hence, when the nurses and midwives at the Plumtree District Hospital told her during a prenatal check-up that she could spend her final days before delivery in a dormitory near the hospital, she was intrigued.
“Long distances are the norm in my area but it’s not so easy when one is heavily pregnant. Going to the hospital in a wheelbarrow or scotch cart is not the best option, but it’s often the only transport available unless you have money and there’s enough time to hire a car. I’m happy about the service here at the hospital, the nurses and midwives are very nice to us,” she said.
When hospitals are few and far between, waiting mothers’ shelters become homes away from home for expecting mothers.
Distance often becomes a barrier to accessing timely health services at a crucial time for pregnant mothers.
However, through the Health Resilience Fund, a co-ordinated effort by the Government and development partners, supporting the Health and Child Care Ministry, pregnant mothers stand a better chance at safe hospital deliveries.
The shelter dramatically cuts the long distances that women must travel to access quality obstetric care.
In the latest Multiple Indicator Cluster Surveys (MICS) 2019 report, Zimbabwe recorded a decline in maternal mortality from 614 to 462 deaths per 100 000 pregnancies since 2014.
A shelter close to medical experts equally prevents haemorrhages, which MICS 2019 reported to have caused 26 percent of maternal deaths in 2019.
Ending preventable deaths in maternal newborn and child health is one of the key strategic focuses of the Health Resilience Fund and safe waiting mothers’ shelters are doing just that, enabling women to have a safe haven during their last few weeks of pregnancy.
For Ms Nothile Jubane (30), who has a high risk pregnancy, said being closer to doctors has helped secure her health and that of her baby.
She recalls the struggles she endured with her first two pregnancies, being away from a good health facility.
“I don’t stay very far from our local clinic back at Ntoli, however, my pregnancy was high risk and the small clinic didn’t have enough supplies and other resources, therefore it was recommended that I come over to the referral hospital in Plumtree and spend the last six weeks of my pregnancy closer to nurses and doctors. I’m grateful for this place as I have peace of mind knowing that the baby and I are safe,” said Ms Jubane.
Zimbabwe has joined many other countries that have turned to maternal waiting rooms to fill a pernicious gap in rural health care.
In many places, women in small communities often live too far from hospitals and clinics to make it to one in time when they are about to give birth.
With such interventions, Matabeleland South Province has managed to significantly reduce the maternal mortality rate, with just 10 maternal deaths being recorded in 2023.
Matabeleland South Provincial Medical Director Dr said good relations between health staff and communities, as well as development partners, made it possible for the province to reduce maternal deaths and have safer births for mothers.
“We have been working with partners who have pulled funds together including Unicef, European Union, Gavi, and other partners to fund the Health Resilience Fund. The main objective has been to strengthen our national health strategy in line with our National Development Strategy 1. Part of the main objectives include reducing preventable deaths in maternal health, neo-natal health, child health and maternal health, as well as strengthening health systems within the ministry. Indeed as a province, we’re seeing the benefits of the programme through our success stories such as the reduced maternal deaths as well as the waiting shelters which are providing so much relief for mothers,”said Dr Muza.
A senior midwife at Plumtree District Hospital, Obert Nyatsuro said the Health Resilience Fund helps the hospital provide nutritious meals for the waiting mothers as some cannot afford to provide their own rations.
He said his team has also been trained, under the fund, to attend to emergencies which he said has contributed to a reduction in maternal deaths.
“Here our doors are open to all pregnant women who need our services and through support from the Health Resilience Fund, we’re able to provide nutritious meals for mothers in waiting who are unable to provide their own food. We have also been able to undergo critical training for lifesaving procedures to deal with birthing complications, also under this same programme,” he said.
For Ms Ntombiyolwandle Ncube, the home has allowed her some time to rest without having to perform hard labour as she comes from a big family at her in-laws.
“Sometimes there’s a lot to do in the home for a woman, even if you’re heavily pregnant, you end up straining yourself. You also worry about the many mouths to feed but when I’m here, I’m spared from most of the domestic duties that I’m sometimes compelled to do as a makoti and I can rest and take care of myself for my health and that of my baby whom I can’t wait to meet,” she said.
Ms Sithembinkosi Ncube said the waiting mothers’ home saves her a three-hour journey to the nearest clinic offering maternal health services in Malalume in Bulilima District.
“The distances we walk to hospital are long and tiresome. I have high blood pressure. If it were not for the ‘idumba’ (waiting mothers’ home) I would be walking a three-hour journey one way, which means a six-hour walk every time I need to do a check-up at the hospital and I guess I may have ended up opting for a home birth with the local midwives. Coming here allowed me to prepare on time and not be caught by surprise by labour pains and then have to find a way to get here. My other children are safe with my mother and aunts, I’m not stressed at all as my relatives visit often and bring me some items from home,” she said.
At Nswazi Clinic in Umzingwane District, Sister in Charge, Phindile Thwala said the HRF funded waiting mothers’ home will help reduce home births in the area.
She said they work with the local community for the centres to run smoothly and engage village health workers.
“We work hand-in-hand with the health centre committee, the traditional leaders as well as village health workers and our mother hospital. This way, there is a sense of ownership of the centre and families understand the importance of allowing vulnerable mothers with high risk pregnancies to come to the centre at least six weeks before their expected date of delivery. Due to the good relations we enjoy with the community, there are no objections to this,” said Sister Thwala.
By waiting out the last days of their pregnancies at facilities near hospitals, expecting mothers can ensure they have access to a trained professional and safer birth.
Using mothers’ shelters, Zimbabwe continues to work towards the global target of reducing the maternal mortality ratio to less than 70 per 100 000 pregnancies by 2030.
Bongani Ndlovu