Ante-natal care took a back seat as Covid-19 ruled

NEVER has Zimbabwe witnessed panic, fear and pandemonium, spreading of myths and misconceptions as what happened between 2020 and 2021.

Most people became “experts” on the Covid-19 pandemic which they knew nothing about.

With medical specialists revealing that Covid-19 was “a new pandemic, we are also learning,” the internet became awash with hearsay.

Some health needs were parked or pending, with all eyes on the new ball; Covid-19 took the centre stage.

Services at some health institutions were altered to reduce the spread of the pandemic and in the process some people were affected.

Other health centres gave more preference to essential services like maternity, emergency and Covid-19 “red zone”.

The name “red zone” itself was a misnomer. We should learn from this pandemic that language use can also perpetuate fear rather than address the intended need.

Due to the Covid-19 pandemic, most people could not continue with their normal life.

The disease brought a new way of doing things and many were not used to that.

A number of people, including the pregnant ones, experienced challenges accessing medical services as it became difficult to move from one area to the other while others were afraid of contracting the disease from the health institutions.

This situation saw some women missing HIV testing that would have led to precautions and prevention of the possibility of infecting the unborn baby.

For some people, the “red zone” that was warning enough not to dare come to such.

During the Covid-19 era, some pregnant mothers missed antenatal care, (ANC) as they could not afford the costs since their sources of income had been disturbed by the pandemic.

With lockdown measures, only essential services reported for duty while for some who were on contracts meant no work and no pay.

For the majority who are self-employed, no savings meant the going was tough.

The roadblocks became a barrier to seeking services as the rigorous questions bordered on stigma and discrimination.

“As a woman living with HIV, it was difficult for me to bring out proof that I needed to collect medication as this revealed my status. I also needed privacy. I ended up not going for my treatment resupply on time,” said Chengeto Musa.

“My husband is self-employed. Informal markets were closed. We could not afford the US$25 maternity fees. I, therefore, gave birth at our community midwife’s place. She knows my HIV status so she took all necessary precautions. I am glad she did not discriminate against me.

“It took me 15 months to have my baby tested for HIV, I am glad the baby is negative.”

For some pregnant mothers, general fear of being in a clinic setting was a hindrance to seek for the antenatal care as hospitals were perceived to be hotspots for possible infections.

The requirement of Covid-19 negative results at the health centres were also a hindrance to some people who wanted to access medical services. The tests were expensive for them.

Many pregnant women and girls were unable to afford the costs of transport to health facilities.

Those with no financial support had no option but to deliver at home under traditional midwives.

A few delivered under the eye of unskilled birth attendants, risking expected procedure under unhygienic conditions.

Some mid wives helped a number of women deliver during the lockdown.

Monalisa Nyoni, who was pregnant during that time, said it was difficult for her to move from one area to the other and ended up being assisted at an Apostolic shrine where she delivered her baby boy.

“After delivery it also took some time to acquire a birth certificate for my baby, so we had to wait until the relevant offices started operating,” said Nyoni.

World Health Organisation (WHO)’s latest statement show that 1,5 million people worldwide were infected with HIV in 2021, with the same figure also being infected in 2020.

It is possible that some of the those who contracted the disease could have been children whose mothers had challenges accessing the ANC due to the pandemic.

Home births with unskilled midwives placed women and girls at risk of maternal mortality and morbidity.

It also placed the babies at risk of vertical HIV infection, that is from mother to child.

During this time, most women skipped HIV tests, blood sugars and blood pressure tests, placing both mother and the unborn child at risk.

Esther Kanyimo of Honde Valley gave birth during the Covid-19 period at Chitungwiza Central Hospital after being referred from a clinic since it was her first pregnancy.

During her pregnancy, she went for antenatal check-up thrice due to travel challenges she experienced.

“Check-up should be on a monthly basis, then weekly visits before delivery, but then we had to adhere to the instructions. During this period, she suffered from fear and anxiety,” she said.

“I feared that my blood pressure could go up putting my unborn baby at risk. I used to hear people saying ‘BP inopisa vana’ (high blood pressure could burn my unborn baby). It was really a difficult time for me and my husband. Thank God my mother would call and give me courage, that made me strong until the day of delivery.

“I hope maternal health care will continue to be on first priority in the event of another pandemic that may arise.”

Kanyimo said she was emotionally and mentally affected, fear of the unknown weighed on her.

“Authorities must make arrangements to ensure women and girls have access to ANC, maternity waiting homes and skilled medical care,” she said.

“They should also allow medical and social support in the post-partum period and ensure access to medication and health care, in case another disaster strikes.”

Maternal mortality in Zimbabwe is 363 per 100 000 live births, according to the Preliminary Results of the 2022 Housing and Population Census.

However, the Ministry of Health and Child Care is working hard to create an enabling environment to improve maternal health.

Nurses are now allowed to perform certain life-saving functions like manual vacuum aspirations, to manually remove the placenta, and to insert contraceptive implants.

The Ministry of Health and Child Care and partners continue to procure and distribute essential equipment, drugs and supplies for maternal health.