New strategy to save lives of expectant mothers

KOMBO Kombo is remembering his wife who died four years ago due to pregnancy(obstetrical) complications.

His wife a mother of three children from Kisiwapanza, a Small Island, South Pemba would have saved her life if she had doctors’ attention in-time.

“I wish my late wife had doctor’s help in time, we would still be living together caring for our children. It is unfortunate that when she started complaining about her pregnancy as she got closer to give birth, it was at night, and the hospital is several kilometres away from home,” said Kombo.

He said lack of reliable transport from the small Island to nearby hospital, lack of communication, lack of health facility with skilled staffs and equipment, ignorance and poverty have been the main challenges leading to women and infants deaths in rural areas and in inhabited small Islands.

Kombo’s wife is among many pregnant mothers, probably in hundreds, who have been getting maternal problems without quick maternal services. There is no official data showing how many women have died or had problems due to lack of/or poor health services in small islands, because most cases in the rural areas are unreported.

In what comes as a comfort to Mr Kombo, mothers, and people living on small islands, the Zanzibar government with support and collaboration with UN agencies have launched ‘Reproductive Maternal Newborn Child and Adolescent Health (RMNCAH)’ Strategy campaign to focus at ‘accountability assurance of safe child delivery.’

Kombo was joined by the 28 year old young house wife Khadija Kheri to thank the government for bringing emergency boat with modern facilities to serve women living in small Islands. They said it was a good development that in the targeted areas must celebrate.

The campaign involved the inauguration of the first ever marine ambulance boat to provide services to mothers, living in small Islands of Pemba, in need of maternal care during emergencies. There are about seven inhabited small Islands around Pemba and one must cross the sea to get health care in the main Island of Pemba.

The boat will serve inhabited Small Island in Pemba such as Makoonngwe, Fundo, Shamiani, and Kojani, before another boat is purchased for Unguja Island area with Uzi, and Tumbatu small Islands. Unguja and Pemba form Zanzibar with the population estimated to be 1.5 million (2018 projection).

Ms Jacqueline Mohan from UN family informed the gathering that the purchase of the boat was among the implementation of the country’s Vision 2020 – translated into the Five-Year Zanzibar Strategy for the Growth and Reduction of Poverty (MKUZA III) with a view to realizing the ambitions of the Sustainable Development Goals (SDGs) as well as the Global Agenda 2030 and African Agenda 2063.

Notwithstanding, Mohan said,“The remarkable achievements mentioned above we also note reduction of preventable maternal and newborn death is one of the areas that has made least progress. From global, regional and local evidence we know what needs to be done to save the lives of women and children.

This evidence must be translated into action under the leadership of the government and the commitment of all partners to align their support to the national priorities of Zanzibar.”

The boat handed over is part of UN wider support to enhance effective referral system both on land and sea to ensure women and children access emergency health care in a timely manner, and the donors said the boat is one of its kind built specifically for Zanzibar.

The Permanent Secretary (PS) in the Ministry of Health Ms Asha Abdalla said that her ministry has been taking different measures to control maternal and child mortality. The major steps taken to safeguard mothers and newborn include improving health services.

She thanked development partners for the ongoing support in improving health services and ensuring mothers and newborns do not die at the time of birth. She thanked WHO, UNFPA, UNICEF, JHpiego, Engender Health, D-Tree, HIPZ, and other development partners.

Ms Abdalla explained RMNCAH programme and the launch of ambulance boat as a milestone in improving health services. She said the new programmes were also the implementation of five years (from 2019-2023) national Strategy for maternal and child health, and the national health policy of 2011.

“In collaboration with development partners, the government has managed to improve health facilities in villages, and that maternal services have improved,” she said adding that the efforts to improve health care delivery has helped to reduce maternal mortality from 377/100,000 in 1999 down to 191/100,000 in 2017 live births, However despite the achievements recorded, more efforts are needed to end maternal and infant mortality.

She said the deaths are linked to ignoring to observe maternal care guidelines including not having regular attendance of maternal clinics during pregnancy, practicing irrelevant myths and customs on pregnancy, “We want all pregnant women to attend clinics, seek advice from qualified midwives, and only use improved facilities. In the past women walked long distance to hospital, but the distance has been minimized by building many health care facilities.

She said, as by this year, Zanzibar has 47 Primary Health Care Units (PHCU) of which 28 provide maternal care and labour services to pregnant mothers’, using modern equipment, while the remaining 19 facilities do not provide the services because of shortage of skilled labour.

The PS said that Work to renovate operation/theater rooms is already complete at Micheweni, and Chakechake hospital, and that a modern maternal and pediatric ward is being constructed at Kivunge hospital in North Unguja Region.

She said hospitals in the country have been improved with modern equipment including emergency services, refrigerators for storage purposes, improve oxygen supply at Mnazi Mmoja referral hospital, improved communication, and availability of essential medicines.

The minister for health Mr Hamad Rashid Mohamed who officiated the launch of the ‘Afya Bora boat’ said that the Government targets to decrease maternal mortality from the current 191/100,000 to 96/100,000 by 2023 and also fight to end or reduce child mortality.

“It is unfortunate that newborn and child mortality is still high, necessitating call for increased concerted efforts,” he said. He also said that the government aim to reduce under-five child mortality from 56/1000 in 2017 to 41/1000 by 2023, and that the ministry is happy to have increased the number of pregnant mother visiting and giving birth in recognized hospitals from 42 per cent in 2010 to 66 per cent in 2017.

“We now have a new ‘Afya (Health) boat. I call on all mothers in small Island to use, particularly during emergencies’,” Hamad said the boat has modern equipment to help pregnant mother. He said that although the ‘Afya Boat’ will be operated under the coast guards (KMKM forces) as experts in riding the boat, the ministry of health will have its staffs on board during emergencies, “Just call for the services at any time.”

The minister said that in addition to what the government has been doing including ‘Maternal & Perinatal Death Surveillance and Response (MPDSR) to prevent deaths to pregnant mother, males have a great role to play by just showing to love to the wife especially during pregnancy.

“Avoid being rude to your wives. Show them love at all times to avoid stress. Encourage mothers to visit clinics by accompanying them to health facilities. Also encourage family planning, it helps to reduces risks of pregnancy complications due to unplanned births,” the Minister emphasized. ‘ ambulance boat’ which will be used as transport by pregnant mothers from the small islands.

...The Kilimanjaro Twins, revolutions and Granpa


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