THE number of children dying within their first 28 days of life has remained high and unchanged over the past 33 years at the back of numerous factors such as malnutrition amongst a host of others, a United Nations Children Fund (UNICEF) has said.
By Michael Gwarisa
Neo-natal mortality refers to the number of deaths during the first 28 completed days of life per 1000 live births in a given year or other period. According to UNCEF’s Annual Report for the year 2021, neo-natal mortality rate has remained practically unchanged since 1988, at 31 deaths per 1,000 live birth, due to malnutrition, AIDS, pneumonia, malaria and diarrhoea.
Stunting rates have however decreased in the last 15years, from 31% in 2007 (as hight as 39 percent in some rural areas) but is now down to a national rate of 23.5 per cent.
Speaking to HealthTimes on the neo-natal mortality situation, Community Working Group on Health Executive Director, Mr Itai Rusike said there is need to improve attitude of health workers, intensify quality improvement initiatives in maternal health services delivery during ANC, labour and after delivery and strengthening life-saving decision making skills for doctors and nurses.
The child immunization rates in the country fell during the Covid-19 pandemic due to the various public health preventive measures put in place by the government to reduce transmission. Some groups, like the apostolic sects, oppose immunization on religious grounds but the decline was mainly due to a drop in service delivery and outreach. Rural-Urban inequalities grew as immunization levels fell, with greater declines in rural coverage.
While coverage rates have improved, Mr Rusike lamented that they remain well below levels achieved in the pre- Covid-19 era.
“The inverse relationship between immunization and under five year mortality suggests that inequities in access to immunization (inverse to need) may be playing a role in child mortality in the country . Village Health Workers who help improve uptake of such health services lack adequate resources to do their work. .
“From having among the highest levels of immunization in the region including achieving universal child immunization in 1990, it is unfortunate that Covid-19 has reversed some of the gains achieved before the pandemic.”
In Zimbabwe, despite the high coverage of births by skilled birth attendance and institutional delivery, maternal mortality remains high at 462/100,000 live births with the majority occurring at health institutions. At least 22% of these of these deaths deaths are adolescent mothers.
Health service coverage, particularly in remote and urban poor areas, remains low due to weak and underfunded health systems, insufficient human resources and weak governance. Nutritional deficiency is a leading cause of the health burden. Poor dietary intake is influenced by inadequate knowledge, cultural-and-gender norms, insufficient quality nutrition services, and food legislation not complying with international standards.
Meanwhile, stunting rates have decreased in the last 15years, from 31% in 2007 (as high as 39 per cent in some rural areas) but is now down to a national rate of 23.5 per cent.
Meanwhile, a big achievement for Zimbabwe in 2021 according to the UNICEF report was on Maternal mortality where mortality rates more than halving in under 10 years, i.e., from 960 per 100,000 live births in 2010 to 462 in 2019 (MICS 2019).
To maintain the positive development around maternal mortality, Mr Rusike said there is therefore need to increase focus on quality of care in the provision of maternal health services.
“Maternity Waiting Homes should be provided for the high risk women and those staying far from the hospital so that they can be accommodated during the final weeks of their pregnancy near a hospital with essential obstetric and neonatal care facilities. There has been revitalization of maternity waiting homes in the last couple of years.
