Safe delivery in Africa, waiting weeks for maternal shelters

Rudia Chiwala, 23, is pregnant with her second child. She waits for her delivery in a shelter for pregnant women at Nagoma Mission Hospital, a rural health institution situated in the heart of Mumbwa, a peri-urban district in central Zambia. “I had to go here for me to have a safe delivery,” she says. “I am so scared to deliver at home where there are no trained personnels." Chiwala has a youthful face and a light complexion. Her hair is braided, and she wears a black T-shirt. She adjusts her chitenge, a traditional Zambian cloth, that is wrapped below her protruding belly. Her chitenge extends below her feet, a symbol of respect and honor for a rural woman. Chiwala has been at the shelter and away from her family for almost a week with only her mother beside her. She’s not sure when her delivery will be, so she patiently waits. “My days are almost due, and I cannot wait and sit at home because the hospital is very far,” says Chiwala, walking around for exercise. The distance between her home and the hospital also makes it difficult to secure food. Although the shelter offers pregnant women a place today, the women need to to obtain their own food. Chiwala says that she and her mother must depend on the meals that their family brings them, which can take a long time. Chiwala is familiar with the lengthy walk her family must make. “I walk two hours to access antenatal services and because there is no clinic nearby, I opted to come to the nearby hospital and had to walk two hours for the sake of our unborn child.” She says it was a difficult journey to walk to the hospital as a pregnant woman. “The following day, my feet would be swollen,” she says. And Chiwala is not the only woman trekking long distances to ensure a safe delivery in rural areas here. “Most of us women are advised to deliver at the hospital because of certain complications,” she says. “Traditional health attendants do not have enough knowledge when it comes to helping a woman to deliver at home.” But the lack of hospitals and health facilities near the women’s homes also make commuting to the hospital a risk. “There are times when women deliver on the way to the hospital,” Chiwala says. Pregnant women in rural areas who want to deliver their babies in hospitals say they must come stay at maternal shelters for a month leading up to their due dates. The nearest facilities are far from their homes, and many must walk despite being pregnant. The daunting journey decreases the number of pregnant women who receive antenatal care, which doctors say is crucial to the baby’s and mother’s health. The government drafted a plan last year to increase access to care, but for now, women must wait. The maternal mortality rate in Zambia decreased by 19 percent between 2001 and 2007, currently standing at 591 deaths per 100,000 live births, according to the Ministry of Health 2011 Action Plan. But the plan still deemed lowering the maternal mortality rate by 75 percent by 2015 the unlikeliest target for the country to meet of the Millennium Development Goals, a U.N. global anti-poverty initiative. In rural areas, nearly half of families live outside a five-kilometer radius of a health facility, according to the action plan. The so-called maternal, or mother’s shelters, are a new tool intended to offer women who live far from health facilities a place to stay in order to ensure safe deliveries.