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Maternal deaths, the neglected tragedy
Tonderai Kwidini, Inter Press Service
July 17, 2008

http://ipsnews.net/africa/nota.asp?idnews=38571

"It is a nasty experience which I do not want to be reminded of. But if you try to keep it to yourself it will remain a shock for a long time. I cannot even explain the pain I felt after being told that I was carrying dead bodies in my womb," said Sesedzai Manzanga, a Harare teacher, as she recounted giving birth to a dead set of twins two years ago.

"But I thank you for coming to hear my story because I am still alive and I know that what I am going to tell you will help a lot of women out there."

Improving maternal health is fifth among the eight Millennium Development Goals (MDGs). In Zimbabwe, the ruling ZANU-PF has insisted that the figures are improving.

But Manzanga's husband Cecil blamed the current contraceptive methods available to Zimbabwean women and falling health standards. He said "it is always painful when your wife fails to deliver but it is better if she survives the ordeal because some women end up dying. At one time I got so stressed that I had to seek counseling from my friends.

"I thought a bad omen had been cast upon me and that I was going to lose my wife. I am glad she is still alive even though she has to live with a lot of pain and various other complications," said Cecil Manzanga, who was reluctant to talk about the issue.

One of the consequences is that Sesedzai Manzanga is unable to have any other children, shattering the couple's dream of having four children.

"Although I feel sorry for my husband who has always wanted a baby boy, I think I have to stop trying because it seems as if luck is not on my side. I am afraid I will end up dead," said Sesedzai Manzanga.

For a long time maternal mortality has been a neglected tragedy as traditional societies accepted the lethal risks of child bearing as normal and unavoidable.

Making matters worse currently is the state of paralysis that the Zimbabwean health sector is in. The costs of maternity services have been going up, making it difficult for pregnant mothers to seek proper medical attention.

Shortly after Zimbabwe attained independence in 1980, the government constructed maternity wings at all major hospitals, provided the necessary drugs and recruited well-trained midwives. At one time the government even abolished maternity fees at all health institutions, except central hospitals.

But over the past decade the health standards in the country have fallen as experienced health personnel leave the country. There has also been a marked reduction in fiscal allocation to the health sector.

The cheapest maternity health services in Zimbabwe's capital Harare are offered by the City Council clinics whose workers were on strike at the time of writing. Pregnant mothers registered at these clinics have not been able to access the necessary health care.

According to the 2005 Zimbabwe Millennium Development Goals (ZMDG) report maternal mortality continues to be a major challenge in Zimbabwe with most women dying due to pregnancy-related complications because of limited access to antenatal, delivery and post natal care.

Alice Mutema, an official at the Southern African HIV/AIDS Information Dissemination Service (SAfAIDS), said if drastic action was taken to revive the collapsing health sector, the Zimbabwean government can at least get closer to attaining MDG five.

She said: "The health sector has to get its act together and avail more funds for other projects other than HIV/AIDS. Maternal health is not being given the attention it deserves, but even if this happens, I do not think we can achieve the 2015 target. But at least we can get closer to the target."

Minister of Health and Child Welfare David Pairenyatwa said, "Zimbabwe's maternal death figures have been showing a tremendous reduction in the recent past. The figures we received recently show a reduction from 900 cases to about 550 cases.

"It is a pity that some people claim that the health delivery system is collapsing when we have such progress and given the work we are doing with our international health partners. We remain hopeful that we will achieve our MDG target despite the hardships we are facing," Pairenyatwa said.

According to the Demographic Health Survey (DHS) report covering the period from 1999 to 2006, the maternal mortality rate in Zimbabwe has decreased from 695 deaths per every 100,000 live births in 1999 to 555 deaths in 2006.

The DHS report is compiled by a US-based organisation, Macro International, in partnership with the Centers for Disease Control (CDC), United Nations Development Programme (UNDP), the ministry of health and the Central Statistical Office (CSO). The technical assistance is provided by the United Nations.

"The decline in mortality is not a significant one and can be attributed to things such as the fertility rate going down as more and more people opt to have less children because of the economic hardships. And I think Zimbabwe will not meet the 2015 target because the risk for reversal is big, even for those MDGs that are going well," said Festo Kavishe, the United Nations Children's Fund (UNICEF) country representative.

"The decline is not because the quality of services has improved but because people are no longer having children like they used to do in 1999, therefore the problem remains huge."

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