Why is Tanzania lagging behind in reproductive health?
https://roztoday.blogspot.com/2014/02/why-is-tanzania-lagging-behind-in.html
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| First Lady Mama Salma Kikwete |
With the deadline to achieve 60 per cent from previous 34 percent in reduction of high maternal and infant mortality rates by 2015 around the corner, the death toll of mother and child is at an alarming stage.
There is a very little voice to influence the government in parliament on issues of reproductive health resulting to very weak budgeting on reproductive health and policy enforcement.
The situation is even worse in rural areas where more than 80 per cent of the whole population resides; however, education on reproductive health and its services reach them at a very low stage that is plus the poor social services including few, distant and unstaffed health centers.
According to studies, poor, rural and less educated women have highest fertility rates, highest unmet need for family planning and lowest contraceptive prevalence rates.
Of course, the government in collaboration with various health stakeholders including World Health Organization (WHO) and World Bank (WB) has made significant progress to improve maternal and child health including buying medicines and equipments, increasing knowledge to health providers, improving information unit and statistics system and encourage society involvement.
However, there is still a very high prevalence of maternal deaths in the country. During a gala dinner fund raising meeting organized by the African Medical Research Foundation (AMREF) Tanzania Chapter in a nationwide campaign ‘Stand up for Tanzania Mothers’ to reduce maternal deaths recently, the Vice- President Dr Mohammed Gharib Bilal admitted on the seriousness of the problem.
He said that the rate of maternal and child related deaths in the country was increasing, citing serious shortage of nursing midwives countrywide as the main reason.
He said only 40 per cent of the needed midwives are available, causing severe situation in rural areas, which often rely on traditional methods that he said are very risky.
The Minister for Health and Social Welfare Dr Hussein Mwinyi was among the invited guests. He said there were plans to increase operational units in hospitals to curb the increasing phenomenon.
The initiatives are among the Big Results Now (BRN), which his ministry was working upon. First Lady Salma Kikwete, the Ambassador of the campaign, noted that urgent efforts are needed to reduce the rate of maternal deaths.
Insufficient facilities and medical personnel have not only been cited by the Vice President as among factors contributing to the rising maternal and child mortality in the country but other stakeholders as well.
The Reproductive and Child Health Programme technical advisor of the Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), Dr Brenda D’Mello spoke of the issue during the Disability Awareness journalists’ training held in Dar es Salaam, she said the public should not only blame health service providers, particularly midwives, for the high rate of maternal and child mortality in the country.
Instead, he pointed out, they should also consider other factors like insufficient facilities and staff which are caused by a poor health policy and planning.
She said: “It is unfair to always blame midwives for the high rate of maternal and child mortality before digging into the truth on the real reason for the problem.”
D’Mello said midwives are very few in health centres and most are inexperienced. According to a survey, she said, about 80 women give birth at Amana and Temeke hospitals every day, and approximately one or two midwives attend to ten women.
With limited space, and to allow other women to give birth, women who have delivered are discharged before they are observed carefully, she said. Hence if some complications occur to either the baby or mother, they die at home due to lack of immediate medical assistance, she lamented.
She said the poor working environment for midwives hinders them to adequately attend to each of the expecting mothers. She therefore called on the government to build the capacity of midwives. This would make them provide efficient health services, thereby reducing maternal and child mortality rates, she noted.
D’mello said the capacity building should cover necessary requirements for the midwives, such as reducing their work load by increasing their number as well as improving facilities like equipment, medicine and space.
Others include improving the quality of healthcare, upgrading health centers to absorb greater delivery loads, training the midwives and offering them better perks.
She said other contributing factors include under-resourced hospitals, shortage of clinics in remote areas, poor transport and poverty. The said, quite often, 80 percent of rural dwellers follow their communities’ beliefs. They therefore resort to traditional healers to deliver babies using herbs and age-old methods.
In Tanzania, an about 13,000 women die due to complications during pregnancy and 157,000 children die before their first birthday; 45,000 of whom die in the first month after birth.
As a result, World Bank development indicators have placed Tanzania the fifth most dangerous place in sub-Saharan Africa for a woman to give birth, behind Sierra Leone, Niger, Malawi and Angola.
Lack of education on reproductive health issues to most people especially rural dwellers is another reason of concern to the high maternal and child mortality. The figures show that few people are aware of reproductive issues.
It has also been proved that among other solutions including improving health services, family planning is one of an effective way to reduce maternal and infant mortality.
During the National Family Planning Conference and Green Star Campaign held in Dar es Salaam recently, Dr. Mwinyi noted that if women will use family planning methods in a right way, maternal deaths will decrease for 20 to 35 per cent and infant deaths for 10 to 12 per cent.
He said that is because family planning enables a woman to create a gap between one pregnancy and the other and hence gives enough time to rest and improve his health. Another thing is that family planning reduces unwanted pregnancies especially to young girls which also reduce unsafe abortion that kills many girls.
Family planning also reduces high-risk pregnancies especially during young age. Women who become pregnant in a young age are in a high risk to lose their lives and their babies as they are bodies are still immature to carry pregnancy and hence during child births many of them encounter complications which results to their deaths.
However, figures show that many girls give birth under the age of 18 and the worst thing is that many of them live in rural areas or places where health services are very few and distant from their residences therefore they do not attend the clinics and they give birth at homes which are very risk.
By STELLA JIMMY
Stellajimmy25@gmail.com 0712 507 234
SOURCE:
THE GUARDIAN
