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Zimbabwe, August 2014: Rebounding health system reduces rural maternal mortality

© UNICEF Zimbabwe/2014/Mupfumira
Sithembile’s baby boy, born a day before she experienced post-partum complications

By Elizabeth B. Mupfumira

What started out as a time of great joy and celebration for the Moyo family of Bulilima District in Matabeleland South Province in Zimbabwe, following the birth of a healthy baby boy, soon turned to near tragedy when a day after giving birth at the nearby rural health clinic, Sithembile Moyo suffered seizures and subsequent unconsciousness brought on by post-partum eclampsia.

“She had a normal delivery at Ndiweni Rural Clinic which is 20 kilometres away from here,” said Plumtree District Hospitals’ Medical Officer, Dr. Langa Sibanda who attended to her. “Soon after she was discharged from the rural clinic she developed symptoms of eclampsia and was rushed back to the clinic by the village health worker and her family.”

What happened next is a testament to the vast improvement in the health delivery system in Zimbabwe, and how years of investing into the health system through the Health Transition Fund (HTF) is saving the lives of women such as Sithembile across Zimbabwe.

After half an hour of being rushed back to the rural clinic, an ambulance was dispatched to transport Sithembile and her new baby to Plumtree District Hospital. There doctors and nurses immediately administered oxygen and magnesium sulphate to revive and stabilize her. Once stabilized, Sithembile was transferred by ambulance to the Provincial Hospital in Bulawayo where she received further Intensive Care Treatment.

“The primary care nurse at Ndiweni Rural Clinic was able to call us via mobile phone, and we immediately dispatched one of our five ambulances to pick her up,” said Matron Mike Mpofu.  “Our emergency response has improved greatly, and we are able to save the lives of many mothers with complicated pregnancies such as C-section, post-partum hemorrhaging and eclampsia, who live far from the hospital.”

Five years ago, Sithembile’s story would have meant certain death. During this time, Zimbabwe’s health system was near collapse as a result of the economic crisis which led to a significant loss of qualified manpower, stock outs of essential medicines and commodities, and breakdown of medical equipment and health systems. During this period Maternal Mortality doubled from 450 per 100,000 in 2000 to a staggering 960 per 100,000 live births in 2011, while under-five mortality rates reached 84 per 1,000 live births.

It was on the backdrop of these high maternal and child mortality rates that the HTF was set up in 2011 to establish high impact and cost effective interventions to revive the health sector, particularly maternal, neo-natal and child health. As part of its strategy, the HTF is working to enhance obstetric and newborn care capacity by providing quality ante-natal care in primary care facilities; improving coverage of institutional delivery and skilled birth attendance; improving quality of care during post natal care and in the case of Sithembile, enhancing emergency care by training practicing midwives in Emergency Obstetric and Neonatal Care.

“Most maternal and neo-natal complications happen within the first 48 hours after delivery,” said Sister-in-charge of the Neo-natal ward Nqobile Ngwenya “Now that we have the equipment and have received training in Emergency Obstetric and Neo-natal Care at a district level we are able to successfully deal with cases such Sithembile’s, and we are able to save a lot more lives.”

Sithembiles’s son is swaddled and lying in the bay next to his mother as the nurses tend to her. The family haven’t given him a name yet. Thanks to the availability of quality care and emergency service at Plumtree District Hospital, his mother did not have to die while giving him life.



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