Zimbabwe has witnessed an increase in maternal and newborn deaths with an estimated 2,400 maternal deaths in 2015 and 17,000 babies dying within the first 28 days of life in 2013; a significant percentage of these deaths were due to infection.
Zimbabwe’s political uncertainty has crippled its economy leaving it in a state of deterioration since 1990. In 2011, 72% of the population of almost 14 million were living below the poverty line. This has contributed towards Zimbabwe’s high maternal and newborn death rates. According to some surveys the maternal mortality ratio has increased in Zimbabwe while other surveys state that it has been in decline. Despite the dispute over figures, it remains that maternal mortality continues to be a major challenge for the country.
In mid-2012, with the support of ZimHealth, the Rimuka Maternity Home in Kadoma applied to Soapbox for funds to support a programme to improve infection prevention and control (IPC) and safe delivery. The programme involved training and the provision of equipment to the Maternity Home including an autoclave (used to sterilise equipment), a baby resuscitaire, and instrument trolleys. Alongside the support from Soapbox, the Kadoma City Council simultaneously funded renovation work in the facility including the upgrading of floors, installing a borehole, replacing a water tank, building of a brick incinerator and the development of plans to renovate the laboratory and construct a new waste disposal unit.
Following the success at Rimuka, in 2014, Kwekwe’s four council clinics, which along with Kwekwe General Hospital serve a population of 104,000, applied to Soapbox with the support of ZimHealth, for funds and technical support to improve their infection prevention and control (IPC) activities.
Through Rimuka Maternity Home, infection control training was delivered to ninety one healthcare workers from the district including midwives, nurses, doctors, environmental health technicians, ambulance drivers and nurse aides. A detailed evaluation of the effectiveness of training and the value and impact of the equipment funded by Soapbox was carried out. The evaluation concluded that the overall objectives of the training were met and, in combination with the facility upgrades and equipment, there was a positive impact on hygiene behaviours and the environment. All mothers interviewed reported satisfaction with their care and the improved sanitary conditions of the labour wards.
“Before training we lacked the confidence to perform hygiene practices in the work place.”
IPC Training Course Participant
January 2016 saw the completion of our project with Kwekwe’s four council clinics where teams made an outstanding commitment to improving their IPC. This has been aided by a multi-disciplinary IPC Committee established in the early stages of the project, which has been able to support the ongoing policy development, audit and training initiatives. With Soapbox’s support, an observational hand hygiene audit tool and hand hygiene training workshops for skilled and non-skilled workers have been developed. Ninety members of staff have now been trained using a “training the trainer” approach, and plans have been made to embed both the hand hygiene audit and regular training in to routine practice. The hands-on, participatory-based training was well received by all staff with the significant majority of both skilled and non-skilled workers strongly agreeing that they had gained knowledge and/or skills as a result of the training.
Phyllis Gochera, Director of Health Services, who led the project in Zimbabwe reported, ‘I really learnt a lot and it was a pleasure making a difference in Kwekwe City clinics. I hope the standards will be maintained‘.
- Kadoma City Council
- Kwekwe City Health
- Amaveni Clinic
- Mbizo Clinic
- Mbizo 11 Clinic
- Al Davies Clinic