Midwife shortage drives rural maternal mortality

Jennifer Masara, 28, from Guruve, made a 200km journey to Harare in the last stages of her pregnancy after the local rural clinic lost its sole midwife.

“I was told a few days before I was due to deliver that the midwife had suddenly left her job,” Masara told The Zimbabwean. She faced expulsion because Ministry of Health and Child Welfare officials felt she was negligent when a mother died during delivery at the health centre.”

Masara is lucky that she could make it to the capital where she delivered successfully, but many rural women are not as fortunate, and die while in labour.

A critical shortage of midwives has been cited as one of the major factors driving maternal deaths in rural areas. Like doctors and nurses, they shun rural areas because of poor working conditions, said a senior midwife at Hurungwe District Hospital who spoke on condition of anonymity.

“Imagine attending to a woman in labour using a candle because there is no electricity. Most hospitals in rural areas are far away from major roads and this makes them inaccessible,” said the midwife.

“Not many nurses are willing to train as midwives because the job is too demanding. The government has advertised for midwives repeatedly but student midwives are not forthcoming,” she added.

She said midwives preferred to trek to South Africa, Botswana and Europe, worsening the shortage. An acute economic meltdown that started in 2000 forced thousands of skilled nurses, doctors, teachers and other experts to migrate as far afield as Europe and the US in search of better fortunes.

Even though a 2009 coalition government has been working to reverse the crisis, skilled manpower still prefers working in other countries because salaried and general working conditions remain poor, particularly in the public sector.

“Salaries are poor, working hours are long, we risk contracting diseases because of poor sanitary conditions and the wards are poorly equipped,” said the midwife. In Zimbabwe, official figures indicate that for every 100,000 women giving birth, 960 die during labour.

“It is disheartening to note that the number of women in Zimbabwe dying during delivery has increased from 725 deaths for every 100,000 live births to 960 deaths for every 100,000 live births,” Deputy Prime Minister, Thokozani Khupe, recently said in a statement.

Women’s rights activists have called for the high maternal deaths to receive serious attention.

“When a bus is involved in an accident and claims 21 people, this is declared a national disaster, but when 960 out of 100,000 die delivering babies, it is ignored,” said Zimbabwe Women Resource Centre and Network Executive Director, Naomi Chimbetete.

Speaking at the launch of a campaign to improve health services in rural areas held in Domboshawa recently, Chimbetete added: “The government should declare this high mortality rate a national disaster and look for ways to reduce the rate at which the people are dying. No woman should die giving birth.”

The European Union recently availed a $2 million package to support the Accelerated Midwifery Training Programme to ensure that at least 60 percent of nurses at any health facility have midwifery skills.

Head of EU Delegation in Zimbabwe, Ambassador Aldo Dell’Ariccia, said the midwifery programme was one aspect of the bloc’s public health sector assistance.

“Quality midwives are key in the effort to achieve the Millennium Development Goal to reduce maternal mortality ratio by 75 percent by 2015,” he said.

Post published in: News

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