Women's experience and perception of maternal health care and emergency services in rural Zimbabwe
Approximately, 3000 women die every year in Zimbabwe during pregnancy, child birth or postpartum. According to the Zimbabwe Demographic Health survey (2011/12), maternal mortality has worsened from 720 deaths per 100, 000 to 950 between 2007 and 2012. Most of what needs to be done is known. Past efforts have managed to sustain high levels of antenatal care (ANC) visits among pregnant women and skilled birth deliveries yet maternal mortality estimates remain high. While quality of care in maternal health services is needed for progress towards reducing maternal mortality, women’s perspectives for policy and action in maternal health seem to be the missing link.
The study examined women’s perceptions and experience of maternal health care services and to what extent such understanding can be used to explore strategies to improve the quality of maternal health and obstetric care in rural Mutare. A feminist interpretive paradigm was employed in the study. A critical qualitative research methodology, using guided in-depth interviews and focus group discussions collected data from 25 women using antenatal, postpartum care services and maternity waiting homes at the time of the research. All focus group discussions and interviews were recorded, translated and transcribed. Transcripts were coded and analysed thematically.
Four broad themes were identified: 1) women’s experience of maternal health care; 2) quality of maternal health care; 3) women’s knowledge of maternal health care; 4) priorities areas of improvement. In summary, women’s knowledge of maternal health care services was low. Women understood that quality of care; barriers to maternal health care; lack of awareness of dangerous signs in pregnancy; and gender inequality had contributed to poor maternal health in the district.
Women’s stories and experiences suggest that behind issues of inadequate maternal health care are the shadows of many other urgent development issues - gender inequality; poverty and unemployment; inadequate education and public health spending and above all, lack of skilled birth attendants and enabling environments. Women’s empowerment through basic education and employment was identified as keys to improve maternal health and quality of care in this district.