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Thandeka Moyo
A heavily pregnant Ntombi Mthembo waddles along a footpath in Lower Gweru’s Makhulambila Village under Chief Sogwala on her way to the local clinic.
She hopes to make it on time despite her tortoise-like pace.
Her bulging tummy makes walking a challenge but she is determined to complete the 18KM journey to Mzila Clinic to access antenatal care and medication.
After what seems like ages, Ntombi reaches the clinic, a brightly painted structure with a few beds. There are a handful of nurses attending to scores of villagers at the clinic.
Unlike the ordinary village woman, Ntombi sees things differently as she is a college graduate based in the city.
She has been visiting her mother in Lower Gweru.
“I almost died of pain that day but all I got was a packet of paracetamol. I don’t belittle the experience of the nurses who prescribed the painkillers for me, but I feel more was supposed to be done to help me deal with a number of ailments I was suffering from,” she recalls.
Despite walking such a long distance to the nearest health facility, Mthembo still failed to access the necessary check-up meant for pregnant women.
“I managed to talk to a nurse who hurriedly asked me a few questions about my health, that of my unborn baby before she moved on to the next patient in the long queue,” she said.
Mthembo acknowledges the nurses’ effort to offer quality maternal health care services. She, however, believes more can be done to improve service delivery.
“Over the past few months, the Finance Minister (Patrick Chinamasa) announced the 2016 National Budget and only allocated slightly above $25 per individual in 2016. It’s appreciated our economy is struggling but it’s time our leaders took health matters seriously,” said Mthembo.
For her, the health budget allocation is likely to worsen women’s suffering in the country especially pregnant women.
Simelinkosi Gumede, a mother of two from Bulawayo says maternal health should be treated with the same importance as education and security.
“I can’t imagine our healthcare system without donor funds. More than 80 percent of medication and infrastructure is there courtesy of donors,” she says.
“An unhealthy nation can’t be productive and we need the government to ensure our safety as women when we are giving birth. I feel our leaders don’t take health matters seriously.”
Cde Chinamasa, the Minister of Finance and Economic Development, allocated $337 million towards health in the 2016 national budget.
The figure lies far below what was agreed by Africa’s Heads of States in 2001 when it was resolved that governments should allocate at least 15 percent of their national budgets to health care.
Zimbabwe allocated just 9,3 percent of its 2016 budget to the Ministry of Health and Child Care which is far below the minimum agreed by AU Heads of States at their 2001 Abuja meeting.
Despite major strides in combating HIV and Aids before the 2015 Millennium Development Goals deadline, Zimbabwe’s maternal mortality rate remains the highest in Southern African with 614 deaths per every 100,000 live births according to Unicef.
World Health Organisation (WHO) defines maternal mortality as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.
“Most maternal deaths are due to haemorrhage, infection, unsafe abortion, and eclampsia (very high blood pressure leading to seizures), or from health complications worsened in pregnancy. In all these cases, unavailable, inaccessible, unaffordable, or poor quality care is fundamentally responsible,” says WHO.
In The Trends in Maternal Mortality Study: 1990 to 2013 by the United Nations Population Fund, the United Nations considers a maternal mortality ratio of less than 100 as low, between 100 and 299 as moderately low, and high when it is 300 to 499.
Community Working Group on Health director, Itai Rusike bemoaned the fact that the bulk of the funding was coming from donors.
“The principle that health is a fundamental human right can never be over-emphasised, particularly now that the Constitution has clearly stated that healthcare is a right of every Zimbabwean. In the 1980s and 90s, Zimbabwe had one of the best primary health care service models in Sub-Saharan Africa which has over the years been eroded mainly by inadequate funding of health from the central government,” he says in the organisation’s annual Input into the 2016 National Health Budget.
He says maternal and child health mortality rates have improved as they are mainly funded by external partners.
“For the past 15 years, patients have borne the burden of paying for health care while external partners have increasingly contributed to the bulk of public financing for health services in Zimbabwe.
External partners through the Global Fund, the Health Transition Fund (HTF), PEPFAR and GAVI continue to provide the bulk of the public health financing. About 98 percent of the drugs in the public health system are funded by external partners,” says Rusike.
He urged the government to increase its domestic funding as the financing mechanism has always proved to be sustainable.
“The drugs include antiretroviral treatment medications, TB and Anti-malaria drugs and primary kits for maternal neonatal and child health (MNHC) services.
“Drug supplies at rural health centre level are also problematic and are a constant source of client discontent. Drug supplies that exist at national level are reported to take up to six months to be delivered to district hospitals and and clinics,” Rusike says.
He says communities spend scarce resources on security services to guard clinics from recurrent theft of drugs and other supplies, given that some of the facilities have no fencing, burglar bars or other forms of security.
Statistics from the Ministry of Health and Child Care show that 251 women died during child birth last year.
“Of the 251 women who succumbed to maternal mortality, three died in the month of October. They were from Matabeleland South, Manicaland and Harare,” read the Ministry’s disease update report.
Lindile Ndebele, a local activist, says the 2016 health allocation is likely to increase women’s woes.
“Women are the most vulnerable yet they have great responsibilities such as taking care of infants. Over the past years more women have succumbed to HIV/Aids and other diseases compared to men,” she says.
“Access to quality healthcare is a human right and I believe women can perform better if the government ensures their health is taken care of. Women can’t continue dying while giving birth or losing children at childbirth.”
Ndebele says the ailing economy is burdening women in many areas.
“Healthy women are productive and productive women are likely to stand against gender-based violence. We really need to revisit our priorities and ensure women are given the chance to lead healthy lives.
That woman who recently died after hours of labour in Gwanda and many others could have been saved if there were adequate resources,” Ndebele says.
A report by Unicef shows that the Ministry of Health and Child Care spending is heavily skewed towards labour, which has since doubled between 2009 and 2012.
About 70 percent of the Ministry’s allocation goes towards paying salaries.