Background: More than half a million women and four million infants are reported to die every year due to complications related to pregnancy and child bearing. The efforts to improve quality maternity care have been on the World Health Organization member countries' agenda. Zambia has been striving to reduce maternal mortality by ensuring universal access to maternal and child health care services. Our study aimed to explore women's experience with socioeconomic factors associated with perinatal morbidity and mortality in Lusaka and Mumbwa districts, Zambia. Methodology: This hermeneutic phenomenological study was conducted at four health facilities in Mumbwa and Lusaka Districts of Zambia. A purposeful sample of 45 consenting women organized in four groups was selected. Each group comprised of 11 to 12 women. The focus group discussion guide was used to direct the discussion and the Olympus Digital Voice Recorder WS-852 (Olympus Corporation, Shinjuku, Tokyo, Japan) was used to record the discussions. The audio data was manually transcribed and verbatim transcript analyzed using ATLAS.ti 8.0 qualitative data software (ATLAS.ti Scientific Software Development GmbH, Berlin, Germany) to ascertain patterns of relationships between themes and quotations. Results: Money, husbands and family support, adequate health care resources, and good nurses attitude simplify the burden of pregnancy, delivery and child rearing for the health care providers, mothers and society. Conclusion: Having money
Antenatal care (ANC) has been recommended as a service that can reduce both maternal and newborn mortalities. However, even in areas recording high ANC attendance, there are unevenly high levels of maternal and new born mortalities. Evidence of a weak relationship between ANC use and maternal and newborn survival has motivated recent calls to focus on content and quality of care provided rather than mere ANC attendance. This was a descriptive cross sectional study which was designed to evaluate the quality of antenatal care services in two health facilities in Lusaka and two in Mumbwa districts of Zambia. The health facilities were selected purposively based on poor maternal outcomes such as high maternal mortality ratio. Women attending antenatal clinics were selected using simple random sampling. Data was collected using a client exist interview schedule designed by World Health Organization for assessing quality of antenatal care. Data was analyzed using Statistical Package for Social Scientist (SPSS) version 24.0. The study revealed a lot of variations in the care provided at the four sites. None of the women had all the blood tests for haemoglobin, grouping and X-match, HIV and syphilis conducted from three out of the four health facilities, while at the fourth, only 30% of women had all the blood tests conducted. Furthermore, less than 20% of women had a full head to toe examination. While less than 10% of women from each of the facility reported that the health providers met the requirements for provision of privacy. Despite not meeting the minimum standards of care, only less than 5% of women categorized the care as poor. All the four health facilities recorded low quality of care on all domains of antenatal care. Therefore, if antenatal care has to achieve its intended purpose of reducing adverse maternal and new born outcomes, then quality of care delivered during pregnancy should be the focus as opposed mere attendance.
Maternal and neonatal mortality has remained a public health challenge in developing countries, particularly in Zambia despite the efforts to improve access and use of maternal health care services universally. Majority of these maternal deaths could be prevented by ensuring access to good-quality maternal health services, such as antenatal and postnatal care, and skilled attendance during child birth, including emergency obstetric care. This study explored the perspectives of midwives on factors influencing maternal morbidity and mortality rates in Zambia. A qualitative approach was utilized for this study to identify the experiences as described by the participants. This study was carried out in Lusaka urban and Mumbwa rural districts. Focus groups discussions were utilized to collect data. The challenges in the provision of care was understaffing and lack of infrastructure, fear of HIV test, attitude of the midwives, trusting herbal medicines, poverty, congestion at the hospitals and distance to health care facilities were mentioned as underlining causes of maternal morbidity and mortality. Equipping midwives with supplies and required equipment in antenatal and postnatal areas may help alleviate the challenges midwives face in the delivery of care
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