By MIRIAM ZIMBA—-
NGOZA Tembo is a 27 year old woman of Kacholola in Nyimba district, whose previous pregnancy was not a very memorable experience.
This is because at the onset of labour, her grandmother gave her some traditional concoction that was meant to speed up her labour.
Unfortunately for her, the results were not as anticipated, because despite having hastened the process of labour, she experienced profuse bleeding- medically referred to as post-partum hemorrhage (pph) soon after delivery.
“I nearly died, I remember having looked at my son once, and then collapsed because I was feeling dizzy and very weak,” she explained.
“When I regained consciousness after sometime, I remember being surrounded by the nurses who just asked me to stay calm,” Ms Tembo added.
I guess they did not want to alert me on the fact that I had bled so much, but when I recovered after some hours, one of the nurses asked me if I had taken any medication prior to coming to the hospital,” she narrated.
“Out of fear, I declined to admit this, because I thought they would chastise me for that,” Ms Tembo explained.
“However, one of the elderly women around the health centre who introduced herself to me as a member of the Safe Motherhood Action Group (SMAG’s), explained the dangers of taking concoctions to hasten the natural process of delivery,” Ms Tembo explained..
It has been two years since that experience, and Ms Tembo recently delivered a baby girl at Kacholola rural health centre.
This time around, she adhered to the instructions of the SMAG’s, who ensured that she began her antenatal clinic (ANC) as early as two months into her pregnancy.
When labour began on the night of May 7th, 2014, Ms Tembo’s husband rushed to the house of one of the SMAG members, who accompanied her to Kacholola RHC.
“The SMAG’s are very helpful. They even simplify some of the things we feel shy to ask the nurses about, and they ensure that they keep track of us, and come to our aid whenever their services are required,” she explained.
The United States Agency for International Development (USAID) is working in Nyimba among other districts, where they are carrying out an intervention subbed Saving Mothers, Giving Life (SMGL).
During a site tour of some health centres in Nyimba district, the USAID Team led by USAID deputy health team leader Jorge Velasco, was impressed with the levels of commitment exhibited by the health staff and SMAGS, who received technical and financial assistance in training to enhance safe motherhood.
USAID’s SMGL programme involves capacity building, for both health workers and SMAG’s for improved maternal health results.
Since the implementation of the SMGL initiative was implemented, institutional based deliveries at Hofmeyer health center in Nyimba has increased from 218 in 2012, to 262 in 2013. This has been attributed to the increased demand in the use of maternal and child health services by the community.
Mr Velasco explained that the USAID supported project for the SMAGS includes training and mentorship, in order to increase the number of pregnant women coming to health centres to deliver.
He points out that part of the basic training that the SMAG’s have received include the need to encourage women to  ensure they attend at least four antenatal visits throughout their pregnancy, to assist detecting danger signs in pregnancy such as bleeding, severe headache, fever, and swelling of hands and feet, among others.
He said when the SMAGS identify these danger signs in pregnancy; they immediately refer the pregnant woman to the health centre to seek medical intervention.
Mr Velasco said the SMAGS are also trained in basic life saving techniques such as helping the baby to breath, malaria prevention, de-worming and others.
SMAG supervisor at Kacholola RHC Bridget Tembo said the initiative to enhance safe motherhood and child health has received support from traditional leadership, a situation she said has less to a decrease in maternal and infant mortalities.
“The community is very enlightened. They now understand the danger signs of pregnancy, and there has been increased participation from the males, who now accompany their wives to antenatal clinics,” she said.
The SMGL comes against the backdrop that in Zambia alone, there are an estimated 600,000 births, with about 2,600 maternal deaths and about 20,200 infant mortalities.
According to the Saving Mothers, Giving Life website, maternal and newborn deaths are largely preventable and are indicative of inaccessible and poor-quality health care facilities, inadequacies of the health system, and low demand for and utilisation of maternal and newborn health services.
For example, although 94 percent of Zambian women have at least one antenatal care visit, only 48 percent of women give birth in a health facility.
The SMGL partnerships have revealed improved maternal outcomes in the pilot districts of Zambia with the number of women dying during pregnancy and childbirth sharply declining.
USAID’s first annual report revealed a 35 per cent decrease in maternal mortality reduction in target facilities in Zambia within the first year of the programme’s operation.
The assistance offered by the SMAG’s has also been commended by health workers who appreciate their contribution toward a decrease I maternal mortalities.
Regina Mudhuzu, is a nurse at Kacholola RHC, and explains that SMAG’s have been very instrumental in assisting the health workers capture and register pregnancies in the communities as early as 4 to 12 weeks.
“The initiative USAID, SMGL has been helping us a lot because we are now able to capture pregnancies as early as 4 or 12 weeks, they also encourage women to come to the health centre to deliver their babies,” she explained.
One of the beneficiaries of the SMGL initiative is Bridget Tembo who is the supervisor of the 20 SMAG members in Kacholola.
She explained that the SMAGS have made frantic efforts in sensitising the community on some the preventable causes of maternal mortality.
“Personally, I have learnt that one of the advantages of delivering at the health centre is that pph, can easily be prevented and controlled when a woman delivers at a health centre,” Ms Tembo explained
Prior to initiatives such as SMGL and SMAG’s, a lot of expectant women in rural parts of the country opted to be attended to by traditional birth attendants (TBA’s), who used to assist women deliver at home.
As a result, maternal mortality was a high as 729 per 100,000 live births in 2001! Currently, according to the 2007 Zambia Demographic Health Survey the country has made strides in maternal mortality to about 591 per 100,000 live births.
Some of these reductions could be as a result of interventions by SMAG’s, coupled with other interventions instituted by government and its cooperating partners.