'Despite shocking disparities there is still a ray of hope for maternal,newborn and child health services '

Voiness Nyatsuro (35) a mother of two gave birth to triplets, two boys and a girl on January 28 ,2016 when she least expected it .

“I did not know l was pregnant but the persisting pains l felt in my stomach made me visit the hospital .

It was a shocker for my husband and l when the scan said I had triplets in my womb of which I had never heard of something like that,” said Nyatsuro.

I was told that giving birth the normal way was not going to be possible but through a caesarean section.

“It was scary because all through the pregnancy I  was in pain such that to a greater  l thought I was going to lose my babies,” she said

On January 28around 1600hours  Nyatsuro felt labour pains and was rushed to Nyanga District Hospital were upon arrival was told that she was going to give birth the natural way.

“It got me worried because I was not expecting it.

Through the hospitals quality assuarance and improvement approach l gave birth to my first baby around 1800 hours weighing  1,250grams ,the second around 2100 hours weighing 1,6 grams and the third one at 0200 hours weighing 2,1 grams .

Immediately l was taken to Kangaroo care ward since the first two babies had not fully grown up to the time of birth,”said Nyatsuro adding that she will forever be grateful to Nyanga District Hospital for the quality and care treatment she was given .

The problem before quality and care improvement

Currently, Zimbabwe experiences one of the highest maternal mortality rates in the region 500 per 100,000 with six women dying each day of pregnancy related complications according to the Multiple Cluster Survey (MICS 2014).

Three quarters of these deaths are preventable, with the most common causes being postpartum haemorrhage, infection, pregnancy related hypertension, and malaria

The country failed to meet the targets for the Millennium development goals four and five at the end of 2015.

Provincial Medical  Director for Manicaland Doctor Patron Mafaune said “ What is killing women and children is known .

Interventions that are effective for reducing these deaths are known and in most cases are also affordable ,”.

She added that high coverage at delivery are known effective interventions for reducing deaths of mothers and babies . 

Quality Improvement initiative

“Ministry of Health and Child care (MOHCC) decided to focus on quality improvement in health service delivery across all areas of care .

Improving the quality of health care services for mothers , babies and children at health facilities is a priority in order to reduce illness and deaths ,”said Dr  Mafaune .

She added that the health ministry in its commitment to provide quality health care it established the quality assurance directorate .

“The quality of care assuarance policy and the quality of care assurance and improvement strategy were developed and launched for use nationally to standardize quality improvement initiatives in health care service provision.

The results based financing (RBF) and Health Development Fund (HDF) are also being rolled out to support the quality improvement initiative at health facilities countrywide,”said Dr Mafaune .

She added that it is important for pregnant women to register early at the clinic.

“…emphasis on the importance of registering pregnancies early at the clinic as well as giving birth at a hospital or clinic is important.

This will us to develop a deeper understanding of the extent to which women and children are dying and make the right choices for our daughters,wives,sisters,children and other pregnant women relative,”said Dr Mafaune  adding that our success as a nation is measured through the reduction of deaths of pregnant women and children.

Dr Mafaune further added that “Religion is ones choice and so is choosing the survival of your wife or child .

No woman should die whilst giving birth and every child should celebrate their fifth birthday,”.

According to 2015/2016 Zimbabwe Demographic Health Survey, 93 percent of pregnant women had at least one visit to the clinic and 76 percent had four or more antenatal care visits during their pregnancy.

Skilled birth attendance at delivery has reached nearly 78 percent and delivery at health facility has increased from 66 percent to 72 percent.

USAID and Maternal and child Health Integrated program (MCHIP), Technical Director Doctor Dawidzoyashe Makosa said quality should be a habit not a one day event.

“There should be always be birth preparedness plan, expectations of outcome and above all the involvement of the father is ensuring quality which should be a habit not a one day event,” said Doctor Makhosa.

Provincial Epidemiological Disease Control Officer, Doctor Masanga said “quality is doing the right thing right the first time and doing it better the next.

There is need to strengthen the way we support mothers and children .A strong support system in breastfeeding guarantees that no baby comes to the hospital with any ailment or another,”.

Nyanga District Medical Officer (DMO) Doctor Admore Jokwiro said it takes team work and knowing the importance of life to produce quality health services.

We are proud as a district and we shall continue working as a team to improve and maintain quality health services in and around Nyanga hospitals,”said Dr Jokwiro after Nyanga Hospital was recognised for quality and care improvement among other hospitals in the province .