Photo courtesy of Margaret W. Nea and Bread for the World
As one of the world’s fastest economically reformed countries, Zambia has made great strides in maternal health during the past decade.
According to 2013 estimates, a Zambian woman faces a 1 in 59 risk of death due to childbirth-related causes during her lifetime. Although the maternal death ratio remains high (280 deaths per 100,000 live births in 2013), the ratio has, in fact, much improved since 1990, when there were 580 maternal deaths per 100,000 live births—a decrease of more than 50 percent ((UN Maternal Mortality Estimation Inter-agency Group, Trends in Maternal Mortality: 1990 to 2013 (Geneva 2014), pp. 31-43.)). The decline in Zambia’s maternal mortality ratio from 1990 to 2013 is roughly on par with other developing countries and slightly better than the Eastern Africa regional average during that time ((Ibid.)). However, while Zambia is making real progress in terms of maternal mortality prevention, considerable challenges yet remain.
Access to quality maternal health care is especially problematic in rural areas, where barriers such as poor education and long distances to health centers are significant ((Committee on the Elimination of Discrimination Against Women, Consideration of Reports Submitted by States Parties Under Article 18 of the Convention on the Elimination of All Forms of Discrimination Against Women, Third and fourth periodic reports of States parties: Zambia, U.N. Doc. CEDAW/C/ZAM/3-4 (1999), p. 57.)). Child marriage is another challenge. In Zambia, nearly half of all women are married by the age of 18—one of the highest prevalence rates of early marriage in the world. Girls that marry early often face complications during pregnancy and childbirth (a leading cause of death among young women), and research within Zambia has shown a high correlation between early marriages and the country’s high maternal mortality ratio ((Lillian Banda, “AFRICA: Traditional chiefs in Zambia work to stop child marriage,” Women News Network, 17 July 2013 (accessed 9 September 2015).)) ((IRIN Humanitarian News and Analysis staff, “Zambia: ‘Marrying off young girls is a tradition here’” IRIN Humanitarian News and Analysis, 20 December 2010 (accessed 9 September 2015).)). Statistics from a 1995 study indicated that a shocking 75 percent of maternal deaths were of teenage mothers ((Committee on the Elimination of Discrimination Against Women, Consideration of Reports Submitted by States Parties Under Article 18 of the Convention on the Elimination of All Forms of Discrimination Against Women, Third and fourth periodic reports of States parties: Zambia, U.N. Doc. CEDAW/C/ZAM/3-4 (1999), p. 48.)).
Despite the legality of abortion in Zambia, unsafe abortion is another significant factor in the country’s high number of maternal deaths, especially in combination with child marriage. For example, in one region of Zambia in 1993, approximately 80 percent of women who were admitted with complications of illegally induced abortions were younger than 19 years old ((Committee on the Rights of the Child, Consideration of Reports Submitted by States Parties Under Article 44 of the Convention, Initial reports of states parties due in 1994: Zambia, U.N. Doc. CRC/C/11/Add.25 (2001), p. 55.)). Additionally, malaria-related maternal deaths are high and, consistent with the country’s high HIV prevalence rate, 15.4 percent of maternal deaths are attributed to HIV ((Central Statistical Office [Zambia], Central Board of Health [Zambia], and ORC Macro, Zambia Demographic and Health Survey 2001-2002 (Calverton, Maryland 2003), p. 157.)) ((UN Maternal Mortality Estimation Inter-agency Group, Trends in Maternal Mortality: 1990 to 2013 (Geneva 2014), p.24.)). In response, the Zambian government claims to have reached at least 80 percent of HIV/AIDS victims with antiretroviral therapy by 2013, which has contributed to the reduction of maternal deaths in the past decade ((UN Maternal Mortality Estimation Inter-agency Group, Trends in Maternal Mortality: 1990 to 2013 (Geneva 2014), p. 28.)).
Photo courtesy of Photoshare and Family Care International, © 2009 Arturo Sanabria
Additionally, government leaders have recently led campaigns to reduce corruption and increase the standard of living, including policies and programs designed to improve maternal health. For example, the Campaign for Accelerated Reduction of Maternal Mortality in Africa and the National Gender Policy both attempt to address women’s limited access to basic health services and maternal health care ((Committee on the Elimination of Discrimination Against Women, Concluding observations of the Committee on the Elimination of Discrimination against Women: Zambia, U.N. Doc. CEDAW/C/ZMB/CO/5-6 (2011), p. 10.)) ((Economic and Social Council, Implementation of the International Covenant on Economic, Social and Cultural Rights, Initial reports submitted by States parties under articles 16 and 17 of the Covenant: Addendum: Zambia, U.N. Doc. E/1990/5/Add.60 (2003), p. 23.)). The government also provides free training to traditional birth attendants in rural areas, teaching them to recognize potential problems during pregnancy and refer women early to health centers ((Economic and Social Council, Implementation of the International Covenant on Economic, Social and Cultural Rights, Initial reports submitted by States parties under articles 16 and 17 of the Covenant: Addendum: Zambia, U.N. Doc. E/1990/5/Add.60 (2003), p. 52.)) ((Central Statistical Office [Zambia], Central Board of Health [Zambia], and ORC Macro, Zambia Demographic and Health Survey 2001-2002 (Calverton, Maryland 2003), p. 128.)). Aside from refurbishing health training institutions and recruiting qualified personnel to supervise deliveries, the government has constructed and expanded maternity wings, procured ambulances and radio communication equipment for rural areas, enhanced family planning services and developed basic health care packages designed to positively impact reproductive health ((Committee on the Elimination of Discrimination Against Women, Consideration of Reports Submitted by States Parties Under Article 18 of the Convention on the Elimination of All Forms of Discrimination Against Women, Combined fifth and sixth periodic reports of States parties: Zambia, U.N. Doc. CEDAW/C/ZMB/5-6 (2010), p. 30.)).
Government efforts in recent years have indeed been laudable, but drastically reducing maternal mortality in Zambia will take time. If the country can manage to sustain its current momentum with respect to maternal health care, however, the process may pick up speed.
Recent Comments