For Edna Paundi, 35, a new maternity wing at Mwanga Health Centre in Phalombe does not only boost prospects for safe motherhood, but also restores women’s dignity.
Living about two kilometres (km) from the clinic, she has seen several women from her village and faraway areas delivering on the way to the health centre. Some women and newborns have died due to complications associated with childbirths. The survivors include those who gave birth as children looked on.
Paundi delivered her only child at the health centre in 2000.
Looking back, she says the old maternity room was congested—too small for a health facility which serves 15 villages in Phalombe East with a population of over 33 000.
Almost 50 babies a month are born at the facility.
However, it had only nine beds, with two in the labour ward.
She explained: “I birthed my baby on the floor because the two beds were occupied. It was by grace that the newborn and I survived the conditions which made many pregnant women reluctant to wait at the health centre.
“A feeling was widespread that it was better to wait at home and go to the clinic when the baby was due.”
According to Paundi, the delays left some on a perilous path as they were prone to go into labour before reaching the health facility.
Despite the opening of the new maternity wing, Traditional Authority (T/A) Jenela is concerned that health facilities in his area are far apart and lack guardian shelters.
“I urge fellow traditional leaders to encourage women to deliver at health facilities. Now that we have a bigger maternity ward, women should go to the hospital in good time to avoid delivering on the way,” he says.
Delivering at a health facility, with the assistance of skilled health workers, reduces maternal complications and deaths.
To promote safe motherhood, some chiefs in Phalombe have adopted by-laws that make women who deliver at home liable to pay K5 000 and a goat.
More women are being served with maximum privacy and respect in the maternity unit constructed by Norwegian Church Aid (NCA) in partnership with Christian Health Association of Malawi (Cham).
A gift from Norway
The Norwegian Development Agency, through the Norwegian Embassy, funded the project to improve maternal health.
Mwanga Health Centre, which is run by the Catholic Archdiocese of Blantyre, has been serving the remote community since 1967.
District health officer Ketwin Kondowe says the state-of-the-art equipment in the maternity wing will drastically reduce neonatal and maternal deaths.
“We recorded four maternal deaths in the district last financial year. From last July to now, 12 maternal deaths were recorded. This is way too high, but we are increasing our capacity to address this challenge,” he says.
Kondowe reckons constructing three health facilities in the district, which currently has no district hospital, will ensure every pregnant woman gets adequate care.
The district has only two public health centres and three owned by Cham.
“There is an average spacing of 22km between these health facilities,” he says.
Phalombe District Hospital is still under construction.
Ministry of Health director of finance Chimwemwe Chimbalu-Banda acknowledges that Malawi continues to face challenges in the promotion of safe motherhood due to long distance to clinics, shortage of trained health workers and underfunding.
Due to lack of financial resources, Malawi is far from attaining the Abuja Declaration which requires health facilities to be situated no more than 8km apart.
With about 489 babies surviving per 100 000 live births, the burning questions remains: Why are the rest of babies dying? What can be done to stop these preventable deaths?
Call for unity
Chimbalu-Banda calls for concerted efforts, saying government alone cannot manage to change the situation.
Cham head of programmes Dr Titha Dzowela sees the figure reducing more with improved partnership between government and stakeholders in the health sector.
Cham runs 40 percent of health facilities in the country and trains health care workers.
It also provides HIV and Aids services on a special agreement with government which also allows women and newborns to access free services in selected Cham health facilities.
NCA country director Havard Hovdhaugen said since 2016, Norway has constructed eight out of the nine maternity units it planned to construct to reduce challenges slowing maternal health in Malawi.
NCA has pumped K1.5 billion in constructing maternity units, staff houses and sourcing medical equipment.
“Each project costs K240 million,” says Hovdhaugen.
However, the major savings in this investment for public health comes in form of lives saved because every breath counts. n