GIVING BIRTH MADE EASY
3 July 2017
. . . Health Centre committees critical in reviving primary health care
Shamiso Mapanzure, 24, had just given birth last week and her husband could not hide the joy of yet another successful birth.
Shamiso, who stays more than 15 kilometres from Shumba Health Centre, Mapanzure in Masvingo Province is a beneficiary of the health facility’s mothers waiting shelter which was built courtesy of the Health Centre Committee in 2013.
While she lives 15km away from the clinic, the waiting shelter has enabled her to get assisted delivery after she got at the waiting home two weeks before delivery.
“I live more than 15km away from this clinic such that it could have not been possible for me to reach this place on time in the absence of this waiting shelter. I could have probably given birth at home but this waiting home enabled me to come and wait and today I successfully gave birth.
“This is my third child and the second I have had here after the waiting shelter was built. I want to thank the health centre committee for facilitating the building of this shelter,” she said as she constantly cuddled his bundle of joy.
Her husband, Ephias Muza concurred that the waiting mother’s shelter had made life easier for him and his wife adding that it had bridged the distance gap between their home and the clinic.
Mothers’ waiting shelters are critical in reducing maternal mortality as they help curb the three delays that usually occur subsequently leading to maternal death, which are; delay in decision to seek care, delay in reaching care and delay in receiving adequate health care.
Muza adds that through the health centre committee he had been educated about male involvement in anti-natal care (ANC) hence he had been by his wife side from the first day she made her ANC booking.
Headman Chikava, Ernest Chikava who chairs the Shumba Clinic Heath Centre Committee says since the building of the waiting home, home deliveries and maternal deaths at the clinic had significantly dropped.
“In 2017 alone, we have not recorded any maternal deaths and under five deaths. On home deliveries, we have not received any as of yet.
“In January, we received 5 deliveries in January, February 9, deliveries, March 1 delivery, April 6 deliveries, May 5deliveries and June 8,” said Chikava.
Health Centre Committees were revived by the Ministry of Health and Child Care partners; Save the Children and Community Working Group on Health under the initiative dubbed ‘Strengthening Community Participation in Health’ in 2013 as they sought to reduce maternal and infant mortality as well as stimulating the communities’ involvement in primary health care services.
The main objective of the programme is to revive the primary health care by bridging the gaps that hinders the community from accessing health care as well as giving communities a sense of ownership and belonging at health facilities.
In some parts of the country, Village heads and chiefs have introduced penalties in the form of cash, livestock or hard labour as a form of punishing offenders who would have given birth outside prescribed health institutions.
Under the same initiative, compulsory antenatal care visits for both husband and wife have been introduced, maternal fees have been scrapped and children below the age of five get treatment free. Through the initiative, most traditional leaders have been championing voluntary HIV testing.
Communities where the programme has been implemented have appealed to the partners to continue supporting them in their health centre committees as they fear for its sustainability if supporting partners leave.
“This programme has been critical in improving primary health care as it also helped improved relations between the community and health facilities. My appeal is for the partners not to leave us as we might fail to sustain this on our own.
“They have taught us so much as communities but we still need their support,” Headman Chikava says.
Save the Children Zimbabwe Communications Advisor Sophie Hamandishe says the strengthening community participation in health projects have been very transformative adding that it has seen rural health centres benefiting from increased community involvement through the resuscitation of health centre committees.
Hamandishe says the high infant and maternal mortality in the country saw them embarking on this project.
“Infant and maternal mortality in the country was so high when we started this project and the main reason was that there were so many home deliveries hence we had to encourage institutional deliveries at clinics where they could also get quality services at primary health level.
“This project has greatly revived primary health care in rural communities. We have had communities taking full ownership of health facilities leading to improved infrastructure that includes newly constructed waiting mother’s shelters, renovation of clinics, staff houses and scrapping of user fees which all has encouraged institutional deliveries.”
She argues that the project has also managed to bridge barriers between the communities and health facilities as well as improving relations between health workers and the community.
“It has empowered patients to know their rights in relation to health services, while effectively increasing demand, access and utilization of Maternal and Newborn Child Health services. Statistics from all the project’s partner health centres indicate an increase in institutional deliveries, a reduction in home deliveries as well as maternal and infant deaths, for example Twin Tops clinic in Mhondoro Ngezi had no maternal deaths or under 5 deaths since 2015” she said.
The project has covered over 100 health facilities in 21 districts and has resulted in reduced maternal and infant mortality as well as reduced home deliveries according to statistics from the health facilities.
Commenting on the project, Community Working Group on Health director, Itai Rusike says the revitalisation of the health centre committees had been necessitated by the deterioration of the health systems in sub Saharan Africa since the debt crisis of the 1980 and the subsequent effects of structural adjustment programme.
“Zimbabweans experienced a heavy burden of disease dominated by preventable diseases such as HIV infection and AIDS, malaria, tuberculosis, diarrheal diseases, nutritional deficiencies, vaccine preventable diseases and health issues affecting pregnant women and neonates.
“So we had to ensure the revitalisation of health centre committees which are a mechanism through which community participation can be effectively integrated to achieve a sustainable people cantered health system at the primary care level of the health system.”
Hamandishe says while the project has come to an end due to funding, they still envisage a Zimbabwe where no woman should die while giving birth, no child under the age of five should die from preventable diseases while no woman should deliver at home.