Maternal Mortality - The 3 Delays

Most preventable maternal deaths and disability occur as a result of a number of interrelated delays which ultimately prevent a pregnant woman from accessing the health care she needs. Each delay is closely related to services, goods, facilities and conditions which are important elements of the right to health.

1. Delay in seeking appropriate medical help for obstetric emergencies due to costs, lack of recognition of an emergency, lack of access to information and gender inequality.
2. Delay in reaching an appropriate facility for reasons of distance, infrastructure and transport.
3. Delay in receiving adequate care when a facility is reached due to limited health staff, or unavailability of medical supplies and medicines. Efforts to address these delays are essential in order to save the lives of mothers and newborns.

Progress

• Maternal mortality rates in Zambia reduced from 398 per 100,000 live births in 2013/14 to 252 per 100,000 live births in 2018. Inspite this progress, the country is still far from meeting its SDG target of 70 per 100,000 live births by 2030.
• Skilled birth attendance increased from 64.2% in 2013/14 to 80.4% in 2018, while institutional deliveries increased from 67.4% in 2013/2014 to 83.8% in 2018.
• The percentage of women who had their first antenatal care (ANC) visit during the first trimester of pregnancy increased from 24% in 2013/14 to 37% in 2018. Further, the percentage of mothers who received a postnatal check during the first 2 days after delivery increased from 63% in 2013/14 to 70% in 2018.

The Focus of UNFPA’s Work

Informed by UNFPA’s global Transformative Results, and in line with the Government of Zambia/UNFPA 9th Country Programme (2023-2027), UNFPA in Zambia works towards ending preventable maternal deaths through five modes of engagement namely:

1. Advocacy and policy dialogue: In Zambia, UNFPA advocates for the right of women and girls to access maternal health services aimed at ensuring safe pregnancies and births. Specifically, UNFPA is committed to partnering with the Government of Zambia and stakeholders in the implementation of the National Health Strategic Plan (2022 - 2026), whose goals include the reduction of maternal mortality from 252/100,000 live births to less than 100/100,000 live births by 2026.
2. Targeted service delivery: UNFPA contributes to the annual aversion of maternal deaths in Zambia through provision of modern methods of contraception; alongside supporting skilled attendance at birth through midwifery training and mentorship; provision of basic and comprehensive emergency obstetric and newborn care (EmONC) services including medical equipment and lifesaving drugs; as well as prevention and treatment of obstetric fistula; and other essential sexual and reproductive health services to ensure “no woman dies giving life”.
3. Capacity development: UNFPA’s support includes strengthening national health systems in undertaking Maternal and Perinatal Death Surveillance and Response (MPDSR); as well as midwifery training and mentorship.
4. Knowledge management: Acknowledging the critical role of data towards informing national policy, planning and resource allocation, UNFPA provides both technical and financial support to the Government of Zambia to scale up national capacity for prevention of maternal deaths. This includes support towards the undertaking of Demographic and Health Surveys, as well as Maternal and Perinatal Death Surveillance and Response (MPDSR), among others.
5. Partnerships and coordination: UNFPA in Zambia continues to mobilize external and domestic resources towards ensuring that no woman dies while giving life. Key partnerships include support from the Maternal Health Thematic Fund as well as national stakeholders contributing to safe motherhood programmes in Zambia.