Zambia, maternal-child health

Currently, 86 percent of people throughout Zambia live below the poverty line and 50 percent are unemployed. According to the United Nations, 64 percent of people have access to clean water. However, some in-country sources state that the number might be as low as 10 percent. A lack of proper health care has taken a severe toll on Zambia’s families as well. Zambia’s maternal mortality rate is 728 per 100,000 live births, with a lifetime risk of 1 in 19. Approximately 43% of all delivering women had skilled attendants at their births. For comparison, the US’s maternal mortality rate is approximately 12 per 100,000 live births, with a lifetime risk of dying in childbirth of 2500, with 99% having skilled attendants at their births. Sadly, however, the risk for black women in the US dying of childbirth complications is between 4 and 5 times higher than their white counterparts.

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Let me do just a little sidebar into birth in Zambia. As a midwife, of course I am interested in birth where ever I go! Most births are in homes in Zambia. To even be accepted into the hospital, you must have a referral from a clinic, specifying why you can not give birth at home (or at the clinic). Then, if you do go to the hospital (for any reason), you (or your family) is responsible for EVERYTHING – for bringing in your food, for bathing you, for providing all supplies for you – sheets, pillow, cotton or whatever you are using for pads for after your baby’s birth, all diapering and clothing supplies for baby – you get the idea
While I was there, I was privileged to attend a birth at University Teaching Hospital. I was quite honored to be there, the mother was grateful and the attending midwife seemed to appreciate the extra set of hands and the extra supplies.

Out in the villages, I taught some community midwives and did prenatal exams on some of the expecting mothers. One mom was pregnant with twins – I got to hear two different heartbeats. That was fun. Two moms had not yet felt the baby move, but we could heat the heartbeat with my hand-held Doppler. Both giggled and one said “So it is real?” I was able to assure them that yes, it was real. I saw one 14 yo mom-to-be, and a couple of Moms in their very early 20’s having their 3rd and 4th babies.

For the children, malaria remains the biggest killer of children under age five and poses a major health problem for the rest of the population. In addition, the HIV/AIDS pandemic is widespread, with 1.1 million Zambian people living with the disease. Approximately 140,000 HIV/AIDS-infected people are currently in urgent need of antiretroviral therapy.

Current population is 11,502,010. The estimates for this country explicitly take into account the effects of excess mortality due to AIDS; this can result in lower life expectancy, higher infant mortality and death rates, lower population and growth rates, and changes in the distribution of population by age and sex than would otherwise be expected (July 2006 est.) Life expectancy in Zambia has markedly decreased. Currently the life expectancy in Zambia is 38 years. Almost half of the entire population of the country is under 15, making the median age for the country a mere 16 years old. According to UNAIDS, some 650,000 boys and girls have been orphaned due to this devastating disease. This factor, coupled with economic challenges and food shortages, has left half of Zambian children suffering from malnutrition.

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