Child death, maternal health challenges

AS THE world prepares for the attainment of the 2015 Millennium Development Goals (MDGs), Zambia too is striving for the same.
Despite the strides Zambia is making, little seems to have been achieved especially in the area of reducing child mortality and improving maternal health.
The setbacks experienced in reducing child mortality rates and improving maternal health by two-thirds by 2015 range from social to economic. These setbacks vary from region to region, depending on social and cultural differences.
However, in North-Western Province, the fight against maternal and child deaths hinge greatly on cultural norms; this is because the habitants are widely known for being cultural.
That is why the culture of silence of keeping one’s pregnancy secret until asked by elderly women to share with the community is religiously observed despite its adverse effects.
Since time immemorial, pregnant women and girls upon knowing they were expecting were not allowed to share the knowledge of their pregnancy with anyone until after a period of three months. Unfortunately this practise has continued in certain parts of North-Western Province and is reportedly hindering the fight against maternal and child mortality deaths.
Acting maternal and child health co-ordinator at Solwezi District Community Office Sarah Tembo indicated that culture is a affecting the fight against high maternal deaths in the area.
Ms Tembo, pregnant women and girls do not seek maternal and child health services on time because they wait until they are permitted by the older women to do so, is normally after three months or more of pregnancy.
She was speaking during the stakeholder’s sensitisation and orientation meeting for Kasempa, Kitwe, Mwinilunga and Solwezi districts recently.
The meeting was aimed at increasing access to maternal and child health services in Zambia organised by PANOS Institute Southern Africa (PSAF) and supported by Save the Children International in line with the MDGs four and five.
MDGs four and five aim at reducing mortality rates by two-thirds, reducing the maternal mortality rate to three quarters and ensuring universal access to reproductive health.
Ms Tembo highlighted that the most important time for a pregnant woman to receive proper antenatal care was during the first trimester because that is when they are given anti-malaria prevention.
She further highlighted that some pregnant wait for as long as seven months hence missing out on the full preventive pregnancy care. Globally, more than 350,000 women die of preventable child birth complications.
In Zambia, 76 out of 1,000 infants die within a year of being born, while 119 out of 1,000 children die between the ages of one-five.
And 591 out of 1,000 children die within a specified period of giving birth due to pregnancy-related complications or child births; these rates are higher in rural areas.
But Zambia National Traditional Counsellors President Iress Phiri explained that traditionally when a woman realises she is pregnant, she is not allowed to tell anyone except her husband.
Further, she has to keep the pregnancy secret for some months until she is asked by an elderly grandmother to share the news with friends and relatives. “All this was purely done to prevent any miscarriages because not everyone is happy to hear that someone else is pregnant,” Ms Phiri said.
And addressing participants who attended the three-day workshop aimed at empowering community groups and local radio stations with knowledge on increasing access to maternal health services in Solwezi, PSAF programme manager Elias Banda reaffirmed the institute’s commitment to work with communities.
Mr Banda said PSAF has started a two-year advocacy campaign in Western and North-Western provinces aimed at increasing demand and access of maternal and child health services in rural Zambia.
He said “the project is aimed at helping Zambia attain the MDGs and will directly reach 24,000 women, 23,000 men, 6,000 boys and 11,000 girls in Mongu, Lukulu, Solwezi, Mwinilunga, Kasempa, Lusaka and Kitwe districts.”
Among the many activities planned by PSAF is the mobilisation of Safe Motherhood Action Group (SMAGS) and Radio Listening Clubs (RLC) among the rural communities to increase awareness on the importance of pregnant mothers and under-five children visiting health centres.
However, this practice has been described as ‘harmful’ by Mufumbwe’s Kanunga SMAG member Amon Muzenze.
Mr Muzenze said in an interview that the cultural practice is mostly observed in rural areas making the work of SMAGs difficult.
He narrated that young girls end up dying while at school because they are culturally-socialised not to share the news of pregnancy with anyone.
“There are situations where a young girl has to wait for the grandmother to instruct her when to go to the hospital for antenatal examination; which often times contributes to rising cases of obstetric fistula,” Mr Muzenze said.
And Kasempa Radio station manager Martha M’soka challenged the media to take the key role in addressing cultural barriers that have posed as a challenge in the fight against maternal and child mortality deaths.
Ms M’soka said local radio stations are key in the fight as they address the challenges the locals can identify themselves with.