DEVELOPMENT-TANZANIA: More Women Dying Preventable Deaths

Sarah McGregor

DAR ES SALAAM, Jul 19 2007 (IPS) – I began walking when I felt contractions. I delivered on the roadside five kilometres from the hospital, says the 22-year-old Veronica Joseph.
It is a wonder that her newborn, only a few hours old, is fast asleep in his snug cloth cocoon. He has had a dramatic life up to now. My mother helped. We put the placenta in a plastic bag and arrived at the hospital. But I feel fine, Joseph insists, speaking Tanzania #39s national language Kiswahili through a translator.

Looking unruffled, she sits on the edge of the bed she shares with two other women and their infants in the crammed one-room maternity ward of the Dodoma Regional Hospital in Tanzania #39s capital city. Only a flimsy curtain separates dozens of resting new moms from the moans of those delivering in the adjoining labour room.

Joseph intended to give birth to her still-unnamed son surrounded by healthcare providers who are trained to handle emergencies on the spot. It is safer here than at my home. The decision is not so clear-cut for many other expectant women in the East African nation.

Tanzania is ranked the fifth most dangerous place in sub-Saharan Africa for a woman to give birth, behind Sierra Leone, Niger, Malawi and Angola, according World Bank development indicators.

For every 100,000 babies born alive in 2000, Tanzania saw an average of 1,500 women die during pregnancy, child labour or shortly after delivery, World Bank statistics show. That year, almost 21,000 women died after problems arose while they were pregnant.
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The situation had worsened from a decade earlier, when the maternal mortality rate was 770 per 100,000 live births and about 8,700 women had died due to complications during pregnancy.

A 2005 government survey, gleaned from a door-to-door campaign, put the maternal mortality rate at 578 deaths out of every 100,000 live births, up from 529 in 1996.

This discrepancy in numbers is said to be due to varying methods of collecting and measuring the information.

The figures do, however, show an unacceptably high prevalence of maternal deaths and concern is mounting that the country is moving further away from the United Nations Millennium Development Goal aimed at cutting maternal mortality by three-quarters between 1990 and 2015.

Under-resourced hospitals, a dearth of clinics in remote areas, poor transport and poverty are blamed for the preventable deaths of would-be mothers in Tanzania.

In many cases, rural dwellers follow their communities #39 beliefs, seeking a traditional healer to deliver babies in a natural way using herbs and age-old methods.

Qualified doctors or nurses took part in less than half of births (46 percent) in Tanzania between 2000 and 2004, according to World Bank statistics.

There is not enough education about safe births, Elizabeth Massawe, a nurse at the Dodoma hospital, tells IPS. Women think if they come here we will operate and they are scared. They would prefer to do it naturally at home. Activists say an increase in public health spending may help reduce the death rate of pregnant women.

An acute shortage of trained health care professionals has seriously compromised the level of hospital care with only about one doctor for every 20,000 patients, according to government statistics.

We need a bigger health care budget. There is an inadequate amount of skilled health care professionals and too few clinics in rural areas, says Rose Mlay, Tanzania #39s coordinator of the White Ribbon Alliance. The alliance represents 50 non-governmental organisations focused on women #39s health.

Women can be a hundred kilometres from a hospital and it costs too much to drive or take a taxi.

Mlay said community leaders should be taught home-based care skills to recognize warning signs of an unsafe pregnancy and birth complications.

Another factor further complicating the issue is gender inequality. In Tanzania, males often rule household decision-making which means women cede control over their own health decisions, Ananilea Nkya, of the Dar es Salaam-based Tanzania Media Women #39s Association said.

Culturally women have a low status in this country. A woman is not supposed to make decisions if the husband is not home, Nkya points out.

Tanzanian President Jakaya Kikwete has said tackling the country s high maternal mortality rate is a top priority on a par with efforts to fight the seven percent AIDS infection rate and to reduce unemployment, which affects more than one in ten people.

Health and Social Welfare Minister David Mwakyusa announced in June this year that the government is aiming for a goal of halving the national maternal mortality rate by 2010, to 265 deaths out of every 100,000 live births.

More efficient patient care, better hospital equipment and improved coordination between clinics and ambulance drivers were promised to reach the target.

We are hopeful because there now seems to be some sort of political commitment, says Mlay of the White Ribbon Alliance. Women should not be dying so needlessly.