Maternal mortality and morbidity. Zimbabwe's birth force.

Publisher: The Network Country of Publication: Netherlands NLM ID: 101084378 Publication Model: Print Cited Medium: Print NLM ISO Abbreviation: Newsl Womens Glob Netw Reprod Rights

Original Publication: Amsterdam : The Network, 1985-

Community Health Workers* ; Delivery of Health Care* ; Equipment and Supplies* ; Health Planning* ; Health Services Research* ; Hygiene* ; Infant Mortality* ; Mass Media* ; Maternal Mortality* ; Maternal-Child Health Centers* ; Midwifery* ; Mortality* ; Pregnancy Complications* ; Prenatal Care* ; Program Evaluation* ; Rural Health Services* ; Rural Population* ; Teaching*; Africa ; Africa South of the Sahara ; Africa, Eastern ; Communication ; Demography ; Developing Countries ; Disease ; Economics ; Education ; Health ; Health Personnel ; Health Services ; Maternal Health Services ; Organization and Administration ; Population ; Population Characteristics ; Population Dynamics ; Primary Health Care ; Public Health ; Social Planning ; Zimbabwe

Indexing Agency: PIP Local ID #: 069336. Indexing Agency: POP Local ID #: 00206799.
Keywords: Africa; Africa South Of The Sahara; Communication; Community Workers*; Delivery Of Health Care*; Demographic Factors; Developing Countries; Diseases; Eastern Africa; Economic Factors; Education; English Speaking Africa; Equipment And Supplies*; Folk Media*; Health; Health And Welfare Planning*; Health Personnel; Health Services; Health Services Evaluation*; Hygiene*; Infant Mortality*; Mass Media; Maternal Health Services; Maternal Mortality*; Maternal-child Health Services*; Midwives*; Mortality; Mortality Determinants*; Obstacles*; Organization And Administration; Population; Population Characteristics; Population Dynamics; Pregnancy Complications*; Prenatal Care*; Primary Health Care; Program Effectiveness*; Program Evaluation; Programs; Public Health; Rural Health Services*; Rural Population--women*; Social Planning; Training Activities*; Training Programs; Zimbabwe
Note: TJ: WOMEN'S GLOBAL NETWORK FOR REPRODUCTIVE RIGHTS NEWSLETTER
Local Abstract: [PIP] The training of traditional birth attendants (TBAs) as a national public health strategy was implemented in the late 1970's in Zimbabwe. Since 1982, the Manicaland rural health programs have trained 6000 women in 12-week courses to change their practices of using unsterilized razor blades, shards of glass, or knives to sever the umbilical cord. These practices and others had led to high rates of neonatal tetanus mortality and maternal mortality. TBAs learned from state certified nurses the basics of personal and domestic hygiene, identification of pregnancy and associated risk factors, the importance of good nutrition, rest, and immunization for pregnant women, and safe practices in labor and delivery. Refresher courses and additional training in prenatal care and family planning have been added recently to the program. Completion of the program leads to a public recognition of their graduation in the base village. Maternity care services are provided as back up. This includes village based maternity waiting homes for women in labor, community health workers, and auxiliary midwives with higher level training. A district health center has been set up for more complicated cases. This access to better health care has led to a 50 and 66% reduction in maternal and infant mortality rates, respectively. A 1988 government survey shows increases in the use of contraceptives and the number of women receiving prenatal care. The components of the program which have contributed to program success and provided similarities to other country's TBA programs are as follows: developing a sense of self esteem and pride among TBAs for their work, utilizing creative ways to teach the largely illiterate TBA population through role plays and songs, and providing involvement in the health care system which reaffirms the TBA's importance. In spite of the advancements made however, there are still problems to solve. Unsafe practices are resorted to when TBAs forget their training. Disruptions in medical supplies handicap TBAs in carrying out their work. Some of the solutions are to utilize bicycles for transporting supplies to remote areas, or mobile clinics which provide supplies and training. If more countries followed Zimbabwe's lead, other countries would benefit from reduced birth rates and improved infant and maternal mortality in a cost effective and culturally compatible way.

Date Created: 19910701 Date Completed: 19920401 Latest Revision: 20111117

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