No woman should die giving birth

Monday September 30 2019

 

By John Namkwahe @johnteck3 jnamkwahe@tz.nationmedia.com

Geita. It was around midnight when Atanas Mbuli, 36, a Community Health Worker (CHW) at Buchundwakende village in Geita received a call informing him that there was a pregnant woman at the village who needed urgent medical assistance. “Without further delays, I got off the bed and grabbed my phone and called a doctor at the regional hospital to inform him about the emergency,” narrates Mr Atanas to Your Health.

He adds; “The hospital promised to send an ambulance to the village so as to carry the patient.”

Mr Atanas recalls how he left his home at midnight and headed to the patient’s house to closely follow up the reported case.

After reaching the house, he met Ms Grace Jeremia, 24, laying on the floor, surrounded by her relatives.

He learned that Ms Grace was eight months pregnant and she had experienced upper-right abdominal pain, severe headache and mental status changes—common symptoms of Eclampsia, the medical sources indicate.

A condition occurs in a pregnant woman during a woman’s pregnancy or shortly after giving birth in which one or more seizures occur in a person often followed by coma and posing a threat to the health of mother and baby, says Ms Stella Filbert, a registered nurse at Geita regional hospital.

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Mr Atanas recalls that for the second time he called the doctor’s number to confirm whether the ambulance was coming.

“They said the ambulance driver had left the hospital in fifteen minutes ago. So we kept waiting,” says Mr Atanas.

According to him, after a few minutes, the ambulance arrived at the village and Grace was referred to the regional hospital for specialized diagnosis and treatment.

Mr Atanas admits that the referral system in the village had improved following the donation of the mobile phones to the CHWs, dispensaries, health centres and the regional hospital by the Jhpiego.

“Since I have been given the mobile phone, it has been easier for me to communicate with the healthcare providers at the health facilities especially during the emergency situations,” says Mr Atanas.

He says previously, scores of pregnant women at the village lost their lives due to pregnancy-related complications.

“The deaths were caused by the poor referral system attributable to lack of communication,” says the CHW.

The mobile phones were donated by Jhpiego under the USAID Boresha Afya project.

The five-year project is supported by USAID, led by Jhpiego partnering with, PATH, Engender Health and the government of Tanzania.

Among other objectives, the project aimed to increase access to high-quality, comprehensive and integrated health services through a package encompassing reproductive, malaria, maternal, newborn and adolescent health services.

Grace received at the hospital

The doctor and nurses at the hospital received Grace and took her to the emergency department. She underwent diagnosis and the results showed that she had eclampsia.

“The doctors feared that the baby was dead. So they took me to the operating room to remove the baby so as to save my life,” narrates Grace in an interview with Your Health.

Grace further narrates that after a successful operation, they found the baby was still alive.

“I was very happy to become a mother. It is something that I had dreamt of for several years,” says Ms Grace.

Tanzania in the past few years has experienced a substantial reduction in child mortality rates. This decrease can be in part attributed to improved breastfeeding practices and high immunization coverage.

Maternal mortality, on the other hand, has not benefited from trends similar to those of child mortality.

This follows, the maternal deaths in Tanzania, with a ratio of 578 per 100 000, represent 18 percent of all deaths of women age 15-49, according to WHO data.

The main direct causes of maternal death are hemorrhages, infections, unsafe abortions, hypertensive disorders and obstructed labours, the medical sources indicate.

Grace’s married life before becoming a mother

After Grace got married in 2011, she was unable to conceive. She opted to use traditional medicine, but it didn’t work out.

“I later consulted a medical doctor (gynecologist) at the private hospital, but I couldn’t afford the treatment cost that stood at Sh400, 000,” recalls Ms Grace.

She adds: “My colleague at the village advised me to go to the regional hospital for further specialized diagnosis and treatment.”

At the hospital, the results showed that she suffered from fallopian tube damage or blockage that leads to infertility.

“I paid Sh70, 000 as treatment fee. After being prescribed to the prolonged medication, I managed to conceive. I want to have four children,” says Ms Grace.

Maternal deaths in Geita

Dr Michael Mashala, Acting Regional Medical Officer for Geita reveals that the number of maternal deaths has decreased from 80 in 2018 to 36 recorded this year between January and June.

The use of mobile phones in improving referral system

Ms Agnes Ndonde, a registered nurse at the Geita regional hospital who doubles as Assistant Labour Ward in-charge admits through the donated mobile phones, the referral system has improved in the region. Ms Agnes highlights that under the USAID’s project the hospital has also received delivery kits.

“Under the project, we also received comprehensive training on reproductive and child health,” she says.

She adds: “Through the training, we have been able to reduce the number of maternal deaths associated with Eclampsia and PPH.”

According to Ms Agnes, the hospital in 2018, recorded 8 deaths associated with Postpartum bleeding or postpartum hemorrhage (PPH), while this year, only one death has been so far reported.

PPH is often defined as the loss of more than 500 ml or 1,000 ml of blood within the first 24 hours following childbirth, says Ms Agnes.

Symptoms include vaginal bleeding that doesn’t slow or stop, she adds.

According to a study titled ‘Maternal mortality in urban and rural Tanzania’ funded by International Growth Centre (IGC) Tanzania, conducted in August 2018, indicates that the maternal mortality rates (MMRs) in Tanzania have remained stubbornly high over the last decade.

These results have raised concerns from the Government of Tanzania and stakeholders about the reasons for such inconsistencies.

The project further indicates that funding challenges remain, therefore resulting in a heavy reliance on external financing.

The study, among other recommendations, suggests that reducing the delays in mothers receiving treatment is key to reducing MMRs in Tanzania

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