Zimbabwe’s health system failing pregnant women

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An estimated 3,000 women die every year in Zimbabwe during childbirth and at least 1.23% of gross domestic product (GDP) is lost annually due to maternal complications, according to Maternal Mortality in Zimbabwe, a UN issue paper released in 2013. According to a IPS report, the UN report found that maternal mortality worsened by 28% between 1990 and 2010. The major causes were bacterial infection, uterine rupture (scar from a previous caesarean section tearing during an attempt at birth), renal and cardiac failure, as well as hyperemesis gravidarum (condition characterised by severe nausea, vomiting and weight loss during pregnancy).

On top of a barely adequate public transportation system, user fees for delivering pregnant women that are charged in healthcare centres are also at fault, say civil society activists. "In 2012, the government crafted and adopted a policy that saw user fees for maternity services being scrapped," Catherine Mukwapati, director of the Youth Dialogue Action Network, a grassroots organisation, said. "But despite this policy, some facilities still charge indirect service fees, which is scaring away many pregnant women from hospitals and clinics, leaving them in the hands of less skilled midwives." Zimbabwe's local authority clinics say they have resisted scrapping maternity fees despite the official directive, claiming that they are not reimbursed as promised.

Meanwhile, the Health Transition Fund, led by the health ministry and managed by the UN Children's Fund (UNICEF) is helping to retain skilled workers by raising low wages. Underpaid doctors make up a large part of the country's "brain drain" and there are now just 1.6 doctors for every 10,000 people.

The Zimbabwe government’s investment in the health sector has been inadequate and the country has generally depended on donor support and direct budget support to run the public health institutions, reports Newsday. The health sector has as a result failed to provide adequate services to the people especially those do not have medical insurance – more than 11m Zimbabweans, representing 90% of the population have no access to medical aid.

Zimbabwe has suffered immensely from a brain drain of doctors. There are now 1,6 doctors for every 10 000 people. Most government rural health centres are manned by two doctors who have to perform multiple tasks. Linked to this, there are just seven nurses and trained midwives for every 10 000 people in the country. The paucity of medical staff is also reflected in the number of specialist doctors. The country has four neurosugeons, two heart surgeons, three dermatologists and one venereologist according to data is Zanu PF's 2013 election manifesto.

Due to poor funding of the health sector, 98% of drugs used in public health centres are funded by donors. The donor community has also equipped a number of rural health centres such that Zimbabwe now has the distinction of patients shunning main referral hospitals to be treated in rural hospitals.

Full IPS report Full Newsday report

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