Call for improved women's healthcare as maternal deaths rise

A leading women's advocacy group in Zambia has appealed to health authorities to spend more funds on improving maternal care. An increasing number of women have died during childbirth in recent years. The latest figures from the 2001/02 Demographic and Health Survey (ZDHS) indicated 729 deaths per 100,000 live births, significantly higher than in neighbouring countries. Lumba Siyanga, the acting executive director of the women's advocacy NGO, Women For Change, said pregnant rural women were made increasingly vulnerable due to the lack of access to reproductive healthcare and the low quality of treatment. "It is estimated that 70 percent of deaths during childbirth occur in rural areas. Women have to walk long distances before they can reach a clinic and, even when they get there, the staff are ill equipped to handle the delivery. Often, if there are complications, there aren't any ambulances to transport the expectant mother to the nearest town," Siyanga told IRIN. According to a study by the UN Population Fund (UNFPA), excessive bleeding accounted for some 34 percent of maternal deaths. Research showed a higher incidence of haemorrhaging among deliveries in the villages (27 out of 48 women), compared to five out of 14 for those at health facilities. Siyanga said although it was generally difficult for rural people to access timely healthcare, it was doubly difficult for women, who were more often poor, voiceless and deferred to customs that expected them to sacrifice for their families. Only three percent of maternal deaths occurred among women in high-income categories, according to the ZDHS 2001/2002. An official at the UNFPA office in the capital, Lusaka, told IRIN that the agency, together with the health authorities, had embarked on a programme to strengthen the education and clinical training of midwives. "The lack of obstetric care in rural areas is very worrying, and that is why we have decided that traditional birth attendants need additional training. As it stands, many of them do not have the skills to deal with birth complications," she said. A pilot project for women-friendly services was established in Lusaka in 2000 to provide quality, affordable healthcare, particularly for poor urban women, who were at greater risk. Siyanga said these services should be extended to rural women. Zambia's national health system has come under enormous pressure in recent years. The government has had to cut back on healthcare delivery in a bid to comply with International Monetary Fund conditions, which stipulate lower government spending. The country is in line to receive substantial debt relief if it reaches the Highly Indebted Poor Countries Completion Point by the end of this year. Once granted, the current external debt of around US $6.5 billion would be reduced to a more sustainable level, paving the way for greater spending on social service delivery.