Maternal health woes derail MDGs target

Tendai Makoni, an expectant mother from the high-density suburb of Glen Norah, arrives at Harare Central hospital in an ambulance at 6am.

Wongai Zhangazha

She is experiencing worrisome complications with her four- month pregnancy.

Despite groaning in pain while clutching her stomach, there is no speedy assistance as she is forced to wait in a long winding queue.

When her turn finally comes, Makoni is told by the nursing staff they could not do much to help until she got a scan which would help them determine the source of her pain and the status of the foetus.

She is taken further aback when the nurses tell her the hospital scan was booked for the next few weeks and since hers appeared to be an emergency, she would have to get it done elsewhere, and is referred to a private medical centre at nearby Southerton, as are many other patients who needed a scan.

There, Makoni has to wait for relatives to come and bail her out as she could not afford the US$30 fee. The scan is finally done at 3pm despite the continuous pain she was in.

With her scan documents in her bag she returns to the hospital using public transport, and has to wait for another two hours to be attended to by the duty doctor who had not yet arrived for duty.

And when the doctor finally examines her, he gives her bad news: there was only a 50 -50 chance that her baby would survive.
At 3am the next morning she miscarries, leaving her health critical.

As the 2015 deadline for the United Nations Millennium Development Goals fast approaches, maternal mortality statistics continue to be a major source of concern for the country, as women and children continue to die over preventable causes.

The Community Working Group on Health (CWGH) in its 2013 annual report released recently said a high number of women and children continue to die of preventable causes with a few months before the deadline.

“With a year to go before the Millennium Development Goals deadline, it’s unlikely that Zimbabwe will be able to meet its obligations. It is estimated that as many as 10 women and 100 children die every day in Zimbabwe as a result of easily preventable diseases; this is worrying indeed,” states the report.

“This scenario is worrisome as it means that with the high cost of health care and unclear policy on user fees for children under the age of five and pregnant women could be failing to access health care.”

Local authorities continue to defy a government directive to scrap maternity fees for pregnant women insisting that it was not economically viable, despite Health and Child Care minister David Parirenyatwa insisting there was need for the scrapping of the fees as most women lost their lives because they could not afford to pay.

“We have got a very high maternal mortality rate at 525 women dying for every 100 000 and one of the biggest causes is because women are required to pay for that service,” Parirenyatwa said.

“We would like to convince our country to pour money into that area so that nobody who is expecting should pay.”

Parirenyatwa said this after being told during a tour of Mabvuku Polyclinic that pregnant women still had to pay US$25 even after the scrapping of the maternity user fees.

Militating against the achieving of the MDGs are the same old problems that include the absence of trained health personnel, a crumbling health care system and lack of funding.

However, the Zimbabwe Association of Doctors for Human Rights (ZADHR) say corruption and fiscal mismanagement in public health facilities limit maternal health services, and the attainment of MDGs.

ZADHR chairperson Rutendo Bonde said the attainment of MDGs four (to reduce by two-thirds, between 1990 and 2015, the under-five mortality rate) and five (reduce by three-quarters, between 1990 and 2015, the maternal mortality ratio) was being derailed by poor governance.

Bonde said: “It is both corruption and weak fiscal management in major public health institutions such as state hospitals and medical aid associations. There hasn’t been prioritisation of clients’ access to health care in public medical aid associations.

“The prioritisation is for the preservation of the particular fund and the people who are managing the fund. When you see high child and maternal mortality, it is evidence of brain-drain and minimum investment. We are still relying on donors, and government’s financial allocations to health have not come up to the Abuja Declaration levels of 15% of the national budget.

She said initiatives that support safe motherhood are not sufficiently supported: “We still see high levels of child and maternal mortality, especially linked to HIV/Aids. We are unlikely to reach our MDG target unless there is a significant investment in programmes that support maternal health.”

Zimbabwe is heavily reliant on donors for the supply of medical drugs, a dire situation that requires more than US$120 million to address as a crisis would arise if donors decide to pull out.

National Pharmaceutical Company (NatPharm) managing director Florah Sifeku told journalists in Harare last week the organisation needed the funds for recapitalisation so as to improve the local pharmaceutical sector and reduce reliance on donors for essential drugs.

Government hospitals have not been spared by the wave of corruption revelations as they were recently exposed by the National Economic Conduct Inspectorate (NECI) report on the Procurement Processes by Government Hospitals for their involvement in dishonest tender deals at provincial hospitals nationwide.

Government is estimated to have lost US$5 million in the dodgy deals.

The investigations were conducted in several government hospitals including Parirenyatwa, Harare, Mpilo, Mutare, Gweru Provincial, Masvingo Provincial, Marondera Provincial and United Bulawayo Hospitals.

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