“The midwives at Epworth polyclinic are very rough and not considerate of the needs of expectant mothers. After you give birth to your child, you are required to wash the bed linen where you delivered. This means that you have to bring your own water from home – because most of the time there is no water at the centre,” she told The Zimbabwean.
Chengaose alleged that the midwives do not care whether the new mothers can manage this task or not. “Even when a person is still weak, they are expected to wash the dirty linen or get a relative to do it for them,” she said.
Evonnia Nzenza, chairperson of Advocacy Initiative, a community organisation working with women in the area, said pregnant women were fined $15 for late registration for ante-natal services at Epworth clinic.
“Pregnant women are fined if they register their pregnancies after 15 weeks – this is on top of the maternity fees of $35. The nurses do not care that the reason why a mother could have delayed registering is because of financial challenges,” she said.
Research has shown that many developing countries do not have national guidelines on antenatal care, although commencement of antenatal care within the first 14 weeks of gestation is widely accepted as early. However, booking after the 14th week of pregnancy is mostly viewed as late.
Nzenza said because the majority of the people from Epworth worked in the informal sector as vendors they cannot afford to pay the fees and the fines. As a result most of the pregnant mothers were registering for ante-natal care in Mbare and Chitungwiza.
“Expecting mothers are also required to pay an ambulance fee when they register – whether they use the services of the ambulance or not. That money is not refunded,” she said. This means they have to part with $70 to register.
Daisy Mbengero from Overspill in Epworth said because it was expensive to seek anti-natal care at the clinic, most of the women preferred giving birth at home.
“I would rather seek the help of a traditional midwife and go to the hospital only when there are complications,” said Mbengero, showing off her one-year-old daughter born at home.
“I paid $10 to the traditional midwife and delivered my baby. She treated me well – instead of me paying $70 to be ill-treated.”
When she delivered at the midwife’s home, she did not buy 15 pairs of gloves, as required at the clinic. “The strict instruction is that you have to be at the clinic as early as 6 a.m yet the health personnel come at 8 a.m. If you are late they shout at you using derogatory language,” she said.
Nzenza said poor women were the most affected because they could not afford to pay for quality obstetric care. Said Veronica Muware from Overspill in Epworth: “It could be that the midwives are frustrated because they are too few or they are poorly paid. Either way, they take out their frustrations on the mothers and lives have been lost because of the midwives’ negligence.”
Although service provision improved with the “dollarisation” of the economy in 2009, which saw the adoption of several foreign currencies as legal tender, access to quality ante-natal care remains a challenge, especially for the majority of expecting mothers.
Maternal mortality in Zimbabwe remains high, exceeding 960 per 100,000 live births. Described as the death of a woman while pregnant or within 42 days of termination of pregnancy, regardless of the duration of pregnancy, from any cause related to or aggravated by the pregnancy or its management, maternal mortality is hard to measure in the absence of a complete registration of deaths and accurate ascertainment of causes of death.
The United Nations reports that an estimated 3,000 women die annually in Zimbabwe during child birth and at least 1.23 percent of the country’s Gross Domestic Product is lost every year due to maternal complications.
Reported the UN in its paper entitled “Maternal Mortality in Zimbabwe: Evidence, Costs and Implications”, maternal mortality has worsened by 28 percent from 1990 to 2010.
It stated that most of what needs to be done is known yet maternal mortality estimates remained high.
“Past efforts have managed to sustain high levels of ante-natal care visits among pregnant women and skilled birth deliveries but maternal mortality remained high. While innovative thinking supported by a stronger vital registration system is needed for progress towards reducing maternal mortality, quality of care in maternal health services seems to be the missing link. There is need to progressively expand the scope and entitlements of maternity protection and provide perspectives for policy and action,” reads the UN report.
The minister of health and child care, David Parirenyatwa is on record saying that it was the duty of government to provide attractive working conditions for staff and efficient health services to the people.
According to the health ministry’s latest weekly report, at least eight maternal deaths were reported in the eighth week of 2014. It is highly unlikely that Zimbabwe will achieve the millennium development goal of improving maternal health and reducing mortality by 2015 amid reports that maternity mortality is still high with an average of nearly 10 deaths every week.Post published in: News