By FELIX MALUNGA –
IT is shocking that only 47 per cent of births in Zambia are attended to by skilled health workers at health institutions while home delivery has an incredible 53 per cent.
Zambians in rural areas have limited access to healthcare, with about 50 per cent of rural communities being within five kilometres to a health facility.
In urban areas, approximately 99 per cent of households are within at least five kilometres to a nearest health centre.
Research has also shown that some socio-cultural factors have compounded families’ healthcare to an extent where children access health facilities late and pregnant women are not given special care.
This is because there is little or no knowledge about post-natal care. Knowledge and practice on infant and young child feeding practices are also low.
Infectious but preventable diseases contribute significantly to child deaths and illnesses, including malaria, respiratory infections, and diarrhoeal diseases.
All these factors have contributed to Zambia’s high maternal, newborn, and childhood death indicators.
For example, more than 591 maternal deaths are recorded per 100,000 live births while the infant, neonatal and under-five mortality rates are at 70, 34, and 119 per 1,000 live births, respectively.
These mortality rates are unacceptably high in the country.
Government is aware of this problem and has shown commitment to the promotion of maternal and child health.
To demonstrate its seriousness, Government abolished user fees for all maternal and child health services. Government has since gone into partnership with several international organisations to improve healthcare for all the citizens.
One of the major programmes is the European Union (EU)-funded Millennium Development Goal Initiative (MDGI), whose theme is ‘accelerating the reduction of maternal, neonatal and child mortality’.
This is a Government programme with the EU and the United Nations International Children’s Emergency Fund (UNICEF) in partnership with the United Nations Population Fund (UNFPA) and the World Health Organisation (WHO).
The aim of the programme is to increase the use of quality health and nutrition services among children, adolescents and women in 11 urban and rural districts in Lusaka and Copperbelt provinces, home of 30 per cent of Zambia’s population.
Recently, the EU Ambassador to Zambia and Common Market for Eastern and Southern Africa (COMESA), Alessandro Marian led a high-level field visit to the Copperbelt to hand over to the Ministry of Health refurbished and equipped maternal and child health wings at three health centres in Ndola, Luanshya and Masaiti districts.
The facilities are Mpatamatu Section 26 Clinic Health Centre in Luanshya, Masaiti’s Kashitu Rural Health Centre and Mahatma Ghandi Health Centre in Ndola.
This made an immediate difference to the affected communities’ ability to access quality health care from these completed facilities.
The total cost for the refurbishment and medical supplies was $484,210 (more than K4.6 million). The EU has poured a total of €48.6 million (more than K533.5 million) into the MDGI programme in Zambia which is being implemented by Government with technical support from UNICEF, UNFPA and WHO. UNICEF is responsible for the management of the EU funds.
Health Permanent Secretary, Peter Mwaba said Government was thankful to the EU and the United Nation for working with the ministry to partially refurbish and equip 52 health facilities in Lusaka and Copperbelt provinces.
“Under-five mortality has dropped in Zambia by 61 per cent and infant mortality by 58 per cent between 1992 and 2013-14 and these achievements have been as a result of key public health interventions implemented by the Government of Zambia,” Dr Mwaba said.
He, however, noted that progress on reducing maternal mortality had not kept pace and Zambia still had an unacceptably high maternal mortality rate of 398 per 100,000 live births.
“This is the strategic motivation behind MDGi – to lower maternal mortality rates through improved health services, nutrition, community involvement, youth-friendly health services and strengthening of the national health systems,” Dr Mwaba added.
The EU Ambassador said the MDGI programme in Zambia was designed to provide a proven cost-effective high-impact package of reproductive, maternal, newborn and child health and nutrition services to mothers, adolescents, babies and children.
“This will be combined with encouraging the public to demand for quality services. We believe that this will result in higher use of services of better quality and it will ultimately save lives of children and women.
“The programme has been developed to build on the efforts of the Government of the Republic of Zambia to strengthen the health system in order to improve overall health and nutrition situation for women and children. We are extremely grateful to the taxpayers of the European Union for making this critically important programme
possible,” Mr Mariani said.
UNICEF country representative, Hamid El-Bashir Ibrahim saluted the community’s involvement of MDGI and thanked the Zambian people for their support to the programme.
Dr El-Bashir said by 2018, MDGI would have helped in building capacity of many neighbourhood health committees comprising members of Safe Motherhood Action Groups, Infant Young Child Feeding community-based volunteers, Integrated Community Case Management volunteers, community-based distributors and peer educators in Lusaka and
Copperbelt provinces.
“This is the true grassroots people helping people and we honour the community spirit of these volunteers. Zambia’s future is indeed quite bright,” he said.
UNFPA country representative, Mary Otieno said the organisation was honoured to be part of the partnership whose aim was to ensure every young person’s potential was fulfilled and every child birth was safe.
Dr Otieno said women, young people and indeed children needed to have access to medical facilities.
Health ministry’s director technical services, Reuben Mbewe said there was need to improve maternal and child mortality including nutrition among the citizenry.
Copperbelt Province medical officer, Consity Mwale said the province was grateful to receive such medical equipment and infrastructure which would contribute to quality delivery of health services.
The MDGI programme is being implemented in six districts on the Copperbelt – Mufulira, Chingola, Kitwe, Luanshya, Ndola and Masaiti.
This represents about 80 per cent of the Copperbelt’s population.
Mpatamatu’s Section 26 Clinic in Luanshya had its maternity wing refurbished and equipped following MDG interventions.
The chairperson for the Mpatamatu neighbourhood committee, Lawrence Banda said the project was timely as the nearest referral centre was in Roan Township.
Mr Banda said there was need to sensitise the community about the new development and appealed to the Mpatamatu residents to guard the facility jealously.
There was relief among the mothers in the area with Sylvia Katontola, who just delivered a baby girl at the refurbished facility, saying: “Things have now changed. People here used to give birth in homes because the nearest referral is in Roan.”
Another mother, Edna Kapondo also noted that “before this maternity ward was built, we only came here for antenatal and when it’s time to deliver, we were referred to Roan. Otherwise most women were taking a risk of delivering at home.”
At Kashitu Rural Health Centre, sister-in-charge, Ivwananji Nachilongo said the demand for the facility came from the local community and that with the MDGI intervention, the centre now had an incubator for premature babies.
“It was a challenge to take care of mothers and babies delivered due to lack of proper equipment. Now we are able to provide quality healthcare. We are covering more under-five children now and mothers should access the services here,” Ms Nachilongo said.
Masaiti District medical officer, Evaristo Kunka said the district’s aim was to ensure no woman dies when bringing life.
At Mahatma Ghandi Health Centre, Ndola District medical officer, Kakungu Simpungwe hoped that the EU would be able to support more clinics and that so far five institutions were being targeted for this initiative.
After handing over the three facilities, the EU Ambassador said his delegation was satisfied with the tour and that their expectations were fulfilled.
Mr Mariani said the facilities would have a ‘terrific’ impact on the maternal and child mortality rates in the area.
He also hailed the high level of participation from the community members.
“The level of participation from the community is amazing. The involvement of volunteers is also commendable,” Mr Mariani said.
With everything done, the MDGI programme will continue to support health facilities to deliver an intergrated Reproductive Maternal Newborn Child Health and Nutrition (RMNCH&N) package.
The neighbourhood health committees will continue receiving training to sharpen their skills in delivering to the community.
Youths will also be engaged to access reproductive health services and strengthen the youth-friendly centres identified in the districts.
Health workers will get additional training in selected RMNCH&N skill areas.
There will also be provision of technical support in Health Management Information System data analysis and data utilisation for planning and decision making.