Zambia tacles CARMMA

By Violet Mengo, 

It is one of the most depressing to lose a life due to preventable health causes, worse off for a mother loosing her life in order to give life. However, this is a reality for thousands of expectant mothers the world over that have continued to die everyday from complications arising from pregnancy and childbirth.

Death of mothers due to known and mostly avoidable causes at delivery reduces by almost half chances of survival of their new babies. Statistics on the number of women and newborn babies dying from preventable causes around the world have shown that tackling maternal complications remain a challenge for many countries.

In Africa, the maternal mortality rate continues to be one of the continent‘s major health problems. The rate remains high despite political commitment evidenced by the adoption of various policies and strategies.

These include the Cairo Consensus in 1994, Maputo Plan of Action in 2006 and the African Health Strategy 2007 to 2015 Millennium Development Goals (MDGs).

While several countries have managed to record some successes in addressing maternal health, a lot remains to be done in ensuring that every woman’s right to health and life is upheld.

Better health facilities will entail that every woman, regardless of location, station in life, experiences safe motherhood and that her life and that of her baby are saved within 42 hours following delivery.

The major causes of maternal death are from various medical complications including hemorrhage, sepsis, eclampsia, obstructed labour, abortion and other direct and indirect causes, notably cultural and traditional practices.

Neonatal sepsis is a serious blood bacterial infection in an infant less than four weeks of age while eclampsia is a condition in pregnancy characterised by abrupt hypertension.

Adolescent pregnancy, harmful traditional practices, low social status of women and high fertility rate, low male involvement  and participation in reproduction health, poverty and HIV and AIDS contribute significantly to maternal deaths.

The causes of new born deaths include sepsis, tetanus, diarrhea, preterm and asphyxia (impaired or impeded breathing). Other causes are complications during pregnancy and delivery, poor care of newborns at household level, inadequate health care for sick newborns and poverty.

The African Union’s response to tackling maternal mortality was the 2009 launch of the Campaign on Accelerated Reduction on Maternal Mortality for Africa (CARMMA) with the theme: Africa Cares, no woman should die while giving birth.

The CARMMA concept aims to accelerate and scale up high impact interventions through high level advocacy and sensitisation. And because of the direct impact the campaigns has on individual countries in terms of reducing maternal mortality rate, many African countries including Zambia, have adopted and are localising CARMMA.

Zambia launched CARMMA in June 2010, joining Ethiopia, Rwanda, Mozambique, Malawi and Swaziland. For Zambia CARMMA means raising awareness among Zambians on maternal mortality and how it can be prevented.

The campaign also aims to raise the profile of maternal mortality to elicit the vital high political will and commitment at national level and accelerate the reduction of maternal mortality.

The implementation of CARMMA includes safe motherhood activities in selected districts of the country, family planning, postnatal care and using men in advocacy at antenatal clinics.

Zambia, one of the countries with the highest maternal mortality in the world, has recorded a decrease in maternal mortality from 729 to 591 per 100 000 live births. The neonatal mortality rate is at 34 per 1000 live births.

In Zambia, the first lady Thandiwe Banda is making tremendous impact on the lives of women. As soon as her husband, President Rupiah Banda won the 2008 elections and assumed office, the first lady set to work and has contributed tremendously in improving health care delivery in Zambia.

She is the patron for CARMMA and has been traveling throughout the country to promote the campaign.

“We aim to ensure that the lives of mothers and babies are saved before, during and after delivery as poor maternal and newborn health have diverse consequences and impact negatively on the development of any nation, Mrs Banda said.

The first lady said it was unfortunate that hundreds of women and newborn babies continue to die every day from preventable causes.

She said it was important for all people to get involved and advocate for improved health services for expectant mothers and newborn in Zambia.

However in order to reap the intended benefits, strengthen policy and programmatic environment to accelerate the attainment of MDG four and five, the campaign has incorporated some stakeholders such as media, private sector, NGO and business house.

Ministry of Health Director Public Health Dr Victor Mukonka said it was important to highlight progress and challenges affecting maternal mortality so that women can be educated on the importance of seeking healthcare service when they fall pregnant.

About K16 billion has been set aside for the effective implementation of CARMMA.

In Zambia expectant mothers are discouraged from carrying their own bucket and use the ones provided by hospitals. The directive was made by Minister of Health Kampembwa Simbao.

“We shall no longer allow pregnant mothers to go with buckets to hospitals when the time for delivery comes, all hospitals have been stocked with enough buckets for expectant mothers,” the minister said.

Ministry of Health spokesperson Dr Kamoto Mbewe said the decision to make women's and children's health the theme of this summit was a sign Africa's policymakers are getting the message.

"Issues of maternal mortality need the urgent action of our heads of state if we are to reverse the negative image of women dying on our continent," said Dr Mbewe.

He said the health of women is important and must be protected. Health women contribute to Zambia’s economy.

He said “it is important to scale up interventions and sensitise people on the interventions. This is the only way they will be able to make informed decisions on their health.

To improve the health status of women and children, Zambia needs to accelerate effective interventions against maternal mortality.

The country  risks losing investments not less than K1 trillion if no improvement is made in maternal health.