Dar es Salaam. Pregnant women in Chanika on the outskirts of Dar es Salaam have learnt how to survive in an area where one dispensary serves over 30,905 residents.
Situated 35km away from the city, Chanika has witnessed a influx of people over the past five years, with several others rushing to buy land. However, the social and health infrastructure in the ward, is poorly developed.
Ms Mary Mwemezi, 22, gave birth to her first child recently at Amana Hospital in the city. She believes that she couldn’t have delivered her baby safely at a health facility back home in Chanika. Mary feared that in case of an emergency, there wouldn’t be a well-equipped nearby clinic to run to.
‘’I did not want to take chances. Some two weeks before giving birth, I asked for temporary accommodation at my aunt’s place at Vingunguti. I thought it was safer staying close to a referral hospital,’’ she told The Citizen on Sunday.
Hers was not an isolated case. As The Citizen On Sunday went further interviewing most other women who were admitted to a post-delivery ward at Amana Hospital in Ilala, more such cases emerged. Some would recall bad memories of some neighbours who had lost a relative during childbirth.
Data from the Ilala Municipality shows that the maternal mortality ratio stands at 151 deaths per 100,000 live births in the district. The current national figure is 410 deaths per 100,000 live births.
Having lived in an area where cases of deaths of mothers during childbirth are prevalent, one of the women who had just given birth at Amana Hospital spoke of her experience with maternal health at Chanika.
‘’When you see the house of your neighbour on fire, carry water to your own,’’ said Ms Fatuma Saidi, as she explained in a proverb the lessons she has learnt from neighbours about maternal deaths over the years.
Fatuma is one of the women who had also decided to stay at a friend’s home in the city to ensure her safety during childbirth. She was anticipating challenges because she was carrying a risky pregnancy.
Back home at Chanika, medics at a dispensary had advised her to deliver in a facility that was well equipped enough to help her deal with high blood pressure. ‘’I thank God that here at Amana they were able to treat my condition,” she says.
Such women would have been secure in their areas of residence with health facilities being constructed close to their homesteads. The maternal deaths would also be reduced if the women delivered at a health facility and in the hands of a trained health worker, according to Dr Christopher Mzava, an anaesthetic officer from the Ilala Municipal Council.
According to Tanzania’s current Demographic and Health Survey, only 51 percent of women who deliver at health facilities are assisted by a trained professional and four midwives are available for 10,000 patients countrywide.
The government has been moving at a slow pace in establishing health facilities in peripheral areas such as Chanika as well as improving human resource capacity for health. Experts say the situation can be improved through encouraging the public-private partnerships.
The Korean International Cooperation Agency (Koica) has already drawn up plans to construct a Sh8-billion maternity hospital in Chanika as part of efforts to cut down maternal deaths by 10 per cent each year.
When completed and handed over to the Ilala Municipality, the hospital will be offering specialised care on maternal and newborn health. It is expected to improve maternal and newborn health in Chanika and surrounding areas.
Plans are also underway to upgrade the Chanika dispensary into a modern health centre in a project that will see thousands of residents seek treatment, said the Koica project manager, Dr Myoung Kim.
‘’The setting of 100 beds will accommodate all pregnant women before and after delivery,’’ reads the plan. ‘’Maternal and newborn health services will be provided at the health centre including Kangaroo mother care facilities.’’
The new development by Koica comes at a time when Tanzania is being named among countries that have failed to meet the Millennium Development Goal 5 of reducing maternal deaths by 75 percent before the end of 2015.
In September this year, the Millennium Development Goals will expire and world leaders are expected to meet in New York at an event that will see the adoption of a new plan, under the name of Sustainable Development Goals, or SDGs in short.
The government efforts to deal with maternal deaths are met with stiff challenges, which include inadequate domestic resources to invest in medical supplies, hence the unending maternal mortality.
According to the director of Preventive Services in the Ministry of Health and Social Welfare, Dr Neema Rusibamayila, Tanzania has witnessed a high number of maternal and newborn deaths over the past 10 years.
But, she says: ‘’Reducing maternal and neonatal deaths needs the concerted efforts of different stakeholders, civil society participation, public and private originations as well as development partners.’’
Dr Rusibamayila appealed to world agencies to support initiatives of helping Tanzania to get out of the maternal death trap. The country is No. 27 in the world for countries with the highest maternal mortality ratio.