By Kuda Pembere recently in Mat South Province
Driven by the need to address challenges faced with expecting mothers during childbirth, maternity waiting homes have contributed to a reduction in the number women who die whilst giving birth in Matabeleland South province.
The shelters are being established through financial support from the Health Resilience Fund (HRF) with the purposes of reducing maternal mortality from 462 to 240 per 100 000 live births and neonatal mortality from 32 to 20 per 1000 live births by 2025.
HRF is funded by the UK Government, the Embassy of Ireland, the European Union, and GAVI while the United Nations Children’s Fund (UNICEF), the United Nations Population Fund (UNFPA) alongside the World Health Organization (WHO) provide technical support to ensure Zimbabwe achieves targets espoused in the National Development Strategy (NDS1) as well as the National Health Strategy (NHS 2021-2025).
For one Notile Jubane (32) from Ntoli Village in Plumtree, the waiting homes have been a blessing to her community.
We use Ntoli Rural Clinic. The distance to my clinic is not that far. It is a walkable distance. The reason why I am here is that for a person with my condition, the distance from Ntoli to Plumtree is reduced. Further the nurses and doctors will be readily available, in the case that when labour pains occur they will be within reach,” she says.
“This is my second pregnancy. I delivered my first baby at Musume Hospital in Mberengwa. I was born and raised there. I was married here in Plumtree and I am carrying my second baby.”
Now eight months pregnant, the hypertensive Notile was referred to Plumtree district hospital for routine medical checkups.
With the normal systolic range expected to be less than 120 mm, Notile’s was high.
“I haven’t had any problems related to distances save for the fact that I have hypertension. The nurses assist us in every way, teaching us how one should manage herself when expecting a baby. They also teach us about hygiene all the time. We have assemblies where they also teach people who are HIV positive how to handle themselves even protecting the child from contracting HIV,” Notile says.
“For me to come here, I started noticing that my feet and hands were swollen. After a medical checkup, it was found my BP was as high as 140. The health professionals said it is important to be monitored at the waiting rooms to avoid complications which require surgery as well as to protect the child.”
Further, she was advised that if the hypertension is left untamed, it could be fatal for not only her life but the baby’s.
“This initiative helps us to be close to health facilities because if afar, when the BP shoots up, it may result in grievous consequences to an extent of losing the child,” she said.
High blood pressure in pregnant women also known in medical terms as preeclampsia, according to Mayo Clinic leaves them at risk of less blood flow to the placenta, placental abruption, intrauterine growth restriction, injury to other organs, premature delivery, and future cardiovascular disease.
“Untreated preeclampsia can lead to serious — even fatal — complications for mother and baby. Complications may include eclampsia, in which seizures develop.
“Previously, preeclampsia was diagnosed only when both high blood pressure and protein in the urine were present. Experts now know that it’s possible to have preeclampsia without having protein in the urine,” reads part of a Mayo Clinic post on the condition.
Dr Solwayo Ngwenya in a 2021 study done at Mpilo Central Hospital on preeclampsia found the development of eclampsia being more frequent in women aged 14-19 years compared to women aged over 35 years.
“Eclampsia was more frequent in women with diastolic blood pressure of 131-150 mmHg), and more than 150 mmHg compared with those with diastolic blood pressure of less than 110 mmHg. Symptoms of visual disturbances were also associated with eclampsia,” he said. “This study has identified independent determinants of eclampsia which can be used to identify which women should receive magnesium sulphate prophlyaxis or more intensive monitoring to prevent deterioration in maternal condition.”
Dr Chido Chitiyo, the acting district medical officer for Bulilima, stated that HRF provided them with critical care drugs.
“As of last year, we had zero percent maternal deaths in Bulilima because we have been able to obtain the critical care medications that are necessary, particularly in this department. Fuel availability has greatly aided us since it allows us to attempt reaching those difficult-to-reach places. Fuel for ambulances transporting patients to Plumtree District Hospital is provided by this money,” according to Dr Chitiyo.
Senior midwife for post-natal care at Plumtree District hospital Winnet Gumbu concurred with the Acting District Medical Officer highlighting how majority of moms received assistance early.
“We have a mothers’ waiting shelter whereby we keep all the mothers, for example the teenage mothers, those who have had risk deliveries, they will be close-by hence they can easily be assisted. This has led to a reduction in maternal deaths,” she said.
According to Mat South Acting Provincial Medical Director Dr Felix Muza, it is through the HRF that they have managed to reduce the institutional mortality rate to 71 per 100 000 live births.
“So in terms of service delivery, what have we benefited as a province with HRF? We realize, like I said, number one, maternal and child health. And over the years, one of the targets that we thrive or that we want to attain is reduction in maternal death.
“And our institutional maternal mortality rate was around 71 per 100000. Please note, this is not the population, but it is institutional maternal mortality rate.
“So, we have noted a bit of a gradual decline in maternal deaths in the province. I’m talking about the institutional ones. That’s one of the things that we’ve benefited from the implementation of the HRF,” he explained.
The Mat South Acting PMD added that community health workers are proving instrumental, identifying vulnerable pregnant women.
“Some of the programs that have been running in the province with regards to maternal and child health includes, if you look at our community health care workers, they actually go out there in the community, identify pregnant women that may be at risk and to refer them early to health care facilities.
“And when they come to health care facilities, the health care workers, some of them, they’ve been trained in essential skills through the support that has come from the HRF and also some of the medical equipment that we use to conduct our deliveries, medical equipment and medicines and sundries, we also get some of those through the pooled fund for the HRF,” Dr Muza said.
In some remote Zimbabwean districts, local communities and governments have created “maternity waiting homes” at hospitals, where expecting mothers can stay during the last six weeks of their pregnancies. The homes are aimed at reducing maternal mortality and educating new mothers about how to look after their newborns.
