Reducing Maternal Mortality in Zambia
The Irish Congress of Obstetrics, Gynaecology and Perinatal Medicine (ICOGPM) has awarded Dr Victor Mukonka, a PhD student at University College Dublin, the Best Overall Oral Presentation for his study aimed at reducing the high maternal mortality rate in his native land, Zambia.
His abstract “Increasing Institutional Deliveries By Skilled Birth Attendants Through Addressing Hidden Costs In Rural Zambia” was chosen from over 130 abstract submissions presented at the ICOGPM Best of the Crop Session. It was then selected as the Best Overall Oral Presentation at ICOGPM 2015.
Zambia has a high maternal mortality rate. The World Health Organisation (WHO) estimates that there were approximately 280 maternal mortalities per 100,000 live births there in 2013.
The high maternal mortality rate in Zambia is largely attributable to the fact that the majority of women living in rural areas there give birth at home without the assistance of professional midwives. According to WHO, institutional delivery by professional midwives is the single most important strategy to reduce MMR in developing countries.
As a result of a community intervention trial devised by Dr Mukonka, and which underpinned his study, there was a 43 per cent increase in the number of deliveries at healthcare facilities in 2014, compared to the previous year.
During the trial expectant mothers attending healthcare facilities in the district of Monze were supplied with health education leaflets and mother and baby delivery packs.
The packs, which contained basic hygenic delivery supplies, such as baby clothes and disinfectants, provided an incentive to expectant mothers to attend healthcare facilities. Their attendance at healthcare facilities meant that they were assisted by professional midwives during childbirth.
Dr Mukonka said he was “humbled and encouraged” by the recognition by the ICOGPM for his efforts to develop evidence-based strategies to address the high maternal mortality in Zambia and other developing countries.
The study also involved carrying out a community cross-sectional study of pregnant women and women who had delivered in the last 10 years in Monze district.
The research found that demands often made by staff at healthcare facilities requesting pregnant women to bring delivery supplies and mother and baby clothes was an important “hidden barrier” to institutional delivery.
Dr Mukonka explained that these basic items are supposed to be provided locally at government-run healthcare facilities but are always in short supply due to many other “competing needs”.
“Those unable to afford baby clothes and delivery materials shun away from delivering at a health facility,” he said.
“The provision of the pack will make a huge difference for the majority of poor people living in rural parts of Zambia, who cannot afford the hidden costs, and ultimately lead to increased institutional deliveries.”
“The study results provide scientific evidence for policymakers to design effective interventions to overcome reversible barriers that hinder utilisation of health facilities by pregnant women, a key intervention for reducing maternal mortality.”
The study also found that the active involvement of expectant mothers’ husbands and partners plays a major role in the successful implementation of maternal and child health programmes, particularly in reducing morbidity and mortality during childbirth.
Dr Mukonka’s academic supervisors were Dr Patricia Fitzpatrick, UCD School of Public Health, Physiotherapy and Population Science, and Prof Fionnuala McAuliffe, Professor in Obstetrics and Gynaecology.
Produced by UCD University Relations