New report finds Zimbabwean government largely responsible for high maternal mortality

The government of Zimbabwe has “failed” to provide adequate maternal healthcare and protect women and girls from abuse during pregnancy, Amnesty International details in a new report published on Thursday. 

The human rights NGO studied the barriers to obstetric fistula prevention and treatment in Zimbabwe, which has one of the world’s highest rates of maternal mortality, and found several reasons for why women and girls don’t seek care at public health facilities, despite the government recommending their use.  

These include cultural, religious, and social factors such as women and girls’ “lack of decision-making power”. Related to this last factor, Amnesty International found, was a partner or family member’s unwillingness to pay for hospital care.

On the government side, the cost of care may be too high and under-resourced facilities contribute to poor quality of care. Some women who spoke to Amnesty International cited a fear of shaming by health professionals for why they didn’t seek government provided healthcare. 

There is also a lack of information available on obstetric fistula, which negatively impacts maternal health outcomes. 

According to the World Health Organization (WHO), obstetric fistula is “directly linked” to “obstructed labour” – “one of the major causes of maternal mortality.” The condition, which causes “an abnormal opening” and can lead to continuous urination and defecation, is preventable and curable in 92 percent of cases after surgery.

Deprose Muchena, Director for East and Southern Africa at Amnesty International, pointed out that the Zimbabwean government has committed “to make maternal healthcare freely available and accessible to all.” While he said this would decrease “risks to giving birth,” the government has not followed through. 

Amnesty International added that, “repair of obstetric fistula was established as a public health intervention in 2015.” 

In addition to government shortcomings, cultural and religious factors may prevent women and girls from seeking government healthcare. 

“Cultural beliefs also mean that some women don’t have a choice but to submit to home births administered by untrained family or community members,” Muchena said. 

Amnesty International found that in some cases, untrained maternal healthcare providers were abusive, especially when they were unable to manage complications in pregnancy and birth, such as those caused by obstetric fistula – Abuse can deepen the trauma experienced by women during and after pregnancy. 

Demographic data cited in the report shows that in Zimbabwe, untrained healthcare providers assist in 20 percent of births; 3 percent of births occur unassisted. 

“It is unacceptable that women and girls remain at risk of this life changing condition while giving birth,” Muchena said. “Zimbabwean authorities must urgently address the root causes of obstetric fistula – giving birth should not come with health risks that could be easily prevented.” 

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