By HLUPEKILE NKUNIKA  –
MATERNAL mortality has continued to be the biggest challenge in the health sector in Sub-Sahara Africa.
Each year, 265,000 women die due to pregnancy related complications.
The region is the most affected by maternal death as it has a number of shortcomings, among them limited access to quality health care services, lack of companies that manufacture drugs, and poverty.
Haemorrhage, hypertension disorders, unsafe abortions, obstruction during labour and infection are some of the leading causes of maternal mortality in the region.
With 440 maternal deaths out of 100,000 births annually, Zambia is among the most affected with unmet needs in the reproductive health sector such as fertility rates, low contraceptive use, high incidences of HIV and AIDS, teenage pregnancies, unsafe abortions and inadequate access to health care services by the underprivileged.
While many maternal emergencies can be prevented with prompt and appropriate life saving care, many women do not receive the attention required from skilled personnel at the right time.
According to United National International Children’s Emergency Fund (UNICEF), excessive bleeding accounts for 34 per cent of maternal deaths and haemorrhage is higher among rural areas where access to professional healthcare services are limited due to unqualified health care service providers and long distances that women have to walk to access these services.
In Eastern Province, low ante-natal care service has also been identified as a contributing factor as expectant mothers do not seek the service and in some cases do so in the late stages of their pregnancies which often make it difficult to identify and treat a problem.
Among the many issues that inhibit access to health services are long distances to health facilities, inadequate and inappropriate modes of community referral to health facilities that include transport and cultural norms that inhibit institutional deliveries.
Some expectant mothers are reluctant to seek appropriate services due to lack of awareness on the benefits of seeking health care services.
Eastern Province medical officer Abel Kabalo notes the need for a multi-sectoral approach in addressing challenges in sexual reproductive health.
Dr Kabalo observes that the province recorded 63 deaths between January and June in 2015 due to pregnancy related complications and notes that excessive bleeding which is referred to as haemorrhage is the major direct cause of death among obstetric complications.
“We recorded 294 delivery complications due to haemorrhage in the first half of this year, this reflects an increase from last year because we recorded 596 cases of haemorrhage among expectant mothers, the increase in such cases raises a concern,” he said.
Dr Kabalo revealed that Lundazi and Chipata districts each recorded 12, reported the highest cases of delivery complications due to haemorrhage while Mambwe District did not record any case.
“The major contributing factors are the three delays which are, delays to seek medical services at community level, the delay in offering the service and the delay in transporting an expectant mother to a health facility,” ge said.
He noted that delayed referral in Petauke District led to the high statistics in haemorrhage especially among cases that were referred to the district from neighbouring Mozambique.
“As you are aware, Petauke is a border town and we receive a number of patients who are referred to health facilities from Mozambique, such cases are usually delayed and in some cases, the use of Portuguese on their records delays even further because we need interpreters or to start our own investigations before we can treat such patients,” he observed.
He noted that the situation was similar in Lundazi as delayed referrals were the major contributing factor in all the nine districts in the province.
He also stated that the province had also seen increased abortions and infections that led to maternal deaths.
“The use of herbal concoctions that accelerate labour lead to strong contractions that in some cases lead to the rupture of the uterus leading to excessive bleeding,” he said.
Dr Kabalo advised expectant mothers in the Province to seek professional health services saying the use of herbal enhancers to induce labour could be dangerous and lead to death.
“There is another critical condition that leads to haemorrhage and this is the failure of the uterus to contract after delivery due to a retained placenta which is generally the placenta that has not undergone placental expulsion within 30 minutes of the baby’s birth where the third stage of labour has been managed.”
Dr Kabalo stated that the uterus is supposed to contract in order to close off all blood vessels inside it and that if the placenta only partially separates, the uterus cannot contract properly so the blood vessels inside the uterus continueto bleed.
“This leads to Haemorrhage and infection,” he said.
The medical officer, however, noted that the Ministry of Health upped its efforts in improving maternal health which he said required a multi- sectoral approach.
“Training of communities has been done and that communities have also formed safe motherhood action groups that help expectant mother’s access health care services from health institutions.” he said.
“We as health personnel are also trying to ensure that we do not delay to offer the service and we are training staff in emergency obstetric care with support from CDC (Centre for Disease Control) and Centre for Infectious Disease Research in Zambia (CIRDZ). We want to ensure we put up appropriate measures so that we don’t see that mother who’s giving life, dying,” he said.
Dr Kabalo also stated that the Ministry of Health had seen an increase in the institutional deliveries which he said stood at 99 per cent.
He also noted that efforts were currently being made to encourage ante natal care among expectant mothers to ensure early detection of complications that could be life threatening. — ZANIS