Hospital tours unearth gaps in maternal health services

VISITS by the Parliamentary Portfolio Committee on Women and Youth led by Priscilla Misihairabwi Mushonga to different hospitals in the country to investigate issues to do with maternal health care and contraceptives have revealed serious gaps in implementation of the free maternal user fee policy.

BY VENERANDA LANGA

As the legislators arrived at different hospitals, they were met by desperate looking women with babies strapped on their backs with pleas to the MPs to assist them to get their children’s birth records which had been withheld from them due to debts for maternal user fees at hospitals.

At Mbare’s Edith Opperman Maternity Hospital several women carried with them receipts to show that they were charged $10 for those birth records.

They said if the mothers and their newly born baby were not detained after failing to pay the maternal user fees ranging from $25 to $50, they are denied the birth so that it became difficult for them to get birth certificates for the children.

Doreen Murwira sat for hours waiting for the MPs to arrive so that she could narrate her story. Her two children, one born in 2009 and the other in 2010 still did not have birth certificates because when she gave birth to them at Edith Opperman Maternity Hospital she had failed to pay fully the user fees and still owed the hospital some money.

“I first gave birth at this maternity hospital in 2009 and had a $5 debt which was unsettled by the time I was discharged,” Murwira narrated to Misihairabwi Mushonga’s committee members.

“In 2010, I gave birth to another child at the same hospital and my debt then ballooned to $30 after I failed to pay the $25 user fees.

To date, I still do not have the birth records of the two children as they were withheld and I cannot get birth certificates for them,” she said.

Several women who attended the public hearing in Mbare related the same story. In order for them to get the birth records after paying their hospital debts, they said they had to also fork out $10 to get the birth records. To worsen their plight, the hospital also demanded that the $10 must be paid cash, not swipe or Ecocash.

“We thought it was part of government policy that maternity user fees were scrapped, but at this clinic pregnant women are charged $25 to access maternal care. It is as if it is a crime for a woman to fall pregnant. Those who do not have money are told to go and give birth where the policy was crafted, and as a result some women end up giving birth at home without adequate care,” Charles Kautare told the MPs.

Other issues raised were the bad attitude exhibited by nurses at maternity hospitals who were said to be rude to birthing mothers and often shouted at them.

When the MPs arrived at the maternity hospital – and before they even introduced themselves to the hospital administration, some nurses could be seen yelling at patients and treating them rudely.

“We receive very rough treatment from the nurses at different maternity hospitals, and those that have no money to pay and they want to access maternal care are made to sleep on the floor. In Epworth, if you do not bring methylated spirit and cotton wool, they do not attend to you,” a woman from Epworth explained.

Misihairabwi-Mushonga said during the committee’s tour to different hospitals the situation was almost the same. She said the maternal user free policy seems to be only on paper and was not being implemented on the ground.

“Throughout the country we found that the policy is implemented in some places, while at other places they said they actually do not know about its existence.

Those in Harare and Bulawayo have higher chances of knowing about the policy than those at smaller towns. When we visited Mpilo Hospital in Bulawayo we found a terrible situation there where little babies were sleeping on the floor with their mothers due to overcrowding. Mpilo is free while other maternity homes like Pelandaba charge $30 user fees,” she said.

“On family planning methods, we found that women are asked to pay for implants like jadelle, but when they wanted it removed they also had to pay.”

She said another problem was that whenever family planning methods or contraceptives failed, there was no solution given to the women who found themselves with unwanted pregnancies. This resulted in backyard and unsafe abortions.

“We had complaints on issues to do with contraceptives and their side effects.

We need to know how women are treated these contraceptives fail and the legal implications when they seek termination of the pregnancy because when they go to hospitals, they are told that it is impossible to get an abortion,” Misihairabwi Mushonga said.

Saliet Kapanda, the sister in charge of the Mbuya Nehanda Maternity Centre (an affiliate of Parirenyatwa Hospital) said some of the common effects of contraceptives that patients complained of were spotting, bleeding, unplanned pregnancies, infertility and at times headaches.

She said Mbuya Nehanda Maternity Centre does offer post-abortal care.

“If someone asks for termination of pregnancy, we refer them to a gynaecologist where they decide what to do. We also try to ensure that there is a youth friendly policy when dealing with young people seeking contraceptives or maternal health care,” Kapanda said.

Parirenyatwa Group of Hospitals financial director Mercy Sanzira said the hospital had complied with the government‘s directive to stop charging maternal user fees.

“For now we have been exempting pregnant women from maternity user fees and we are not detaining women and their babies for failing to pay user fees.

The Registrar General Tobaiwa Mudede issued a directive that we should not withhold birth records from women that fail to pay user fees,” Sanzira said.

On male contraception, only two men asked for vasectomy at Parirenyatwa Hospital in 2018. Female condoms were said to be also less popular than male condoms.

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