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| Investing in girls and women's health is not just the best thing to do, it is the smartest thing to do. (File photo) |
Between
January and March, nine mothers lost their lives giving birth at
Makole Health Centre in Dodoma district. The number is three times the
deaths recorded at the centre between October and December last year
where three women died.
Harriet Kidayi, the Reproductive and
Child Health Coordinator in Dodoma district based at the health centre
blames this on late referrals to hospital.
To some, the number
of women who died giving birth at the health centre, may not seem to be
a big deal. But the reality is no woman should die giving birth. No
woman should die giving life.
Globally, almost every minute a
woman dies of complications related to pregnancy and child birth. And
99 per cent of these deaths occur in developing countries. Experts say
the likelihood of a motherless child dying prematurely is ten times
more than that with a mother. Every year, more than one million
children are left motherless.
The late referrals that Kidayi, the
reproductive and child health coordinator in Dodoma district says
caused the deaths of mothers at Makole health centre this year are just
one among many causes of maternal deaths in Tanzania. And there are
various reasons why expectant mothers get to the hospital late and many
are beyond their control.
Things like lack of transport to the
nearest health facility. This is a big problem in rural areas. There
are areas where expectant mothers walk for two days to get to hospital
for delivery. Because of poverty, they can’t afford to hire a vehicle
to the hospital. And the list of reasons for late referrals is long.
With
only 18 months left before the 2015 Millennium Development Goals
deadline, the Tanzanian government and other stakeholders in the health
sector are fighting to see to it that the country attains goals number
four on reducing child mortality by two thirds and number five on
maternal mortality reduction by three quarters by 2015.
The
government has been promoting family planning as part of the national
reproductive health strategy. This is because 20- 25 per cent of
maternal deaths could be avoided through prevention of unplanned and
unwanted pregnancies.
Also mothers and children can become
healthier and families can better provide for the care and upbringing
of their children. Girls will not be forced to drop out of school
because of unexpected pregnancies. Moreover, family planning is good
for the overall development of the country.
Tanzania’s target is
to have 60 per cent of women and girls using contraceptives by 2015 in
a bid to reduce child and maternal mortality rates and improve women’s
health. However, this is a challenge given that only 34 per cent of
all women use family planning today. But we can get there if we want
and this year’s health budget allocation of 1bn/- for reproduction
health is a good move.
This is the first time that the
government is allocating its own money for the purpose. The minister
for Health and Social Welfare, Dr. Hussein Mwinyi said when tabling the
health budget in parliament last month that this is a big step that
signals to development partners that Tanzania is serious about the
matter. However, some Members of Parliament were not convinced 1bn/-
was enough. This year’s budget allocation for health is 753.9bn/-.
Family
planning is one of the most powerful ways of improving the health of
women and children and of controlling population growth of a country.
This is a fact that is yet to be known by many people especially those
living in the rural areas of developing countries like Tanzania.
It
is because of this high level of illiteracy that the US-based
Population Reference Bureau (PRB) recently organised a one-week workshop
in Dar Es Salaam for health journalists who can be good ambassadors in
spreading the message.
The journalists were equipped with
information on maternal and reproductive health. They also discussed
how the press can play a vital role in addressing reproductive health
and fertility issues and how these can cause socioeconomic development.
PRB
is a non-partisan and evidence based organization with a mandate of
informing people around the world about population, health and the
environment and at the same time empowering them to use that information
to advance their well being and that of generations to come.
Presenting
the Tanzania MDGs progress report at the journalists’ workshop, the
Director of Advanced Family Planning, Halima Shariff said infant
mortality rates have declined by more than a half in the last decade.
According to 2010 statistics, the rate stands at 51 per every 1,000
live births. This therefore is a green light that the set target of
reducing infant mortality rate to 31 out of every 1000 births by 2015
is achievable.
On the other hand, reducing maternal mortality
ratio remains a challenge. In 1990, the maternal mortality ratio stood
at 529 per every 100,000 live births and after 10 years, in 2010 that
is, the ratio was 454 women per every 100,000 live births. At this slow
pace, the efforts of decreasing this to 133 by 2015 may clearly not be
achieved.
Access to family planning services is one key
component in achieving the above. Both men and women need to know the
importance of child spacing and how this greatly contributes to
improving the health of both the mother and the child. They also need
to know the importance of giving birth in a health facility.
2010
statistics show that only 51 per cent of births in Tanzania are
attended to by a skilled personnel. It therefore becomes difficult for
the 90 per cent target to be attained in less than two years. This is
given the country’s serious shortage of skilled workforce among other
reasons.
To curb the shortage, the government has promised to
increase the number of medical personnel and also to create a
user-friendly environment for family planning services especially for
youths since most are denied access to the services.
Harriet
Kidayi, the Dodoma Reproductive and Child Health Coordinator says there
has been an improvement in accessibility and use of family planning in
Dodoma. She says most women prefer modern methods like the injectable
method.
In 2011 62 per cent (84,804) of the targeted women were
using contraceptives out of the targeted 136,004. In 2012, the
percentage rose to 77 per cent (110,234) out of the targeted 142,596.
She however says that there is still more to be done in the peri-urban areas to have more women enlightened on the matter.
“Men’s
involvement in family planning issues should be enhanced to help the
current situation. Though as a district we have never received serious
complaints of men battering their wives due to decisions they take on
family planning as is the case in some regions,” Harriet says.
On
maternal deaths, Harriet says; “to address this, the government has
increased the number of health centres in the region by introducing
Hombolo and Kikombo facilities. It has also introduced clean delivery
packs containing all the necessities needed by women during labour and
this is given to every woman at 39 weeks of pregnancy to help in case of
emergencies.”
She also added that the number of mothers dying
during delivery had greatly gone down in Dodoma district. A total 66
deaths were recorded in 2012 compared to 129 in 2011.
To attain
the target goals by 2015, more efforts are needed and these include
channeling more funds in the sector. The government needs to stop
depending entirely on donors since delay of funds usually causes
shortages. For years, family planning budget has been dependent on donor
funds.
Another area of concern is addressing high fertility
rates especially in the lake zone regions. Women in rural areas still
have a high rate of seven children while those in urban areas have four
children per woman. Lack of access to family planning services in
rural areas, lack of willingness to use them and teenage pregnancies
are cited as major factors contributing to the high fertility rates.
Dr.
Muzdalifat Abeid, Head of Maternal Unit at Temeke Hospital says women
are not willing to use family planning due to myths and misconceptions,
low understanding of family planning by men thus discouraging their
wives, religious beliefs and inadequate resources to sensitize people
and facilitate delivery of the services.
All these are vices to fight if we want to see changes in infant and maternal mortality rates.
Speaking
at the opening of the recently concluded high level global meeting on
girls’ and women’s rights in Kuala Lumpur, Malaysia, Women Deliver
President, Jill Sheffield said investing in the health and reproductive
rights of women and girls has benefits for both the families and the
country at large.
“When we invest in girls and women’s health,
it’s not just the best thing to do, it is the smartest thing to do,”
said Ms Sheffield. She explained that sexual and reproductive health
should be looked at as a human rights issue.
“We should look at
it as a human right to have access to contraceptives and give it a
central place in our work. All these commitments are in place and
governments only need to implement them,” she said.
World leaders
attending the meeting called on governments to invest more in the
wellbeing of mothers and girls. Having been represented at the
conference, we hope Tanzania will heed the call and thus meet the MDGs
on maternal and child mortality come year 2015.
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