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Midwives Leading the Way with Quality of Care in Rural Central Province

Central Province, Zambia – The availability of skilled midwives during pregnancy and child birth remains crucial in addressing Zambia’s high maternal mortality rates, which currently stands at 398 per 100,000 live births. Rural areas across the country are estimated to have only 70 health care workers per 100,000 populations, with some rural health facilities being managed by only one health worker or unqualified support staff. Central and Western Provinces of Zambia are not excluded from this scenario, where critical numbers of nurses, midwives, medical and clinical officers fall below the World Health Organization recommended threshold of 2.28 per 1000 of population.

Flavor Kangwa is a midwife at Bwacha Health Center, one of the 50 health facilities targeted for support by the GRZ-DfID-UN Joint Programme on Health Systems Strengthening and Social Accountability in Central Province, with a passion to contribute to the reduction of neonatal and maternal deaths in the Province.

“Every time I report for work, I strive to offer quality services to mothers, including conducting deliveries and discussing infant nutrition and care with new mothers, among other things” she highlights.

However, like many rural-based health workers, Flavor lacked essential skills to enable her provide lifesaving Emergency Obstetric and Newborn Care (EmONC), in particular undertaking repairs for cervical tears.

A cervical tear during labor and delivery is often influenced by multiple factors that women face, including being a first time mother, having a large baby, when the baby is in an unusual position or having prolonged labor, among others. In light of these factors, some women are more likely than others to experience a cervical tear, which may take time to heal. During this time, women will experience discomfort which consequently affects other aspects of their overall social wellbieng.

Through onsite training and mentorship in the provision of EmONC services, facilitated by UNFPA with funding from DFID,  Flavor is now able to successfully perform procedures such as cervical tear repairs.   

“A few weeks ago, I facilitated an undiagnosed twin delivery. After delivering the babies, I noticed the mother begun bleeding heavily and when thoroughly examined, I discovered that she had a cervical tear. Using the skills I acquired through onsite mentorship facilitated by UNFPA, I managed to repair the cervical tear and the bleeding stopped. Six days after she was discharged, the new mother came to the health center for postnatal checkup, during which we certified she was well with no compliant. I was filled with so much joy, knowing that I contributed to restoring her health!” Flavor narrates with a smile.

Sharing her joy after a successful cervical tear repair undertaken at Bwacha Health Centre, Nancy, a new mother, underscores the key challenges faced by mothers when they experience complications such as cervical tears:

“Previously, we used to hear of situations where mothers who developed complications after delivery could not be transfered in a timely manner to a higher level hospital for further management because there is only one ambulance in our area. Fortunately for me, I was very privilaegded to learn that this clinic [Bwacha Health Centre] has now trained a nurse who was able to repair the [cervical] tear I had after I delivered. I was very happy and I am sure this will help many other women like me in future" says Nancy.