Maternal Health During COVID-19 Times, Time To Rethink Health Priorities

Young Preganant Women

MOST Zimbabweans at some point  thought our country had done very well in curbing COVID-19 infections. That was before we started to experience a steady increase in new infections towards the end of 2020. Reports showed that in week 46 of the year, there were 281 new cases and in week 47 there were new 594 cases.

By Edinah Masiyiwa 

These statistics did not scare Zimbabweans enough though as people went to parties during the festive season, including a big party in Harare where thousands of people gathered to celebrate the new year. The result of this irresponsible behaviour was a sharp increase of new COVID-19 cases and deaths. The month of January and part of February has been a nightmare as people have died every day.

A case that really disturbed me was that of Vimbai (not her real name), a pregnant woman. Vimbai tested negative for COVID-19 when she was admitted for a caesarian section at one of the hospitals in Harare. As is the normal practice with all caesarian cases, Vimbai stayed in hospital for three days. Upon discharge, the family noticed that she was coughing, but they did not really make much about this as they thought the cough was due to the irritation caused by the tube that was put in her throat during the operation.

Over the next days, however, the coughing continued. When the family took her back to the hospital, doctors did not initially administer a COVID-19 test, but instead focused on Vimbai’s sugar levels which were not stable. (Vimbai was also diabetic). When a COVID-19 test was finally done, it showed that Vimbai had COVID-19, which she must have contracted at the hospital during labor, but not much could be done as she died two days later after spending about an hour in hospital.

This sad story shows how complicated it is for pregnant women to access maternal health services during this time of heightened COVID-19 infections. Indeed, pregnant women may face the risk of contracting COVID-19 simply whilst admitted in hospital. Further, COVID-19 has presented more challenges for pregnant women as some centers are requesting COVID-19 testing before admitting them when in labour.

It’s no wonder that anecdotal evidence shows that women now prefer to deliver at home in Zimbabwe. This was also confirmed through a research done in Kenya where it was found that home deliveries had increased as facility uptake of services became a challenge which included fear and economic challenges.  But home births are traditionally less safe than ones at hospitals, so it is important to ensure hospitals are accessible and healthy places for women to deliver.

As a first step to ensure pregnant women’s safety in hospitals, I call upon the government to ensure that all medical staff have adequate personal protective clothing (PPE) if we are going to conquer COVID-19. Right now, hospitals continue to report shortage of PPE. Reports have shown that nurses have been going on strike as they demand PPE.  The issue of PPE has been raised by health workers from the time Zimbabwe had the first case of COVID-19. In its response to the disease, the nation has a pillar that focuses on infection prevention and control. However, what is on the ground shows that the response guide is not being followed.

PPE is crucial as it will protect both the nurses and patients. By the first of February, 3389 health workers had been infected by COVID 19 with 11 of them dying from the disease.  Thus, PPE is essential and cannot be overlooked. PPE is key and we can not have health workers helping people, including delivering babies, without PPE, it puts both them and their patients at risk otherwise.

Secondly, I am calling upon our leaders to display this kind of leadership in order to save the lives of people who are dying from COVID. Particular emphasis should be put on procedures for handling women seeking maternity services. All measures to protect this vulnerable group should be put in place.

United Nations Development Programme (UNDP) in their publication highlight the need for leadership and solidarity in order to defeat COVID 19.  The same publication UNDP identifies one of the critical pillars to focus on as preparedness, which will be achieved through supporting the country to build resilient health systems. Zimbabwe has to go beyond the response plan and ensure all that is planned for is implemented.

Finally, I call upon women to seek all the necessary information on COVID-19 prevention for when they go into labour. This includes wearing masks throughout their stay in hospital and washing hands. Community members have an important role to play in sharing this information with pregnant women to prevent the spread of COVID-19.

Let us take our place and ensure that we stop further spread. We have seen the misery and stress caused by COVID-19 as members of our families died and we were not even allowed to do the usual funeral rituals, such as body viewing. Let’s truly do what we can to prevent any more of these deaths.

Edinah is a women’s rights activist. Currently she is the Executive Director of Women’s Action Group. Edinah is an Aspen Institute Senior Fellow

 

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