By HLUPEKILE NKUNIKA –
WITH an estimated population of 15.8 million people, Zambia faces challenges in the delivery of quality healthcare service due to inadequate qualified personnel, inadequate health facilities, illiteracy and the poor state of roads which, in some cases, become inaccessible during the rainy season.
The situation is worse in rural areas where 80 per cent of the population is poor and lives below the poverty datum line.
Such disadvantaged people in the remote rural communities lack basic health services which, in most cases, makes them seek medication from traditional healers.
It is such people that are mostly affected by a high disease burden, of illnesses like, malaria, tuberculosis, maternal mortality, HIV and AIDS, and diarrhoea which are leading causes of fatalities in Zambia.
With a population of 1.8 million people, Eastern Province is the fourth highest populated region in the country.
The province has in the last five years recorded increased economic and social activities which have led to population growth.
But that growth has stretched the capacity of health services which have not been improved to cope with population growth.
The province only has six hospitals which are not adequate to provided first and second level healthcare services.
To respond to healthcare needs, the Government, in the last five years, undertook an ambitious infrastructural development which that included construction of four district hospitals in Nyimba, Chipata, Lundazi and Vubwi districts.
Provincial Medical Officer Abel Kabalo disclosed during a Provincial Integrated Technical Review meeting in Petauke District that progress was reported in the construction of district hospitals in the region.
Dr Kabalo noted that phase one of the construction works on Nyimba District hospital, where works started in 2013, were completed and the hospital began operating in 2016.
He said the district hospital was built at a cost of K9.6 million.
“The construction of a similar structure in Chipata District at the cost of K10 million is nearing completion, while phase three of the construction of Lundazi District hospital is also progressing well,” he said.
Dr Kabalo also stated that the initiative by Government to construct prefabricated health posts across the country, out of which 57 were allocated to the province, led to a total of 41 being completed and had by the end of last year started operating.
The development cheered both residents and the local authority in Vubwi District, whose access to a first level hospital is a challenge and patients had to cover a distance of over 50 kilometres to receive such services.
Council Secretary John Kamanga explained that people in Zozwe, which borders with Malawi, seek health services in Mchinji District of Malawi.
Mr Kamanga further stated that the construction of a district by Zamchin Construction Company at the cost of K13 million would help address the health needs of the district population of 34,000.
“The construction of this hospital will reduce on the referral cases most of which were referred to Mwami Hospital in Chipata District.
Five health posts were also allocated to the district and some have already been completed,” he said.
In Lundazi District, residents were happy that prefabricated health posts reduced the distances that they used to walk to access healthcare services.
Maria Banda of Chief Mphamba’s area said people used to face difficulties in accessing healthcare services.
“We use to walk a distance of about 10 kilometres and patients, especially expecting mothers, had challenges. So the construction of this health post has really assisted us,” she said.
With regard to malaria which remains the number one killer disease, the province managed to reduce malaria cases in the last three years.
Prior to the reduction, Eastern Province used to record the highest incidents of malaria.
The province recorded the highest number of cases in 2012 and 2013 but due to mass distribution of insecticide treated nets (ITNs), Indoor Residual Spraying (IRS) and other interventions, the malaria incidence reduced from 540 in 2013 to 491 per 100,000 hospital visits in 2014.
“In 2015, the incidence rate was 491. It dropped to 377 per 1,000 hospital visits in 2015 and in the third quarter of 2016, the incident rate was 54 per 1,000,” he said.
The disease still remains a major cause of death in the province and for this reason, authorities prioritize efforts towards spraying and distribution of ITNs.
Being a rural province with a number of people lacking adequate access to quality healthcare, maternal mortality is among the biggest health concerns.
Although the region recorded increased infrastructure development which improved access to healthcare services and delivery of medicines, the number of expecting mothers remained high.
Dr Kabalo disclosed that the province had improved on institutional deliveries which stood at 74 per cent.
“On a sad note, the province has continued to record an increase in maternal deaths, 19 were recorded in the third quarter, giving a cumulative figure of 87 in 2016,” he said.
He urged all health institutions to strengthen the Safe Motherhood Action Groups (SMAGS).
The SMAGS initiative is made up of community volunteers trained on messages and practices that lead to safe pregnancies for women in rural areas.
Excessive bleeding was cited as the number one cause of death among pregnant women.
In Lundazi District, the problem was worsened by child marriages and early pregnancies as maternal and child health coordinator Chileka Imbisa observed.
The Ministry of Health, in coordination with other stakeholders, was engaging traditional leaders and the local community to fight early marriages and encourage institutional deliveries which could prevent mortality in the province.
Chief Mphamba of the Tumbuka people of Lundazi District, who is a safe motherhood champion, was working with his subjects to encourage institutional delivery in his chiefdom.
The traditional leader believes that infrastructure development is important to the success of institutional deliveries.
“We want all mothers to deliver in health facilities so that they can be quickly attended to, should there be complications. Those who deliver at home are penalised,” he said.
He warned that parents who marry off their children at an early stage risked being penalised because the royal establishment wanted the children to complete secondary education.
The HIV pandemic was another health challenge that affected the region.
Health authorities put up several interventions that subsequently reduced the infection rate from 9.3per cent in 2012 to six per cent in 2014.
This is according to the Zambia Demographic Health Survey.
Dr Kabalo said the province provided Anti-Retroviral Therapy (ART) services through 33 static and 71 mobile sites across the province.
He said the ministry of Health was also receiving support from the Centre for Disease Control and Prevention in funding HIV/ AIDS programmes.
“Currently, there are 62,525 adults on ART while the number of infants is 4,053. We need to improve on paediatric enrolment on ART. The province has also scaled up on option B+ in an effort to eliminate the transmission of HIV from mother to child,” he said.
Option B+ helped HIV positive pregnant and breastfeeding women who were provided with anti-retroviral drugs regardless of CD4 count or World Health Organisation (WHO) clinical stage.
This was done in an effort to prevent the transmission of HIV from mother to child which is commonly known as Prevention of Mother to Child transmission (PMTCT).
In relation to breast and cervical cancer, which is becoming a growing health concern, Eastern Province, with support from the Centre for Disease Control (CDC) established cervical cancer screening facilities at Chipata Central, St Francis, Minga and Lundazi hospitals.
A total of 28,550 women were screened for cervical cancer out of which 341 were confirmed cases.
Dr Kabalo said there was need to roll out screening services to all the nine districts.
This would increase the number of people accessing screening services in the province.
Dr Kabalo said the province also acquired three vehicles and 22 motorbikes to ease the transportation challenges and enhance outreach programmes.
The provincial medical officer also disclosed that Government had recruited 300 health workers.
He said this had improved staffing levels in various health facilities across the region.
With regard to the poor state of roads, Government in the last five years prioritized the construction and rehabilitation of roads.
Eastern Province Minister Makebi Zulu said a number of feeder roads were rehabilitated in all the nine districts of the province.
He said that this improved access to social services, such as schools and health posts.
Eastern Province recorded improved service delivery in the health sector.
These developments were expected to improve the health of the local people and subsequently, the Gross Development Product (GDP) as only a productive people would contribute to the economy of the province.-ZANIS.