President Emmerson Mnangagwa’s government has with immediate effect scrapped maternity fees and ordered the free treatment of children under the age of five, as well as all people above 65 years as part of its 100-day action plan.
This comes as Zimbabwe remains one of the few countries in the world that is still recording many deaths among pregnant women — with the latest statistics showing that 242 known pregnant women died while giving birth in 2017 alone.
“With the coming in of the new dispensation, Cabinet has approved a 100-day plan which everyone has to work towards achieving. One of the issues in the 100-day plan, which requires attention, is the removal of all forms of payment for non-paying groups.
“The following groups are supposed to be treated for free:
a) children under the age of five years;
b) all maternal cases;
c) senior citizens above the age of 65 years.
“These groups are not supposed to pay any consultation fees, card fees, table money, administration fees or whatever name the fee might be called.
“You are therefore expected to advise all your institutions to remove these fees with immediate effect,” the government announced in a memorandum written by Mashonaland Central provincial medical director, C. Tshuma.
“DMOs (District Medical Officers) are being reminded that the first progress report is due on January 25,” Chuma further said in his memorandum to medical superintendents/chief medical officers, Rural District Council chief executive officers and town clerks.
Although the government of former president Robert Mugabe promised on numerous occasions to scrap maternity fees, public hospitals continued charging fees which ranged between $25 and $30.
In 2013, rural and district hospitals temporarily lifted maternal fees as part of the government’s much-hyped $450 million Health Transitional Fund (HTF), but reversed the decision after Treasury failed to allocate the funds.
Zimbabwe is struggling to contain maternal deaths as many pregnant women can’t afford giving birth in hospitals. As a result, most women fail to access ante-natal care at public hospitals.
Many either give birth at home or visit clinics when they are due for labour.
According to latest statistics released by the Heath and Child Care Ministry, at least 242 women died while giving birth in 2017 — almost half the number of deaths recorded in 2016.
However, observers say the number is probably much higher since many cases are never reported, and particularly considering that Zimbabwe records between 500 000 and 700 000 pregnancies every year.
Some of the reasons that lead to high mortality among pregnant women according to World Health Organisation (WHO) include “religious and traditional objectors to modern medicine … for instance refusal to seek care at health facilities, refusal of blood transfusion, refusal of modern medicines or surgical procedures and use of traditional uterine contracting medicines to quicken labour”.
Apart from maternal deaths, Zimbabwe is still struggling to reduce the number of infants who die at birth.
The new measures are expected to reduce both the maternal and infant mortality rates which spiked at the height of the country’s economic problems in 2008.
According to the Zimbabwe Demographic Health Survey (ZDHS)’s 2015 report, at least one in every 15 live births die before reaching the age of five.
The report further states that the level of under-five mortality is 69 deaths per 1 000 live births.
The estimate of the maternal mortality ratio for the seven-year period preceding the 2015 ZDHS report was 651 deaths per 100 000 live births — that is, for every 1 000 births in Zimbabwe, there were about seven maternal deaths.