Post-Covid-19 recovery: Why maternal health must take centre-stage

BY FUNGISAI DUBE

The importance of healthcare workers has been clearly demonstrated during the Covid-19 global health emergency, with millions of healthcare workers  at the frontline of a crisis that has cost many lives  and threatened  with collapse, even the most robust healthcare systems.

As Zimbabwe celebrates more than four decades of independence, the government must renew its commitment to universal healthcare, its commitment to better working conditions for thousands of poorly remunerated healthcare workers and its commitment to improving maternal health care so that women do not continue to die, needlessly during childbirth.

In the past year, health disparities have been brought into sharp focus with women being disproportionately affected by Covid-19. Sexual reproductive health services suffered as money was diverted to fighting the virus at the expense of maternal health.

The government must be commended for its significant efforts at reducing maternal and infant mortality since independence, although this remains worryingly high.

According to the 2019 Multiple Indicator Cluster Survey (MICS), Zimbabwe’s maternal mortality ratio stands at 462 maternal deaths per 100 000 live births, one of the highest in the region. It is unlikely that Zimbabwe will meet  its target  of reducing the maternal mortality to 325 per 100 000 live births by 2030 unless urgent action is taken to scale up investment in maternal health.

Covid-19 sadly threatens to reverse all the gains made to reduce infant and maternal mortality as resources were diverted to fighting  the virus at the expense of sexual reproductive  health services.

As part of its post-Covid-19 recovery programme, the government must take urgent action to restore critical sexual reproductive health services and transform service delivery, in particular to ensure broader access to family planning services and a reduction in unsafe home deliveries. Investment in women’s health must take many forms including investing in staff, infrastructure, technology, psychosocial support and efficient referral systems.

The government has since independence, spent millions in training doctors, nurses including midwives, increasing the number of universities and training institutions for health care staff, and for this government must be commended.

Little has been done, however, to retain staff in the sector, with the past four decades marred by strikes by doctors and nurses,  as the government has failed to  pay them a living wage, failed to  provide adequate infrastructure, accompanying equipment, resources and medicines for them to carry out their work effectively.

At independence,  doctors and nurses were well regarded in the communities they lived in and were paid a decent wage for taking up these noble professions . As the years  progressed, and especially in recent years, lives have been put at risk as staff have repeatedly left their  working stations as they demand better conditions of work.

Government needs to do more to resolve the problems relating to health staff, ensure better remuneration and retention and introduce incentives to dedicated healthcare professionals who were at the centre of the country’s Covid-19 response. Highly skilled health care staff, who are well regarded regionally and internationally, continue to leave the country for better prospects.

Other countries have made obvious the importance of the healthcare sector and have moved quickly to strengthen their health workforce using overseas labour. For instance, in August last year, the UK government announced a fast-track visa for healthcare staff saying it would “make it cheaper, quicker and easier for healthcare professionals from around the world to come to the UK.”

This week, the UK government  announced further measures to retain overseas staff saying it would automatically extend, by a year, for free, the visas of frontline health workers that were due to expire.

British Secretary for Health and Social Care Matt Hancock, commenting on the extension of visas for healthcare staff said: “This extension will cover healthcare professionals working in the NHS and the independent health and care sector. Their visas will be extended for a year, free of all fees and charges, including the Immigration Health Surcharge.”

As Zimbabwe goes into its fifth decade as an independent country, there must be renewed effort to deliver quality, accessible, affordable  and comprehensive health care.

As the country celebrates over four decades of independence it does this against the  backdrop of a struggling health system. This period in the country’s history presents an opportunity for transformative leadership around maternal health issues and health delivery.

Even those who could afford to pay for health care outside the country were confronted with the services that are available in the country as Covid-19 regulations restricted travel. They too must also join calls for better health services for all.

The government and private sector will also have to innovate around domestic health care funding and stop the dependence on donor funding for the healthcare sector. Countries across the world are also faced with struggling economies as they seek to  recover or adjust and learn to live with Covid-19.

In the immediate future, it is unlikely that these countries will be able to commit significantly higher resources to reviving the health systems of other countries as they confront their own problems.

Government must also commit to  transparency in the procurement of health supplies so that citizens regain their trust in the government, following revelations of corruption in the  procurement of Covid-19 supplies.