Shelters: Hope for teen moms Pregnant women relax in one of the rooms at a mothers waiting shelter at Plumtree District Hospital
Pregnant women relax in one of the rooms at a mothers waiting shelter at Plumtree District Hospital

Pregnant women relax in one of the rooms at a mothers waiting shelter at Plumtree District Hospital

Roselyne Sachiti Features Editor

WHEN other girls her age walked to school six years ago, nine year-old Chipo (not real name) sat under a tree at their home in Mbimba Village, 87 kilometres from Plumtree.

The last child in a family of 10, she was forced to drop out of school in Grade 3 because her widowed, unemployed mother could not afford to pay her school fees. All available social safety nets like the Basic Education Assistance Module failed to cushion her but instead pushed her to themarital bed at a tender age.

Today, 14-year old Chipo is expecting her first child. Her boyfriend, Thomas (15) (not real name) is a Grade 7 dropout. The two do not stay together because of a family feud over the pregnancy but are in love.
Both teens stay with their parents.
Thomas is unemployed.

Chipo is one of the pregnant women at a Health Transition Fund sponsored mother’s waiting shelter at Plumtree District Hospital in Matabeleland South Province.

The mother’s waiting shelter has 16 rooms and is one of the effective interventions put in place by government and its partners like Unicef to reduce child mortality and improve maternal health.

The country’s performance in key health indicators has been lagging behind on Millennium Development Goals 4 and 5.
Being at the mother’s waiting shelter means both Chipo and her baby have a higher chance of surviving should they face any complications during birth in a country where the overall maternal mortality ratio is 525 per 100 000 live births, according to the Zimbabwe 2012 population census.
This rate was highest in Matabeleland South (677).

Up to 80 expecting mothers referred by five clinics in Bulilima and three in Mangwe can be accommodated there and stay up to one month.
Chipo is fortunate.

Because of HTF, she receives free maternal health services. Free blood coupons will be available should she require them. Ante- and post-natal care is free.

Says Chipo: “Because of my age, Ndolani, the nearest health facility to my village, referred me to the hospital which is well equipped to handle complications if any arise.”

She feels safe as she has seen other teens and women with risky pregnancies deliver under the care of well trained workers at the hospital.
“I always picture the day I will go in labour. I hope nurses and doctors will provide the same high quality care making the process safe for me and my baby.

“My mother accompanied me to register my pregnancy at our local clinic where I was tested for HIV. They said the test was done to protect my child if I had HIV. I was also told to use condoms should I have sex,” she discloses.
Her pregnancy makes her sad.

Her mother and Thomas never visit her at the mother’s waiting shelter.
Thomas cannot afford the bus fare, while her mother has to look after her grandmother who is ill.

“Both visited me while I was admitted at Ndolani rural hospital, 14 km from home. This hospital is too far and Thomas cannot travel here. At least he bought a few baby clothes. My mother bought the rest,” she says.

The economic situation is worse as she rarely has adequate food.
At the mother’s waiting shelter, the hospital can only affords to provide maize meal and beans for the pregnant mothers in the shelter.
Women cook using firewood under a small shed. Each mother also receives a blanket and is allowed to bring extras from home.
“I only have the hospital blanket. The nights are so cold. I miss home,” she says.

The pregnant women in the mother’s waiting shelters also source their own breakfast.
Chipo has nothing and other pregnant mothers who sympathise with her help.
She regrets falling pregnant.

“When news of my pregnancy broke, some villagers asked me why I chose Thomas. They even went to his mother and told her not to accept me as a daughter-in-law. That is why I still stay with my parents,” she adds.
Chipo hopes to find a job in Bulawayo so that she can give her child the education she never received.

Another pregnant teen, Pamela (not real name) also at the mothers waiting shelter, said her husband is an injiva (Zimbabwean who earns a living transporting a variety of goods from South Africa to Zimbabwe) based in South Africa.
He takes good care of her, providing R1 500 every month. However, she is HIV-positive.

Pamela has vast knowledge of prevention of mother to child transmission and is confident her baby will be HIV-negative. This is her first pregnancy and she prays for a normal delivery since she has been battling with high blood pressure.
She will also be initiated on Option B+ when she gives birth.

“I will take ARVs for life. This will protect my baby and me,” she says.
She hopes to join her husband in South Africa when she delivers.
She also prays that Chipo, the youngest of them all, will have a safe delivery.

Mangwe district labour ward nurse sister Nqobile Ngwenya confirmed that 50 percent of women who deliver at their hospital are teenage mothers referred from clinics in Bulilima and Mangwe districts.

She said the mother’s waiting shelters were playing an important role to ensure these mothers are close to well equipped health facilities.
If anything, most deliveries have been successful with only a few cases being referred to Bulawayo.

However, she said, such young mothers experience complications that include difficulties in delivering, prolonged labour, difficulties in pushing, giving birth to babies that fail to adapt to new environment and post-partum haemorrhaging.

“During periods like September, the mothers waiting shelter usually has more than it can handle.
“More women who would have conceived in December (when their Botswana and South Africa based husbands return for Christmas) usually fill up the rooms,” she said.

Next door, Bulilima District has a similar challenge of underage pregnancies and is one of the health centres that refer teen mothers to Plumtree.
They also have another headache, that of high HIV prevalence within this group.

Bililima District Medical Officer Dr Norbert Singine said there was a 15 percent HIV prevalence rate in that district and migration was behind the increase.

“The prevalence is alarming because of the injivas. They come and sweet-talk these young girls who cannot negotiate for safe sex,” he complained.
About 172 km from Plumtree is Gungwe Village in Gwanda.

Here another teen mother, 15-year old Mollyn (not real name) had a safe delivery a month ago.
A Form 2 school dropout because of the pregnancy, Mollyn still stays with her mother. The father of her child, a 20-year old local man, now works in Gwanda.

Just like Chipo, she carried the pregnancy to term because her boyfriend said he wanted her to give him children. She also benefited from the mother’s waiting shelters at Gungwe clinic.

The state of the art four-bedroomed shelters were funded through the World Bank’s Result Based Financing.
The clinic also received cement from Lutheran Development Services.
The community also played its part by moulding bricks and building the mothers waiting shelter.

Today, Mollyn is a happy mother and had come for her baby’s routine weighing. Her parents want her to go back to school and rebuild her life.
“He visited the baby for the first time yesterday and bought her diapers and clothes. But, this time I will use condoms if he wants intimacy,” she says.

Nurse in charge at Gungwe Clinic, Zanele Ncube, said they had been receiving several cases of teenage pregnancies, especially in March.
“When injivas come in December we have an increase in women and teens booking three months later. We usually have an average of 12 bookings but in March the figure goes up to between 17 and 18,” she explained.

Long distances most girls in the area walk to school, she explained, could be the reason why they fall pregnant as boys easily lure them.
“Some of the boys and men will buy them snacks (jiggies) and sweets and this attracts most girls. The boys know what time the girls finish school and meet them half way, spoil them with the goodies,” she added.

She said they had been visiting schools to speak to the students on the dangers of early pregnancies and unprotected sex.
Before she fell pregnant, Chipo was among at least 200 million women and girls worldwide who are unable to access family planning services that would allow them to control when they can have children.

As the district grapples with the challenge of teen pregnancies, over 800 people who gathered in Johannesburg recently for the Partnership for Maternal, Newborn and Child Health Forum, heard that 289 000 women still
die every year from complications at birth.

Then, 6,6 million children do not live to see their fifth birthday, including nearly 3 million newborns.
Recent data published in the Lancet Every Newborn series released at the Johannesburg conference says globally, 15 000 babies are born and die every day without ever receiving a birth or death certificate.

The accompanying analysis found that 3 million maternal and newborn deaths and stillbirths in 75 high burden countries, Zimbabwe included, could be prevented each year with proven interventions that can be implemented for an annual cost of $1,15 per person.

The Every Newborn Action Plan, which was approved by ministers of health worldwide at the May 2014 World Health Assembly, also brings together the latest evidence on effective interventions for a clear roadmap to end preventable stillbirths and newborn deaths.

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