Maternity waiting homes should be a high priority
By Lahja Nashuuta
IN 2015, an estimated 303,000 women died from complications related to pregnancy or childbirth, notes the World Health Organisation (WHO).
Most of these deaths were due to haemorrhage, infection, unsafe abortion, and eclampsia, or from health complications worsened during pregnancy. In all these cases, unavailable, inaccessible, unaffordable, or poor quality care is fundamentally responsible.
Maternity waiting homes are regarded as an alternative to decentralisation of essential obstetric services.
Maternity waiting homes are residential facilities, located near medical centres, where women defined as “high risk” can await delivery and be transferred to a nearby medical facility shortly before delivery, or earlier should complications arise.
These homes are considered to be a key element of a strategy to bridge the geographical gap in obstetric care between rural areas with poor access to equipped facilities and urban areas where the services are readily available.
They are meant to provide a safe environment and setting that provides them with accommodation during the final weeks of their pregnancy near hospitals.
Some maternity waiting homes have expanded their purpose to include not only decreased maternal mortality but also improved maternal and neonatal health.
In these homes, additional emphasis is put on education and counselling regarding pregnancy, delivery and care of the newborn babies and family.
Despite the most important role maternity waiting homes play in preventing maternal and neonatal mortality, in some countries including Namibia, the issue is still treated as a step child.
The rural nature of Namibia’s population means that a trip to hospital during labour often entails a long journey, usually on foot, bicycle or donkey cart. This results in many women giving birth on the way to hospital, while others opt to deliver at home assisted by traditional midwives.
It is because of poor roads, lack of transportation and distances of up to hundreds of kilometres that make it difficult for rural women to reach hospitals on time.
Many expectant mothers are forced to relocate close to the hospital several weeks before the delivery date.
And due to the absence of maternity homes, they are forced to live under deplorable conditions that expose them to further risks.
Media in Namibia have reported how pregnant women in Omusati and Ohangwena regions in northern Namibia are forced to bath and relieve them in the open.
Some health experts have argued that it is the lack of obstetric services that made it difficult for Namibia to achieve Millennium Development Goal 4, the global target that calls for the reduction of child mortality as well as Goal 5 that seeks to improve maternal health.
WHO in 2015 says the maternal mortality rate in Namibia was 265 deaths per 100,000 live births and the infant mortality rate was 33 deaths per 1,000 live births.
Little effort has been made under the Programme for Accelerating the Reduction of Maternal and Child Mortality (PARMaCM) to build maternity homes across the country.
Many women are shunning the facilities because they cannot afford the R10 daily charges. Health Minister, Dr Bernard Haufiku, has also conceded that the majority of women, who are also unemployed, are unwilling to pay the daily charges.
This is an indication that the government, especially health authorities, are treating maternal waiting homes as a step child while women are dying due to during pregnancy, childbirth or within 42 days after giving birth.