Columnists Features

Zambia scores successes in maternal, child health

BENEDICT TEMBO, Lusaka
WITH former South African President Nelson Mandela’s widow Graca Machel present, one of the big names on the international scene, Caroline Phiri-Chibwe, did not have to worry about self-confidence as she stood on the podium to deliver her message on maternal child health.
Dr Phiri’s role before the over 100 delegates at the just-ended Partnership for Maternal, Newborn and Child Health meeting in Lusaka, was to showcase to the global community Zambia’s progress in key maternal and health issues.
The gathering included Ms Machel, the Partnership’s board chair and founder of the Graca Machel Trust, Ministry of Home Affairs permanent secretary Elwyn Chomba and a host of distinguished personalities.
In her presentation titled ‘Zambia’s Successes, Challenges and Partnership Role,’ Dr Phiri reported that in the last two decades, Zambia has made monumental progress towards women’s and children’s health goals.
Dr Phiri, who is Ministry of Community Development and Social Welfare director of mother and child health, said Zambia has achieved these results because the country improved its strategy in governance issues in the health sector by being accountable for the health of women and children.
She also alluded to the multi-stakeholder engagement with social protection, traditional and religious leaders.
Dr Phiri said there has been investment made in transport, infrastructure and equipment to address access to quality services.
Government has also invested in capacity building for human resource for health (public and private training institutions).
She said there is increased availability of skilled birth attendants by 64 percent while qualified health workers have been working with community groups for safe motherhood, action groups, neighbourhood health committees as well as conducting maternal death surveillance and response.
Dr Phiri highlighted the improvements in indirect causes of maternal mortality ratio, saying malaria contributes 10 percent to the maternal mortality ratio. The maternal mortality ratio represents the risk associated with each pregnancy.
Intermittent preventive treatment coverage remains at 73 percent  while at 41 percent, Dr Phiri said the use of insect treated mosquito nets among pregnant women is low but the  national HIV prevalence rate stands at 13.3 percent. She said prevalence in pregnant women remains high and that 95 percent of pregnant women are tested for HIV.
Dr Phiri said the prevention of mother-to-child transmission coverage which stood at 86 percent as of December 2014, remains high.
Zambia has reduced its maternal mortality ratio from 729 deaths per 100,000 live births in 2001/2002 to 398 deaths per live births in 2013/2014, representing a 54 percent reduction.
She said for newborn care, there has been capacity building of the community by caring for the new born at home as well as development and implementation of strategies and guidelines, including appointing a focal person for new born care at the Ministry of Community Development and Social Welfare to spearhead newborn care.
There has also been an increase in exclusive breastfeeding for six months from 61 percent to 73 percent.
There has been training for infant and young child feeding for health and community workers, including mother child support groups.
Dr Phiri also said there has been improvement in access to safe water and sanitation.
IMMUNISATION
Dr Phiri said immunisation coverage has been maintained at 86 percent, including cold chain expansion and introduction of new vaccines for pneumonia, diarrhoea and measles second dose.
MANAGEMENT
Dr Phiri said there has been scaled up integrated management of childhood illness that includes newborn care and integrated community case management, prevention of mother-to-child-transmission, early infant diagnosis and paediatric case management as well as strengthened malaria control programme.
She said health authorities in Zambia know what matters most, citing maternal mortality reduction by cutting teenage pregnancies, offering skilled care during pregnancy, childbirth and post-natal period, providing access to emergency obstetric and newborn care as well as access to family planning.
Under the child mortality reduction, newborn care, breastfeeding, infant and young child feed have been prioritised, so is the prevention and management of common childhood illnesses such as pneumonia, diarrhoea and malaria.
There are plans to engage all stakeholders such as parliamentarians, co-operating partners, the private sector, non-governmental organisations, youths, academicians and researchers, and health association bodies.
There are further plans to develop a business plan for mobilising resources to support the implementation of commitments at global strategy level.
There are also plans for private sector engagement in service delivery and for reduction in commodity pricing, especially for new vaccines and rural household commodities.
To ensure sustainability, Dr Phiri said government would like to see more local civil society organisations working both in advocacy and service delivery, especially in rural areas.
CHILD SURVIVAL
Dr Phiri said there has been significant decline in maternal mortality ratio in maintaining focus on the Millennium Development Goals number four and five today and beyond 2015, which is ending preventable child deaths from pneumonia and diarrhoea by 2025.
In particular, in the last two decades, Zambia has significantly reduced infant and under-five child mortality, which have declined by 58 percent and 61 percent respectively.
Despite this progress, Zambia continues to face obstacles to improving the health of women, children and adolescents, including high rates of teenage pregnancy and motherhood, limited numbers of skilled birth attendants and a high unmet need for family planning services.

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